Enhancing Permanency in Children and Families (EPIC)

A multi-agency program in Ohio addresses parents' substance use disorder (SUD) and provides family support services to those with children in the foster care system

Substance misuse by parents, including opioid use disorder (OUD), is a risk factor for child neglect and downstream psychological and cognitive problems, with children sometimes placed in foster care. In the wake of increasing incidence of parental OUD in Fairfield and Pickaway counties, the Ohio State University College of Social Work, in collaboration with Job and Family Services, initiated the Enhancing Permanency in Children and Families (EPIC) program. EPIC uses a three-pronged approach to establish a coordinated system of care across multiple agencies and disciplines, including the Ohio Family Treatment Drug Court, peer recovery services, and parenting support based on the Nurturing Parent Program. The treatment court facilitates communication between substance abuse treatment providers and child welfare caseworkers, who, together with peer recovery coaches, make weekly visits to participating families. In addition, workers trained on the Nurturing Parent Program provide home-based support to caregivers for children placed with relatives, helping to establish healthy, non-punitive adult-child relationships. Parents with OUD are incentivized to work with the treatment court and start a course of medication for opioid use disorder (MOUD), while recovery coaches help to maintain retention in treatment and provide case management to connect participants with appropriate services.

The three key elements of EPIC - treatment court, peer recovery support, and guidance in parenting - have been shown increase the probability of parent-child reunification, helping to reduce caseloads in the child welfare system. A detailed description of the EPIC program rationale, implementation, and forthcoming evaluation is available here

A multi-agency approach to bring treatment and recovery services to parents struggling with opioid use disorder helps to minimize developmental risks to children and keep families intact. 

Continuum of Care
Treatment
Recovery
Type of Evidence
Implemented
Response Approach
Comprehensive services
Family Support
Medications for Opioid Use Disorder
Recovery coaching
Peer-reviewed Article

Evidence of Program Effectiveness

"Family Treatment Drug Court (FTDC) is considered the most effective intervention to improve substance abuse treatment initiation and completion in child welfare populations. Parents who participate in FTDC are more likely to enter substance use treatment, get into treatment quicker, stay in treatment longer, and complete treatment more often. Additionally, families who complete FTDC are more likely to be reunified with their children as compared to parents who do not participate....Peer recovery supporters have had great success in reducing substance use and improving child welfare outcomes. Peer recovery supporters improve access to substance use treatment, decrease time children spend in out-of-home care, increase the odds of reunification, decrease maltreatment recidivism, and reduce racial disparities in reunification."  B. Freisthler et al., 2021.