In addition to establishing the objective of preventing placements, the Adoption Assistance and Child Welfare Act of 1980 called for the reunification of children in foster care with their biological parents whenever possible, within the larger context of efforts to achieve permanent and safe living conditions for children. Yet, the issue of family reunification continues to be overshadowed by burgeoning attention to efforts to prevent placements. While most states have developed programs aimed at preserving intact families, there are relatively fewer programs designed to reunify families (Ahart, Bruer, Rutsch, Schmidt, and Zaro 1992). Furthermore, Barth and Berry (1987) suggest that children who are reunified with their parents are the group that is least well-served; they called attention to the need for more and longer-lasting services for these children and their families to prevent reabuse and foster care reentry. Here we review what is known about the outcomes of intensive services designed to facilitate the reunification of families with children in foster care.38
In assessing the impact of programs aimed at family reunification, we are interested in program effects on the rates at which children are returned home. Since reunification occurs during the normal course of child welfare services (most children in foster care are returned to their homes within a two year period),39 we need to know whether intensive services actually improve the chances of family reunification and shorten the time to reunification. As in the case of placement prevention programs, the best way to determine this is through randomized experiments, in which cases eligible for reunification services are assigned randomly to treatment and control groups.
The achievement of reunification is only one of the goals of these programs. As indicated above, an overarching objective is to find safe and permanent living situations for children.40 Yet children who are reunified with their families are at greater risk of subsequent maltreatment than children in out-of-home placements (Barth and Berry 1987). Regarding permanence, there is some indication that reentry rates may increase as a result of efforts to speed reunification (Wulczyn 1991).41 Thus, intensive family reunification programs try to resolve the conditions that led to placement and improve the chances that children will remain in their homes without further maltreatment. To gauge the success of these efforts, we need information about what happens after children are returned to their homes and whether their families provide stable and safe living conditions for them. Relevant outcomes include rates of subsequent maltreatment among children who are returned to their families, other indicators of child and family functioning after reunification, and the rates at which children reenter foster care or move into other types of living arrangements.
Since there have been few intensive reunification efforts, evaluations of the outcomes of these programs are scant. Most of the studies that do exist are based on small samples, most have used non-experimental designs or non-equivalent comparison groups, and few have obtained information on outcomes other than reunification rates.
For example, Boyd (1979) found that children in the Temporary Foster Care program in Michigan spent less time in foster care and were more likely to be returned home than children who were in foster care prior to the implementation of the program. Lahti (1982) reported results of an evaluation of the three-year Oregon Permanency Planning Project. Children in this project received intensive services aimed at removing barriers to reunification. Three years and four months after the project began, the placement status of 259 children served was compared with that of 253 children who had received regular child welfare services. There were no significant differences between groups in the proportion of children that were reunified with their families (26% of the children in the project and 24% of those in the comparison group had been returned to their parents).42 At a 15-month follow-up period, there were no significant differences between groups in the stability of placements.
More recent studies include a Homebuilders pilot project which reported that 13 of 14 "hard to serve" adolescents were quickly reunified with relatives (the average time between intake and reunification was 8 days) and 12 of the 14 adolescents were not in out-of-home care at a one-year follow-up (Haapala, Johnston, and McDade (1990). Similarly, Brown and Little (1990) reported that all 50 families involved in a study of the Full Circle program in California had been reunified after three months, 80% remained intact after six months, and 74% after one year. However, Lerner (1990, cited in Maluccio, Fein, and Davis 1994) reported a reunification rate of only 25% in a privately- funded program in a public housing project in Brooklyn, New York. Walter McDonald and Associates (1992) found that 57% (20) of 35 children served in a Milford, Connecticut reunification program were returned to their homes at the end of services.
Fein and Staff (1993) reported that 38 percent (26) of 68 children served in the first two years of the Casey Family Services reunification program43 were reunited with their families. Of those reunited, 19 children were still at home at the end of the second year (13 were still receiving program services) and 7 (10%) had been returned to foster care.
In a recent report on the results of the family reunification initiative in Illinois, Schuerman, Rzepnicki, and Johnson (1994) reported that 40% of the children in placement at the time of referral to the project had been reunified with their families within 6 months after referral, 48% were reunited within 9 months, and 53% within one year.44 Reunification rates varied widely across the agencies that participated in this project.45 Comparisons were made to other children who entered foster care during the time period of the study and met other criteria for referral to the program.46 Children in families in the intensive reunification program had shorter stays in placement than those in the comparison group. Differences were greatest in Chicago, where reunification rates for the comparison group were relatively lower. The program did not appear to affect the likelihood of foster care reentry. Approximately 12% of the children who had been reunited with their families returned to out-of-home care within six months, at 12 months the figure was around 20%, at 18 months 24%. These rates were similar to those in the general population of children who return home from foster care.
In sum, reunification rates have varied from 25 percent to 100 percent across several studies of programs aimed at reunifying families. There is some evidence that families in intensive reunification programs are reunified more quickly than other families with children in foster care, but as with evaluations of placement prevention programs, the results of non- experimental studies of intensive reunification efforts are difficult to interpret in the absence of clear evidence about what the rates of reunification and foster care reentry would have been in the absence of these services. Since there are considerable variations in the reunification and reentry rates for different subgroups of children, across geographic locations, and over time (Maluccio, Fein, and Davis 1994), comparisons between program participants and other foster care cases do not provide convincing evidence of program effects. Cases referred for intensive reunification services may be those which workers believe are good candidates for reunification; thus, in the absence of intensive services, the likelihood of reunification may be greater in program populations than in the larger population of families with children in foster care. Controlled studies are needed to provide information on the effects of a program on reunification and reentry rates.
38 Studies of efforts to reunify families with children in residential treatment are provided by Carlo (1985, 1993) and others.
39 See Wulczyn, Goerge, and Harden 1993.
40 Ahart et al. (1992) observed that most family reunification programs have very broad definitions of successful outcomes. They report that most of these programs focus on permanency planning and few view family reunification as an appropriate goal for all clients.
41 Foster care recidivism generally occurs within three years for approximately 30% of the children who are returned to their homes (Wulczyn and Goerge 1992).
42 Forty percent of children in the program and 21% of those in a comparison group were adopted at the end of the project--a statistically significant difference. However, to be eligible for the project, children had to be considered (by their caseworkers) adoptable and unlikely to return home, while this criteria was not applied in the selection of comparison cases.
43 This 3-year demonstration program was instituted in Hartford, Connecticut, Portland, Maine, and White River Junction, Vermont in 1989.
44 Within six months of referral, partial reunification (that is, the return home of at least one child in placement) had occurred in 45% of the families served; within nine months, 54% of the families had been reunited with at least one of their children; within one year, the figure was 59%.
45 Across 23 agencies, nine-month reunification rates ranged from 8% to 73% of the children in placement at the time of referral. Reunification rates in the Chicago area were generally lower than in other parts of the state.
46 Like cases in the reunification program, children in the comparison group were under 12 years of age and had been the subject of fewer than four substantiated investigations of child maltreatment. To increase comparability with cases in the reunification program, the comparison group was limited to children who had been in non-relative foster homes for at least 7 days.