Family-Based Recovery

Target Population

FBR is designed for parents who have a substance use disorder and have children ages 0–5. To participate in FBR, parents must: (1) have had recent substance use (self-reported or positive test) in the past 30 days and currently meet criteria for having a substance use disorder, (2) have at least one child age 0–5, and (3) be in a caregiving role for that child at least 50% of the time. Additionally, the child must reside in the home at least 50% of the time or, if currently placed outside the home, have a plan for imminent reunification within 30 days. 

Dosage

FBR team members deliver services over 6–12 months in three sequential phases of decreasing intensity. In Phase 1, the substance use clinician meets with the client twice a week (either twice at home or once at home and once at Social Club), the parent-child clinician meets with the client once per week in the home, and the family support specialist meets with the client once per week in the home (often in conjunction with a visit from the substance use clinician or the family-child clinician). In total, the client meets with members of the FBR team minimum of three times a week (across home visits and Social Club), though the number of visits can be temporarily increased if needed. Phase 1 lasts a minimum of six months, and the client can move to Phase 2 after the FBR team determines the client is ready for this transition. 

In Phase 2, the FBR team members meet with the client two times per week— either two home visits or one home visit and one Social Club meeting. In weeks with one home visit and one Social Club meeting, both the substance use clinician and the parent-child clinician meet with the family during the home visit. In this phase, the family support specialist meets with the family once per week – either at home or at Social Club. 

In Phase 3, the FBR team members meet with the client once per week in the home, with the substance use clinician and the parent-child clinician alternating weeks. The client can choose to attend Social Club, but attendance does not replace a home visit. Phase 3 typically begins within one month of a planned discharge date after the FBR team has determined that the client is ready to step down to less frequent services.

Location/Delivery Setting

Recommended Locations/Delivery Settings

FBR is delivered in the home, in community settings, and virtually.

Location/Delivery Settings Observed in the Research

• Home

Education, Certifications and Training

FBR substance use clinicians and parent-child clinicians are behavioral health professionals with at least a master’s degree. An FBR supervisor oversees the substance use and parent-child clinicians. FBR supervisors are master’s-level clinicians with prior clinical supervisory experience and a mental health professional license from the state in a social service field. FBR family support specialists must have at least a bachelor's degree and working knowledge of mental health and substance use treatment for adults and child engagement. FBR part-time psychiatrists and advanced practice registered nurses must meet state requirements for licensure. 

All FBR team members receive FBR model training from the FBR Model Development and Operations (MDO) team who provides an initial FBR model training. FBR MDO consultants also conduct weekly 1.5 hour clinical consultation calls with the FBR team—a 60-minute call with the entire clinical team and a 30-minute call with the FBR supervisor. Clinical staff are cross trained on all model components to give them equal emphasis in treatment and increase sensitivity on how substance use and parenting issues are interrelated. Sites implementing FBR must have their FBR teams credentialed on an annual basis by the FBR MDO team.

Program or Service Documentation

Book/Manual/Available documentation used for review

FBR Model Development and Operations. (2024). Inside the FBR Box: FBR treatment manual (5th ed.). Yale Child Study Center.

Available languages

FBR materials are available in English.

Other supporting materials

Consultation and Training Information

For More Information

Website: https://medicine.yale.edu/childstudy/education-and-training/professional-development-training-and-consultation/clinical-training-and-consultation/family-based-recovery-model-development-and-operations/  

Email: karen.hanson@yale.edu 

Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.

Results of Search and Review	Number of Studies Identified and Reviewed for Family-Based Recovery
Identified in Search	3
Eligible for Review	1
Rated High	0
Rated Moderate	1
Rated Low	0
Reviewed Only for Risk of Harm	0

Outcome	Effect Size	95% Confidence Interval	Implied Percentile Effect	N of Studies (Findings)	N of Participants	Summary of Findings
Child safety: Child welfare administrative reports	Not Calculated	-		1 (1)	388	Favorable: 0 No Effect: 1 Unfavorable: 0
Child permanency: Out-of-home placement	Not Calculated	-		1 (1)	388	Favorable: 1 No Effect: 0 Unfavorable: 0

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention condition and a negative number favors the comparison condition. A range of comparison conditions, including no intervention, minimal intervention, placebo or attention, treatment as usual, and head-to-head comparison conditions are eligible for review (see Section 4.1.7 of the Handbook Version 2.0). Different types of comparison conditions may affect the magnitude of the effect sizes across studies. For example, an intervention compared to a no treatment comparison condition may produce a larger effect size than the same intervention compared to another intervention because the other intervention may itself be effective. The effect sizes shown may be derived from samples that overlap across studies.

See the Individual Study Findings table for information about the specific comparison conditions used in each study and the Studies Reviewed section for information about any overlapping samples. The effect sizes presented here are provided for informational purposes only and are not used in determining a program or service rating.

Effect sizes for some outcomes were not able to be calculated by the Prevention Services Clearinghouse.

