Blending Perspectives and Building Common Ground. Defining Outcomes and Success


Substance abuse and child welfare agencies have different views of what represents a successful outcome and what they seek to achieve.  Most substance abuse treatment outcome studies focus on the extent to which treatment results in decreased alcohol and drug use, decreased criminal behavior, and decreased need for and utilization of health care services.  Very few measure child- and family-related outcomes unless they are programs specifically designed for women and their children, of which there are few.  By these definitions, treatment may be successful even when child safety issues remain and may be unsuccessful even if child welfare goals have been met.  Similarly, for a child welfare agency, the child's safety, well-being and ensuring he or she has a permanent family situation in which to grow up are the primary goals.  These may be met either within the family of origin or by identifying a substitute.  But success may be achieved at a cost of separating a child permanently from his or her biological parents.  Further complicating the situation, custody decisions are made by family court judges who may hold yet another set of expectations for clients and may seek additional evidence of success.

As staff begin to work together more closely, child welfare and substance abuse agencies should talk through these issues, both institutionally and also on a case-by-case basis, seeking common ground regarding their definition of the client, mutual expectations for the client and for each other as the case develops.  Establishing joint case goals for clients may also prove helpful, particularly identifying interim goals that will allow both agencies to determine, together, the extent to which progress is being made.  Such discussion on joint goals may lead to broader interagency agreements on working together.  Involving judges in setting expectations may also help assure key players are all in agreement.