Drug-Related Child Protection Cases: The Decision-Making Context of Caregivers’ Substance Use within the Child Protection System

Background and Purpose: Caregiver substance use is a highly moralized issue that sits at the boundary of acceptable parenting, yet Taiwan’s child welfare legislation does not explicitly define caregiver drug use as a form of child abuse or neglect. This ambiguity places drug-related cases in a gray area within the child protection system, leaving frontline social workers with considerable discretion in assessing risk and determining intervention. Drawing on Decision-Making Ecology (DME) theory, which conceptualizes child protection decisions as products of multilevel factors—including organizational culture, policy frameworks, local governance, and individual practitioner characteristics—this study examines how child protection social workers understand, assess, and respond to cases involving caregiver substance use (referred to as “drug-protection cases”). Specifically, it asks: How do practitioners construct risk and justify intervention in the absence of explicit legal mandates? What institutional logics and professional contexts shape their decision-making?

Methods: Guided by a hermeneutic-qualitative approach that emphasizes meaning-making within institutional and relational contexts, this study conducted semi-structured, in-depth interviews with 11 child protection professionals—9 social workers and 2 supervisors—from four regions in Taiwan. Participants were recruited through purposive and snowball sampling, with eligibility criteria requiring current or former employment at a domestic violence and sexual assault prevention center, experience handling drug-related child protection cases, and at least one year of child protection practice. Interviews were conducted between October and November 2024, each lasting 1.5 to 2 hours. Data were analyzed using a four-layered thick description and interpretation method, moving iteratively between surface-level accounts, contextual actions, broader institutional dynamics, and reflexive reinterpretation of professional roles within the policy landscape.

Results: Two key themes emerged. First, regarding the construction and enactment of state parenting, practitioners translated ambiguous legal provisions into operational criteria through strategic interpretation, particularly invoking catch-all clauses to establish intervention legitimacy. Decision-making standards varied significantly across practitioners and regions, shaped by individual professional beliefs, organizational norms, supervisory oversight, and local governance pressures—including media scrutiny following high-profile cases. This variation reflects the co-constitution of governance logics and professional discretion rather than systemic inconsistency. Second, the child protection system functioned as a constructed “omnipotent institution.” Network partners routinely deferred complex family issues to child protection services, expecting the system to resolve problems beyond its design capacity. The system’s risk-control orientation conflicted with caregivers’ nonlinear recovery trajectories, exemplifying the “two clocks” dilemma—institutional timelines for permanency planning versus the extended time required for addiction recovery. Social workers were caught between supportive and surveillant roles, as court proceedings and evidence-gathering demands eroded therapeutic relationships and pushed families toward adversarial interactions.

Conclusions and Implications: This study argues that decision-making variability in drug-related child protection cases reflects essential ethical reflexivity and contextual sensitivity inherent to professional practice. Policy implications include developing integrated cross-sector collaboration among social welfare, health, and judicial systems; establishing recovery-oriented residential programs that combine addiction treatment with parenting support; and creating institutional mechanisms that accommodate the temporality of recovery processes rather than imposing rigid compliance timelines, ensuring that child protection balances family recovery with children’s best interests.