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Implementing SafeCare®

Yes (SafeCare Augmented only)

Program Model Overview

Last Updated

April 2017

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The information in this profile reflects feedback from this model’s developer as of the above date. The description of the implementation of the model here, including any adaptations, may differ from how it was implemented in the studies reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the DHHS criteria for evidence of effectiveness.

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Implementation Support

The National SafeCare Training and Research Center (NSTRC), as part of the Mark Chaffin Center for Healthy Development at Georgia State University, provides training, technical assistance, implementation support, and quality assurance to all agencies and systems that deliver the SafeCare model.

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Theoretical Model

SafeCare is a structured parenting program that is designed to address the behaviors that can lead to child neglect and abuse. The program was developed to offer a more easily disseminated and streamlined program to parents at risk for child abuse and neglect, based on key components of its precursor, Project 12-Ways.

SafeCare provides parent training in three focused areas: (1) parent-child/parent-infant interactions, (2) infant and child health, and (3) home safety. The model emphasizes learning in a social context and uses behavioral principles for parent training across the three modules. SafeCare Augmented, an enhanced version of SafeCare, adheres to the SafeCare model with additional training on Motivational Interviewing and domestic violence.

Project 12-Ways employs an ecobehavioral approach to the treatment and prevention of child abuse and neglect. Ecobehavioral refers to the multifaceted in-home services provided to families. Twelve key services are offered: (1) parent-child interaction, (2) stress reduction for parents, (3) basic skills training for children, (4) money management training, (5) social support, (6) home safety training, (7) multisetting behavior management, (8) infant and child health and nutrition, (9) problem solving, (10) marital discord counseling, (11) alcohol abuse referral, and (12) a variety of pre- and post-natal prevention services for young and unwed mothers.

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Target Population

SafeCare, like its precursor Project 12-Ways, is designed for families with a history of child maltreatment or risk factors for child maltreatment, including young parents; parents with multiple children; parents with a history of depression or other mental health problems, substance use, or intellectual disabilities; foster parents; parents being reunified with their children; parents recently released from incarceration; and parents with a history of domestic violence or intimate partner violence. The program also serves parents of children with developmental or physical disabilities, or mental health, emotional, or behavioral issues. SafeCare is intended to complement the more specialized intervention services these families might be receiving from other agencies.

SafeCare is available to parents with children ages birth to 5 and has been used with culturally diverse populations. SafeCare Augmented was adapted for high-risk, rural families who do not have a long history of involvement with child welfare services.

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Targeted Outcomes

SafeCare aims to prevent and address factors associated with child abuse and neglect by offering services targeting improved health care skills, including identifying symptoms of illness or injury and seeking appropriate treatment; safety of the home environment; and parenting skills, including providing stimulating activities and positive parent-child interactions.

Project 12-Ways aims to reduce first-time, repeated, and recidivistic child abuse and neglect among clients by offering 12 distinct services (see the Theoretical Model section).

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Program Model Components

SafeCare, like its precursor Project 12-Ways, includes one-on-one home visits between providers and families. All SafeCare modules include baseline assessments and observations of parental knowledge and skills, parent training, and follow-up assessments to monitor change. Each module typically involves a baseline assessment session, followed by four training sessions, and concludes with a follow-up assessment. Providers use a four-step approach to address target behaviors: (1) describe and explain the rationale for each behavior, (2) model each behavior, (3) ask the parent to practice the behavior, and (4) provide positive and constructive feedback. The training is designed to promote generalization of skills across time, behaviors, and settings.

SafeCare Augmented adds domestic violence training and Motivational Interviewing, a technique that explores and builds on an individual’s motivation to change.

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Program Model Intensity and Length

NSTRC recommends that SafeCare providers conduct weekly or biweekly home visits for approximately 60 to 90 minutes each.

SafeCare is typically delivered between 18 and 22 weeks, depending on parents’ progress and whether other services are integrated into SafeCare delivery. Providers work with parents until they meet a set of skill-based criteria established for each of three program modules (health, home safety, and parent-infant/parent-child interactions).

Project 12-Ways involves up to 12 programs over one year.

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Location

NSTRC is part of the Mark Chaffin Center for Healthy Development in the School of Public Health at Georgia State University in Atlanta, Georgia. NSTRC has trained SafeCare providers in the following 24 states: Alaska, Arizona, California, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Maryland, Montana, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Texas, Vermont, and Washington. Internationally, NSTRC has trained SafeCare providers in Australia, Canada, Israel, Spain, Taiwan, and the United Kingdom.

Project 12-Ways has been implemented in southern Illinois for more than 30 years.

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Adaptations and Enhancements

SafeCare was adapted from Project 12-Ways. SafeCare Augmented is an enhanced version of SafeCare that incorporates additional training for providers on Motivational Interviewing, and ongoing consultation for providers from local experts in substance use, mental health, and intimate partner violence. An enhancement to the Planned Activities Training (PAT) curriculum module known as CPAT incorporates cellular telephones to promote family engagement between home visits. Providers send families daily text messages and occasional voice messages to encourage and remind them about newly learned parenting strategies.

The developers will consider enhancements or adaptations to the SafeCare model.

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Notes

The information contained on this page was last updated in April 2017. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the National SafeCare Training and Research Center on January 18, 2017. HomVEE reserves the right to edit the profile for clarity and consistency.

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