One-Year Outcomes from the Casaworks for Families Intervention for Substance-Abusing Women on Welfare

Abstract

Aim: To evaluate the effectiveness of a multiservice intervention designed to move substanceabusing women on welfare to sobriety and self-sufficiency by addressing their substance abuse, domestic violence, employment, and basic needs. Design: A field evaluation with repeated measures at 6 and 12 months on an intent-to-treat sample of 529 women conducted in 11 selected sites across the country. There were significant improvements shown in substance use and family and social functioning by the 6-month point, and additional improvements in employment by the 12-month point. By 12 months, more than 46% were abstinent from alcohol and other drugs, and 30% were employed at least part-time. There were only modest improvements shown in the medical and psychiatric status of these women. These preliminary findings suggest that site-level interagency coordination and program-level case management were associated with improvements in the targeted areas as predicted by the model. Future work will require a more closely specified, manual-guided form of the intervention plus the inclusion of control groups and cost measures to fully evaluate the cost benefits from the final form of the intervention.

Get full access to this article

View all access options for this article.

References

Campbell, D. T., and J. C. Stanley. 1965. Experimental and quasi-experimental designs for research. Chicago: Rand McNally.

Etheridge, R. M., S. G. Craddock, G. H. Dunteman, and R. L. Hubbard. 1995. Treatment services in two national studies of community-based drug abuse treatment programs. Journal of Substance Abuse Treatment 7:9-26.

Fiorentine, R., and M. D. Anglin. 1997. Does increasing the opportunity for counseling increase the effectiveness of outpatient drug treatment? American Journal of Drug and Alcohol Abuse 23 (3): 369-382.

Gerstein, D., and H. Harwood, eds. 1990. Treating drug problems. Vol. 1. Washington, DC: National Academy Press.

Hosmer, D.W., and S. Lemeshow. 2000. Applied logistic regression. 4th ed. NewYork: Wiley and Sons Publishing.

Institute of Medicine. 1996. Managing managed care: Quality improvement in behavioral health, edited by M. Edmunds, R. Frank, M. Hogan, D. McCarty, R. Robinson-Beale, and C. Weisner. Washington, DC: National Academy Press.

McLellan, A. T., I. O. Arndt, G. E. Woody, and D. Metzger. 1993. Psychosocial services in substance abuse treatment? Adose-ranging study of psychosocial services. Journal of the American Medical Association 269 (15): 1953-1959.

McLellan, A. T., J. Cacciola, H. Kushner, F. Peters, I. Smith, and H. Pettinati. 1992. The fifth edition of the Addiction Severity Index: Cautions, additions and normative data. Journal of Substance Abuse Treatment 9(1): 142-154.

McLellan, A. T., G. Grissom, and P. Brill. 1997. Improved outcomes from treatment service “matching” in substance abuse patients: A controlled study. Archives of General Psychiatry% 54:730-735.

10.

McLellan, A. T., T. A. Hagan, K. Meyers, M. Levine, F. Gould, M. Bencivengo, and J. Durell. 1998. Improved outcomes following service enhancements in public substance abuse treatment programs. Addiction 104:167-172.

11.

McLellan, A. T., T. A. Hagan, K. Meyers, M. Randall, and J. Durell. 1997. “Intensive” outpatient substance abuse treatment: Comparisons with “traditional” outpatient treatment. Journal of Addictive Diseases 16 (2): 57-85.

12.

McLellan, A. T., M. Levine, T.A. Hagan, K. Meyers, M. Randall, F. Gould, M. Bencivengo, and J. Durell. 1999. Does clinical case management improve outpatient addiction treatment? Drug and Alcohol Dependence 55:91-103.

13.

McLellan, A. T., L. Luborsky, J. Cacciola, and J. Griffith. 1985. New data from the Addiction Severity Index: Reliability and validity in three centers. Journal of Nervous and Mental Disease 36(2): 111-116.

14.

McLellan, A. T., L. Luborsky, C. P. O’Brien, and G. E. Woody. 1980. An improved diagnostic instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Disease 168:26-33.

15.

McLellan, A. T., and C. Weisner. 1996. Achieving the public health potential of substance abuse treatment: Implications for patient referral, treatment “matching” and outcome evaluation. In Drug policy and human nature, edited by W. Bickel and R. DeGrandpre. Philadelphia: Wilkins and Wilkins.

16.

Morgenstern, J., A. Riordan, D. Dephilippis, T. W. Irwin, K. A. Blanchard, B. S. McCrady, and K. H. McVeigh. 2001. Specialized screening approaches can substantially increase the identification of substance abuse problems among welfare recipients. Research Notes(January): 1-7.

17.

Simpson, D. D. 1997. Effectiveness of drug abuse treatment: Review of research from field settings. In Treating drug abusers effectively, edited by J. A. Egertson, D. M. Fox, and A. I. Leshner. Cambridge, MA: Blackwell.

18.

Watkins, K., and K. B. Wells. 1999. Drugs, disability and mental health: The impact of mental illness on maintaining social security benefits in Los Angeles County. American Journal of Public Health 132:1556-1558.

19.

Woolis, D. D. 1998. Family works: Substance abuse treatment and welfare reform. Public Welfare 12 (winter): 24-32.