18, No. 1
SafeCare: An Evidence-Based Intervention for Child Neglect
More and more, child welfare agencies are turning to empirical research to help them select the most effective ways to help families struggling with child maltreatment. Current evidence suggests that of the programs that address child neglect, SafeCare is one of the best.
SafeCare is a parenting program in which professionals provide weekly in-home, direct skills training to parents in the areas of infant and child health care, home safety, and parent-child interactions.
Target Population: Parents of children ages birth to 5 at risk or reported for child maltreatment, including young parents; parents with multiple children; parents with a history of depression or other mental health problems, substance abuse, or intellectual disabilities; parents being reunified with their children; parents recently released from incarceration; parents with a history of domestic violence or intimate partner violence; and parents of children with developmental or physical disabilities.
- Health Module. Targets risk factors for medical neglect. Teaches parents to use health reference materials to prevent common childhood illnesses and injury, identify symptoms, and provide and seek appropriate treatment.
- Home Safety Module. Targets environmental neglect and unintentional injury. Includes childproofing the home and eliminating safety and health hazards.
- Parent-Child/Parent-Infant Interactions Module. Targets risk factors for neglect and physical abuse. Includes skill development in child behavior management.
Intensity and Length. SafeCare home visitors conduct weekly or biweekly home visits for approximately 90 minutes each over 18-20 weeks, depending on parents' progress and whether other services are integrated into SafeCare delivery. Home visitors work with parents until they meet a set of skill-based criteria established for each of three program modules.
Evidence of Effectiveness
The California Evidence-based Clearinghouse for Child Welfare (www.cebc4cw.org) rates SafeCare as "2-Supported by Research Evidence," a relatively high rating indicating that SafeCare has been shown to be effective in at least one rigourous randomized controlled trial with a sustained effect of at least 6 months.
In fact, SafeCare continues to be the subject of considerable study; at least five papers have been published about it since 2008. This includes a 10-year Oklahoma-based study which found SafeCare reduced child abuse and neglect recidivism in very challenging families (Chaffin, et al., 2012). The 2,175 families in this study averaged five prior encounters with CPS. Over 90% of the referrals included neglect, and 70% were exclusively neglect. Of the families included in the study, 82% lived below the poverty line.
This study found that families who received standard home visiting services plus SafeCare were 26% less likely to experience CPS reports than families who received home visiting services alone.
Support for Implementation and Fidelity
As part of its effort to disseminate the SafeCare model nationwide, the National SafeCare Training and Research Center (NSTRC) pays special attention to issues of implementation, fidelity, and sustainability. Agencies considering SafeCare are asked to complete a readiness assessment. The NSTRC uses a variety of means to support agencies as they develop the capacity to faithfully implement SafeCare.
To Learn More
Additional information, including contact information, can be found at the National SafeCare Training and Research Center website (http://publichealth.gsu.edu/968.html).
SafeCare is available in 15 states and several international locations. Currently two agencies in North Carolina are doing SafeCare with child welfare-referred clients:
- Exchange Clubs’ Family Center of Durham County (Durham)
- Children’s Center of Surry and Yadkin (Dobson)
In addition, the National SafeCare Training and Research Center has worked with several agencies to integrate
SafeCare with another evidence-based early childhood parent education, family support, and school readiness home visiting model, Parents As Teachers (PAT). This is part of a research project in which they will compare the results of PAT+SafeCare with the results of PAT alone. North Carolina agencies involved in this study are:
- Rockingham Co. Partnership for Children (Reidsville)
- Children and Family Resource Center (Henderson)
- Kids Advocacy Resource Effort (Waynesville)
- Beaufort-Hyde Partnership for Children (Washington)
- Sampson Co. Partnership for Children (Clinton)
References for this and other articles in this issue