Comprehensive services for mothers of drug-exposed infants: relations between program participation and subsequent child protective services reports

It is unclear whether intensive services for women using drugs during pregnancy can reduce child maltreatment. Within-subjects, dose-response analyses can be conducted using Child Protective Services (CPS) reports. Dose of services received can indicate either engagement or higher need for services. Using data from an intensive intervention program for mothers of drug-exposed infants, the authors examined associations between CPS reports and (a) dose of services received and (b) a termination status variable combining dose of services received with duration of service involvement and progress on treatment plan goals. Cox regression revealed no association between dose of services and follow-up CPS reports. The termination status variable was strongly related to follow-up CPS reports, such that higher ratings were associated with significantly lower risk of re-report, even after controlling for baseline motivation. Findings suggest that program effects may be detectable using a treatment process-- based index that combines dose, duration, and quality of program involvement.