Addressing Substance Use Disorders Among Families Involved with the Child Welfare System: A Cross-Agency Collaboration

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Community Burden Study

Stakeholder Focus Group Guide

Introduction

1. To start, please tell me what type of agency or organization you work for and how long you’ve worked at this organization?

Priority Substance Use Issues

Now, I’d like to talk briefly about the kinds of substance use issues your county is encountering.

2. From your perspective, how severe of a problem is the opioid epidemic in your county?

   1. [If not a priority issue] What would you say are the priority substance use issues in your county?

Probe cocaine, crack, meth, amphetamine, hashish use, etc.

Children’s Exposure to ACEs

1. ACEs List

• Physical abuse or neglect

• Emotional abuse or neglect

• Sexual abuse

• Substance misuse within the household

• Household mental illness

• Intimate partner violence

• Mother treated violently

• Parental separation or divorce

• Incarcerated household member

Next, I’d like to talk about how [the opioid epidemic, drug use] is affecting families in your county, including whether children are being exposed to violence or adverse childhood experiences as a result of a parent’s opioid/drug use. [Show ACEs list] Adverse childhood experiences, or ACEs, are stressful or traumatic events, including abuse and neglect. As shown on this card, ACEs also may include household challenges, such as witnessing domestic violence or growing up with family members who have substance use disorders.

3. In your experience working with families, how has [the opioid epidemic, drug use] affected families and children in your county?

Probe family separations, children’s exposure to violence and ACEs, issues at school, etc.

Available Programs and Services

I’d like to turn now to talk about the programs and services in your county that are available to help families affected by [the opioid epidemic, drug use]. These may be provided by your agency or other agencies or organizations within the county. We’ll focus on substance use services first, and then talk about other programs and services.

4. What substance use programs or services are available to families in your county?

Probe substance use treatment providers, detox facilities, community-based programs, medication assisted treatment (MAT), needle exchange programs, support groups, etc.

5. What other programs or services are available to families affected by opioid/substance use in your county?

Probe parenting classes, respite care, support groups, family or children’s programs, etc.

6. Please describe any barriers or challenges for families to access these programs and/or services

Probe for low awareness of programs, lack of interest, lack of time (families work) stigma in accessing programs, etc.

7. What would make it easier for families to access these program?

8. What gaps in programs or services for families affected by [the opioid epidemic, drug use] do you think exist within your county?

9. How can these gaps be addressed?

Most Promising Programs and Services

We’ve discussed the various types of substance use and other programs and services available to the families your agency/organization supports. Please take a moment to think about how successful these programs and services have been.

10. From your perspective, which of these programs and services are working well and why?

    1. Which programs are not working as well and why?

11. In your opinion, what else is needed within your county to address the [the opioid epidemic, drug use] and prevent children’s exposure to violence and ACEs?

Before we finish, I have a few more questions about the impact of state and local policies on efforts to address [the opioid epidemic, drug use].

12. Can you talk about how state and local policies affect the availability of services for families affected by [the opioid epidemic, drug use] in your county? [for instance, policies regarding treatment, reunification, etc.]

Probe: Are there certain policies that work against each other? For example, the need for naloxone or other treatments, but the requirement that parents must be substance free before reunification can occur?

13. Is there anything else that you would like to discuss?

Closing

Thank you for taking the time to speak to me today. Those are all of the questions I have for you. Is there anything else you’d like to add to our discussion before we end?

Community Burden Substudy – Provider/Stakeholder Guide 2