Implementing Promoting First Relationships®—Home Visiting Option

Implementation last updated: 2019

The information in this profile reflects feedback, if provided, from this model’s developer as of the above date. The description of the implementation of the model(s) here may differ from how the model(s) was implemented in the research reviewed to determine this model’s evidence of effectiveness. Inclusion in the implementation report does not mean the practices described meet the HHS criteria for evidence of effectiveness. Similarly, models described here may not all have impact studies, and those with impact studies may vary in their effectiveness. Please see the Effectiveness button on the left for more information about research on the effectiveness of the models discussed here.

Model overview

Theoretical approach

PFR-Home Visiting Option is a version of PFR used with parents in the home. PFR can also be used one-on-one with parents in a health clinic and with child care providers and early childhood teachers responsible for group care. The information in this profile describes PFR-Home Visiting Option unless specified otherwise.

PFR in general, based on attachment theory, posits that developing strong early relationships with caregivers is the key to healthy social, emotional, behavioral, language, and cognitive development in children. The model aims to foster parent-child relationships by helping parents read and understand child cues and the unmet needs behind challenging behaviors, and supporting parents’ use of sensitive and responsive caregiving behaviors.

View Revisions

Implementation support

The Barnard Center for Infant Mental Health and Development at the University of Washington developed Promoting First Relationships®-Home Visiting Option (PFR-Home Visiting Option). Parent-Child Relationship Programs (PCRP) at the Barnard Center for Infant Mental Health and Development provides training on the model.

View Revisions

Intended population

PFR-Home Visiting Option serves parents of children ages birth to 5 years.

View Revisions

Targeted outcomes

PFR-Home Visiting Option seeks to promote children’s social-emotional development by fostering secure and healthy parent-child relationships.

View Revisions

Model services

PFR-Home Visiting Option involves home visitors providing feedback to parents based on video recordings of the parent’s interactions with the child. The home visitor makes video recordings of the parent interacting with the child at home, and the home visitor and parent view and reflect on the recordings. The home visitor highlights positive interactions observed and offers instructive comments to enhance caregiving. The home visitor also helps the parent reflect on his or her own behavior, feelings, and needs during the interaction, as well as on those of the child. In addition, PFR-Home Visiting Option provides parents with information, including handouts, on the social and emotional needs of young children, and strategies to meet these needs. The home visitor and the parent discuss ways to handle challenging behaviors and explore the parent’s own social-emotional development and how that influences caregiving.

View Revisions

Model intensity and length

PFR-Home Visiting Option is designed to provide weekly hour-long home visits for 10 to 14 weeks. The model can be extended based on a family’s needs.

View Revisions


Agencies deliver PFR-Home Visiting Option in 11 states: California, Delaware, Florida, Idaho, Montana, New Mexico, North Carolina, Oregon, Rhode Island, South Dakota, and Washington. Practitioners in an additional 20 states have attended the initial PFR workshop and may be using the PFR curriculum and handouts. These practitioners are not delivering PFR-Home Visiting Option. Agencies also deliver the model, including PFR-Home Visiting Option, internationally in Australia and Canada.

View Revisions

Adaptations and enhancements

PFR-Home Visiting Option has been adapted for use with American Indian families.

View Revisions

Implementation notes

The information contained on this page was last updated in July 2019. Recommended Further Reading lists the sources for this information. In addition, the information contained in this profile was reviewed for accuracy by the Barnard Center on February 26, 2019. HomVEE reserves the right to edit the profile for clarity and consistency.

View Revisions