Recovery coaches and substance exposed births: An experiment in child welfare

Joseph P. Ryan, Sam Choi, Jun Sung Hong, Pedro Hernandez, Christopher R. Larrison

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


Objectives: Substance exposed infants present a major challenge to child welfare and public health systems. Prenatal substance exposure and continued substance abuse in the home are associated with a wide range of adverse social, emotional, and developmental outcomes. The objective of the current study is to evaluate the use of recovery coaches in child welfare. Methods: The current study is longitudinal and utilizes an experimental design. The sample includes 931 substance abusing women enrolled in a Title IV-E Waiver Demonstration, 261 in the control group, and 670 in the experimental group. Women in the experimental group received traditional services plus the services of a recovery coach. Administrative records are used to indicate substance exposure at birth. Results: Of the 931 women enrolled in the waiver demonstration, 21% of the control group and 15% of the experimental group were associated with a subsequent substantiated allegation indicating substance exposure at birth. Cox proportional hazards modeling indicates that women in the experimental group were significantly less likely to be associated with a new substance exposed birth. Conclusions: The use of recovery coaches in child welfare significantly decreases the risk of substance exposure at birth. Integrated and comprehensive approaches are necessary for addressing the complex and co-occurring needs of families involved with child protection.

Original languageEnglish
Pages (from-to)1072-1079
Number of pages8
JournalChild Abuse and Neglect
Issue number11
StatePublished - Nov 2008


  • Evaluation
  • Substance abuse
  • Substance exposed births


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