Background and Purpose: Parental substance abuse is a prominent theme in child welfare. Substance abuse treatment models include psychosocial, pharmacological, and legal interventions (Eggins, 2016). However, whereas the focus on child outcomes (e.g., re-unification) is clearly the long-term, or ultimate, goal, treatment engagement, attendance, retention and completion are important intermediate goals of the treatment system (Marsh, 2012). The purpose of this scoping review addresses the research question: “What is known about interventions that have assessed intermediate and ultimate goals for substance-abusing parents involved with child welfare? Specifically, our aims included ascertaining how many studies linked the intermediate outcomes to the ultimate outcomes. Methods: We used Arksey, and O’Malley’s (2005) five-stage scoping review framework to identify, select, chart, collate, and report on relevant studies. Databases searched included Social Work Abstracts, Scopus, CINAHL, ERIC, Web of Science, PsychArticles, and PsychInfo, as well as reference lists in related review articles. We also searched the websites of existing networks and relevant organizations. Inclusion criteria of literature: peer-reviewed; no date or study design restrictions; used “child welfare” and “substance abuse” as search terms; and reported on intermediate and ultimate goals. At each stage of the search each author read the abstract and the full article, as needed, to decide on articles to be included. Results: The search resulted in 26 peer-reviewed studies that met criteria, 21 published within the past 15 years. Studies were categorized using Eggins (2016) framework of treatment categories: Home-Visiting (n = 1); Family Treatment Drug Courts (FTDC) (6); Multidimensional Interventions (9); and Family, Parent or Child Focused Interventions (10). Study samples ranged from 15 to 1562 clients. Just over 45% of studies involved experimental (31%) or quasi-experimental (15%) designs. Certain categories or specialized interventions within categories increase engagement over traditional child welfare services. These include family drug courts, recovery coaches, service matching, and intensive case management. These interventions also resulted in improved ultimate outcomes. However, only six of the studies included ultimate outcomes and only two of those studies directly examined the link between the intermediate and ultimate outcomes. Further, although these interventions were statistically effective, some studies also reported overall low rates of both service utilization and reunification. Themes in non-experimental studies included the importance of therapists’ attitudes, child welfare involvement as an important motivator for engagement, and ongoing challenges of treatment access and structural barriers. Conclusions and Implications: The limited literature from this scoping study suggests various intervention models are successful in substance abuse treatment engagement, retention, and subsequent re-unification for families involved in child welfare. A next step is to further examine the linkage between the intermediate outcomes of engagement and treatment attendance and ultimate outcomes. Further, these should be mixed method studies that capture the salient components of the interventions that lead to increased intermediate outcomes and well as ultimate outcomes. Identification of the most useful interventions and mechanisms within the interventions are critical for informing best practices for the growing parental substance abuse problem within child welfare.

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Sedan införandet av nya socialtjänstlagen 1982 har socialtjänsten gått mot en alltmer tydlig specialisering. Specialiseringen gör samverkan mellan olika enheter nödvändig och det är också något som Socialstyrelsens riktlinjer förordar. Syftet med denna kvalitativa studie är att undersöka socialsekreterares upplevelse av intern samverkan kring missbrukande föräldrar. Ett mål med studien är att synliggöra vilka främjande och hindrande faktorer socialsekreterarna ser i samverkansarbetet. Studiens material baseras på sju semistrukturerade intervjuer och är bearbetat med tematisk analys. I analysen av materialet används samverkans- och systemteori för att förstå, förklara samt organisera resultaten. De främjande faktorerna som socialsekreterarna upplever är att det finns en god kommunikation, att man har förmöten innan klientmöten, att det finns bra rutiner och stöd från ledning samt att man har goda relationer till sina kollegor. Hindren i samverkan utgörs främst av bristande förståelse för varandras arbetssätt, resursbrist samt stress och hög ärendebelastning. Resultaten visar att hindrande och främjande faktorer finns på olika nivåer ur ett systemteoretiskt perspektiv. På makronivå påverkas samverkansarbetet av lagar samt politiska- och ekonomiska beslut. Faktorer som påverkar samverkan på mesonivå utgörs av de organisatoriska förutsättningarna och innefattar exempelvis policys, stöd från ledning och resurser. På mikronivå påverkas arbetet av de interpersonella relationerna, kommunikationen samt roller och synsätt. / Since the introduction of the new Social Services Act in 1982, social services have moved towards an increasingly clear specialization. Specialization makes cooperation between different units necessary, and this is also something that the National Board of Health and Welfare's guidelines prescribe. The purpose of this qualitative study is to investigate social workers' experience of internal collaboration around abusing parents. One goal of the study is to make visible which promoting and hindering factors the social workers see in collaborative work. The study's material is based on seven semi-structured interviews and is processed with thematic analysis. In the analysis of the material, cooperation- and systems theory is used to organize, explain and understand the results. The promoting factors that the social workers experience is good communication, that you have pre-meetings before client meetings, that there are good routines and support from management and that you have good relationships with your colleagues. The obstacles in collaboration mainly consist of a lack of understanding of each other's working methods, a lack of resources as well as stress and a high caseload. The result shows that hindering and promoting factors exist at different levels from a perspective of systems theory. At the macro level, collaborative work is affected by laws as well as political and economic decisions. Factors that affect collaboration at the meso level are made up of the organizational conditions and include, for example, policies, support from management and resources. On a micro level, work is affected by interpersonal relationships, communication, roles and approaches.