Outcome	Effect Size	Implied Percentile Effect	Months after treatment when outcome measured	Number of Participants
Child safety: Child welfare administrative reports
Study 15700 - Family-Based Recovery vs. Treatment as Usual (Restrepo, 2025)
Child Protective Services Re-Referral (%)	Null	not calculated	6	388
Child permanency: Out-of-home placement
Study 15700 - Family-Based Recovery vs. Treatment as Usual (Restrepo, 2025)
Out-of-Home Placement (%)	Favorable *	not calculated	6	388

*p <.05

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention condition and a negative number favors the comparison condition. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Version 2.0, Sections 6.4 and 6.5 and may not align with effect sizes reported in individual publications. The Prevention Services Clearinghouse uses information reported in study documents and, when necessary, information provided by study authors in response to author queries to assign study ratings and calculate effect sizes (see Section 8.4.2 in the Handbook of Standards and Procedures, Version 2.0). The Prevention Services Clearinghouse typically relies on study-reported p-values to form the basis of the assessment of statistical significance for a finding, but will perform its own statistical test of a finding using any available information in study documents or author queries, as needed (see Section 6.3 in the Handbook of Standards and Procedures, Version 2.0). As a result, the effect sizes and statistical significance reported in the table may not align with the estimates as they are reported in study documents. Effect sizes for some outcomes were not able to be calculated by the Prevention Services Clearinghouse.

Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.

Full citations for the studies shown in the table are available in the "Studies Reviewed" section.

The participant characteristics display is an initial version. We encourage those interested in providing feedback to send suggestions to preventionservices@abtglobal.com.

The table below displays locations, the year, and participant demographics for studies that received moderate or high ratings on design and execution and that reported the information. Participant characteristics for studies with more than one intervention versus comparison group pair that received moderate or high ratings are shown separately in the table. Please note, the information presented here uses terminology directly from the study documents, when available. Studies that received moderate or high ratings on design and execution that did not include relevant participant demographic information would not be represented in this table.

For more information on how Clearinghouse reviewers record the information in the table, please see our Resource Guide on Study Participant Characteristics and Settings.

Characteristics of the Participants in the Studies with Moderate or High Ratings
Study Location	Study Year	Demographic Characteristics	Populations of Interest*	Household Socioeconomic Status
Study 15700 - Family-Based Recovery vs. Treatment as Usual
Characteristics of the Children and Youth
Connecticut, USA	2016	50% 0-12 months, 14% 13-35 months, 36% 36 months and older	--	--
Characteristics of the Adults, Parents, or Caregivers
Connecticut, USA	2016	5% 20 and younger, 52% 21-30 years old, 43% 31 and older 63% Non-Hispanic White 21% Non-Hispanic Black/African American 11% Hispanic 5% Other 92% Female 8% Male	100% Parents; 100% Child welfare-involved parents; 72% Single marital status	59% Annual family income $20,000 or less 35% Annual family income more than $20,000 6% Annual family income not available 38% Full- or part-time employment

“--” indicates information not reported in the study.

* The information about disabilities is based on initial coding. For more information on how the Clearinghouse recorded disability information for the initial release, please see our Resource Guide on Study Participant Characteristics and Settings.

Note: Citations for the documents associated with each 5-digit study number shown in the table can be found in the “Studies Reviewed” section below. Study settings and participant demographics are recorded for all studies that received moderate or high ratings on design and execution and that reported the information. Studies that did not report any information about setting or participant demographics are not displayed. For more information on how participant characteristics are recorded, please see our Resource Guide on Study Participant Characteristics and Settings.

Sometimes study results are reported in more than one document, or a single document reports results from multiple studies. Studies are identified below by their Prevention Services Clearinghouse study identification numbers. To receive a rating of supported or well-supported, the favorable evidence for a program or service must have been obtained from research conducted in a usual care or practice setting.

Studies Rated Moderate

Study 15700

Restrepo, M. T., Hanson, K. E., Vendetti, J., Chan, G., Duryea, E., & Ungemack, J. (2025). Enhancing family stability: Child removal and CPS re-referral outcomes through the Family-Based Recovery program. Child Maltreatment, 31(2), 337-348. https://doi.org/10.1177/10775595251352200

This study was conducted in a usual care or practice setting (Handbook Version 2.0, Section 7.2.2)

Studies Not Eligible for Review

Study 15701

Hawke, J. M., & Steinberg, K. (2012). Family-Based Recovery: Evaluation of child permanency outcomes. University of Connecticut Health Center.

This study is ineligible for review because it does not use an eligible publication source (Handbook Version 2.0, Section 4.1.2)

Study 15702

Hanson, K. E., Duryea, E. R., Painter, M., Vanderploeg, J. J., & Saul, D. H. (2019). Family-based recovery: An innovative collaboration between community mental health agencies and child protective services to treat families impacted by parental substance use. Child Abuse Review, 28(1), 69-81. https://doi.org/10.1002/car.2545

This study is ineligible for review because it does not use an eligible study design (Handbook Version 2.0, Section 4.1.5)