Blending Perspectives and Building Common Ground. Improving Our Ability to Engage and Retain Clients in Care and to Support Ongoing Recovery


Assuring adequate treatment capacity is not sufficient to produce significant changes in families' behavior unless clients engage in the recovery process and stick with programs long enough for learning to occur and behavior to change.  Too often, clients fall through gaps between agencies before intervention begins, as relapses occur, and after treatment programs end.  A clear lesson shown by research is that engagement and retention is an extremely difficult process with this client population.  It is precisely during these transition periods that contact with clients is likely to be lost, and with it the opportunity for constructive intervention.

In order to assist service providers to implement effective engagement and retention strategies, ACF and SAMHSA, with other agency partners, will:

  • Expand our research in this area to build knowledge and develop effective program strategies.
  • Utilize our technical assistance mechanisms to assure materials on effective approaches are available to the field.  In ACF this will include updating materials on substance abuse and child welfare that are available through its clearinghouse and resource centers.  In addition, materials will be developed for the field regarding assessing progress in treatment and on decision making for families of children in foster care.  SAMHSA/CSAT is also exploring the development of a technical assistance publication or publications for use by child protective services agencies that will answer questions about substance abuse treatment services.
  • The Children's Bureau within ACF will make particular efforts to work with the Court Improvement Projects (State grantees working to improve courts' capacity to deal with dependency proceedings) to share information on effective programs, assessing treatment progress, and on the application of drug court methods to juvenile and family courts.
  • SAMHSA/CSAT will continue to focus on increasing opportunities for family reunification and improved child safety though the Family Drug Court Program.  Since 1997, SAMHSA/CSAT has funded this pilot program to evaluate the use of family drug courts as a strategy for reducing the cost and trauma that result from foster care in neglect and abuse cases.

We encourage child welfare and substance abuse treatment providers at the local level to design programs with a recognition that the recovery from addiction is an ongoing process that is characterized by the risk of relapse and that clients are prone to dropping out of treatment.  To mediate against the likelihood of these events and to respond to them, services need to be structured in ways that promote retention and provide relapse prevention and supportive services.