Connecticut Family Stability Project

The Problem

Child abuse and neglect is harmful to children and families and costly to the state. Child maltreatment costs more than $210,000 per incident over the course of a child’s life, and child abuse and neglect costs the Connecticut Department of Children and Families (DCF) more than $600 million per year. In 2013, more than half of the families involved with DCF struggled with substance abuse. 

The Basics

Location: Connecticut

Policy area: Family stability and substance abuse

Population served: 500 families across Connecticut that struggle with a substance use disorder, are working with DCF, and have children up to the age of 6-years-old

Service provider: Yale Child Study Center

Size of investment: $11.2 million

Intermediary: Social Finance

Other partners: Harvard Kennedy School Government Performance Lab (technical assistance), Jones Day (legal support)

Evaluator: University of Connecticut Health Center

Evaluation methodology: Randomized control trial

Outcome payor: Connecticut Department of Children and Families

Outcomes that yield payments: (1) Prevented out-of-home placements, (2) prevented re-referrals to DCF, (3) reduction in substance abuse, (4) successful FBR enrollment

Timeframe: 4 year service delivery term

Date announced: February 2016

Photo via Shutterstock.

The Intervention

Intervention: Family-Based Recovery (FBR) provides in-home attachment-based parent-child therapy and contingency management substance abuse treatment. The mission of FBR is to ensure that children who have one or more parents struggling with substance abuse develop optimally in drug-free, safe, and stable homes with their parent(s). Services are provided by a team of two clinicians and a family support specialist. The team provides individual, couples and family therapy; promotes positive parent-child interaction for secure attachment; works to increase a parent’s awareness and understanding of child development; provides case management services and conducts weekly relapse prevention and parenting group. 

Evidence base behind the intervention: From its start in 2007 through June 2014, FBR administered assessments designed to measure program outcomes to the 806 families it served. The Connecticut Department of Children and Families referred families to the program because of risk of child maltreatment due to parental substance abuse. All 806 families had a mother or father who abused substances in the 30 days prior to referral, and had a child under 3 years of age. At intake, 90-day intervals, and discharge, the parent-child clinician completes three assessments designed to measure program outcomes. Scores from these assessments are used to determine if there has been a significant change during the course of treatment. Analysis of pre-post paired scores on these clinical measures provides preliminary evidence that caregivers in FBR treatment experience reductions in depression and parental stress and enhanced parental bonding with their children. Toxicology reports suggest decreasing levels of substance use over the course of FBR treatment. This model has not yet undergone a rigorous experimental evaluation, although non-experimental evidence suggests positive outcomes for the families served. The Connecticut Family Stability Project uses different inclusion criteria than described above: Families served by FBR through this PFS project may have children up to 6 years of age.