ArticleBMC health services research2026
Cross-system collaboration between the child welfare system and substance use treatment providers: a qualitative analysis of strategies, facilitators, and barriers.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundParental substance use in the child welfare system (CWS) is common, and collaboration between CWS and substance use treatment agencies is critical for parents' success. Research on the challenges to cross-system collaboration exists, but much of the published literature is dated despite recent efforts to improve cross-system collaboration. The current manuscript seeks to understand collaborative strategies used between child welfare and substance use treatment providers and their perceived effectiveness, identify facilitators and barriers to collaboration, and understand the impact of collaboration on child welfare system case and parent outcomes.
methodsQualitative data analysis was conducted on semi-structured interviews, completed September 2023 - June 2024, with n = 31 CWS personnel (90.3% female; 96.8% White, Non-Hispanic) and n = 28 substance use service providers (96.4% female; 76% White) across Indiana.
resultsCollaborative strategies targeted facilitation of service referral and initial service connection between systems and ongoing care coordination. Beyond formal strategies, frontline personnel described informal efforts to improve collaboration. Facilitators to collaboration included positive attitudes towards collaboration and teamwork, such as understanding the importance of teamwork and respect for others' roles and responsibilities. Barriers to collaboration included workforce turnover and large caseloads, competing perspectives on how to address substance use (SU), and competing expectations (i.e., CWS focus on child safety versus SU provider focus on parent).
conclusionFindings highlight the need for continued efforts to support collaboration between CWS and SU service agencies through organizational and broader policy and reiterate the benefits of collaboration on effectively supporting parents and families.
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