Building Substance Use Competence In Child Welfare: Preliminary Findings from a Longitudinal Fellowship Evaluation

Background and purpose: Child welfare systems sit at the front lines of the nation’s substance use crisis, yet the workforce responsible for supporting affected families has historically been underprepared to address alcohol and other substance use disorders in meaningful, evidence-informed ways. In this study, we seek to evaluate the Child Welfare Addiction Fellowship, a post-graduate longitudinal cohort-based training program, to help address this gap. We recruited social work graduates from Title IV-E programs in Virginia for a 2-year fellowship program that embeds traditional substance use education within ongoing supervision and multidisciplinary real-world case consultations.

Methods: This study utilized a concurrent mixed-methods design to examine changes in fellows’ confidence, professional role perceptions, and perceived participation benefits. Seven of 11 fellows completed baseline and one-year quantitative assessments, and eight completed a one-year semi-structured qualitative interview. Measures included demographics, years of professional experience, caseload composition, and attitudes and role perceptions (Short Alcohol and Alcohol Problems Perception Questionnaire, SAAPPQ; Drug and Drug Problems Perceptions Questionnaire, DDPPQ). Paired t tests examined changes from baseline to year-one assessment. Mixed-effects regression models assessed whether time, years of experience, and caseload composition predicted outcomes. Thematic analysis of qualitative interviews was mapped to SAAPPQ/DDPPQ domains.

Results: Mean scores increased from baseline to year one across most domains. Role adequacy showed significant improvements on the SAAPPQ (t(6)=3.27, p=.017) and DDPPQ (t(6)=4.45, p=.004). Time also was a significant predictor of role adequacy (SAAPPQ: β=0.73, p=.005; DDPPQ: β=0.96, p<.001) in multivariable regression models. Additionally, years of experience predicted higher professional self-esteem (β=0.83, p=.030) and greater perceived role support (β=2.25, p<.001) on the DDPPQ. Caseload composition did not significantly predict outcomes. Qualitative results aligned with the quantitative results, with quotes reflecting all domains of the SAAPPQ and DDPPQ identified by the coders. A selected quote representative of the role adequacy domain is presented here. Fellows described changes in their feelings of perceived role adequacy in working with clients with substance use issues: (Fellow 6, 1-2 years in current position) “I think I feel more confident that I know what I'm talking about. Whereas before I thought I knew and I really had no idea.” Qualitative interviews further provided evidence of reduced stigma, enhanced use of non-stigmatizing language, and greater confidence in family engagement.

Conclusions and Implications: Although the findings are preliminary and limited to a single cohort, they point to the potential of a comprehensive cohort-based workforce development model to contribute to broader change. The observed improvements in role adequacy support the value of sustained, practice-based learning environments. These changes reflect not only individual skill development but also shifts in professional identity that are essential for working effectively at the intersection of child welfare and substance use. By leveraging existing Title IV-E infrastructure, this approach may further offer a scalable pathway for strengthening the child welfare workforce nationally. Continued evaluation with larger samples, longer assessment periods, and system-level outcome measures is warranted to assess the full impact of this model on practice quality, family outcomes, and child welfare decision-making.