There is a limited, but growing body of research on the effectiveness of peer recovery coaches in promoting treatment engagement, retention, and completion among child welfare-involved parents with substance use disorders. A quasi-experimental design was employed using propensity score matching to examine treatment engagement and treatment completion among child welfare-involved substance abusing parents who were exposed to either peer recovery coach engagement services or professional, non-peer engagement services. Using propensity scoring, the comparison sample of parents that did not have peer recovery coaches was statistically matched on the presence of substance exposed newborns, parental use of methamphetamine, and other predictors of maltreatment recurrence and substance abuse treatment engagement. We examined the effect of peer recovery coaches on outreach, assessment, service initiation, and treatment completion. Participants who were exposed to peer recovery coaches engaged in treatment services at a higher rate and more rapidly despite receiving fewer outreach attempts, relative to participants who received only professional staff outreach services. Those participants who received peer recovery outreach services also demonstrated longer engagement in treatment than their counterparts exposed to professional outreach services only. Interestingly, those participants exposed to professional outreach services demonstrated higher rates of treatment completion, relative to their counterparts exposed to peer recovery coaching. Given that recovery coaches were assigned to clients for only the first 60 days, these findings suggest that peer recovery services may need to be provided for a greater length of time for improved treatment completion rates to be observed.

Key Take Away Points

  • Child welfare-involved families with substance-using parents often do not access, engage in, and complete substance abuse treatment.
  • Peer support services are receiving increased recognition as a potential means of overcoming substance abuse treatment barriers related to disengagement and attrition, but there is limited empirical research on the effectiveness of peer recovery coaches for child welfare-involved parents who use substances.
  • Findings from this study suggest that peer recovery coaches may help increase treatment engagement and length of treatment for child welfare-involved substance-using parents, but these increases are not indicative of greater treatment completion rates.


The Parent to Parent (P2P) Recovery Program was established in 2008 as a result of a three year grant awarded to the Arizona Department of Economic Security, Division of Children, Youth and Families (ADES/DCYF) from the Substance Abuse and Mental Health Services Administration (SAMHSA). The authors would like to thank Charles Davis, Babu Kumaran, Pradeep Jayapal, Sunil Mukkavilli, Ramya Anupindi, Rajat Kosuri, and Harsha Undapalli for their contribution in preparing the data for analyses. The authors wish to also thank staff of the Arizona Department of Economic Security, Division of Children, Youth and Families, and TERROS, Inc. for their ongoing cooperation and assistance. In particular, Susan Blackburn and Esther Kappas of ADES/DCYF, and Kate McGinty, Tony Morgan, and Ron Carpio of TERROS have been very helpful throughout this process.