SafeCare – For Court Involved Families

An in-home evidence-based parent training program for the prevention of child maltreatment for families with children age birth to 5 years.

In-home direct skill training to parents in four key areas:

Health

The goals of this module are to train parents to use health reference materials, prevent illness, identify symptoms of childhood illnesses or injuries, and provide or seek appropriate treatment by following the steps of a task analysis. To assess actual health-related behavior, parents role-play healthy baby temperature scenarios and decide whether to treat the child at home, call a medical provider, or seek emergency treatment. Parents are provided with a medically validated health manual that includes a symptom guide, information about planning and prevention, caring for a child at home, calling a physician or nurse, and emergency care. Parents are also supplied with health recording charts and basic health supplies (e.g., thermometer). After successfully completing this module, parents are able to identify symptoms of illnesses and injuries, as well as determine and seek the most appropriate health treatment for their child.

Home Safety

This module involves the identification and elimination of safety and health hazards by making them inaccessible to children. The Home Accident Prevention Inventory (HAPI) is a validated and reliable assessment checklist designed to help a provider measure the number of environmental and health hazards accessible to children in their homes. Rooms are evaluated using this assessment tool and then training takes place to assist parents in identifying and reducing the number of hazards and making them inaccessible to their children. Safety latches are supplied to families. This protocol is effective in significantly reducing hazards in the home and these reductions have been found to be maintained over time.

Parent-Child/Parent-Infant Interactions

This module consists of training on parent-infant interactions (birth to 8-10 months) and parent-child interactions (8-10 months to 5 years). This purpose of this module is to teach parents to provide engaging and stimulating activities, increase positive interactions, and prevent troublesome child behavior. The primary method for teaching this module is Planned Activities Training (PAT) Checklist. Providers observe parent-child play and/or daily routines and code for specific parenting behaviors. Positive behaviors are reinforced and problematic behaviors are addressed and modified during the in-home sessions. Providers teach parents to use PAT checklists to help structure

Problem Solving and Communication

Two additional focal points of the SafeCare model are problem-solving and communication skills. Problem-solving is used by SafeCare providers to help parents work through the many problems they may face that are not addressed by the SafeCare model. Structured problem-solving involves correctly framing the problem, generating potential solutions, identifying pros and cons of those solutions, choosing a solution, and acting. SafeCare also teaches providers to use good communication skills including: how to frame a session, building rapport, how to ask questions to elicit more information, how to provide positive and corrective feedback, and how to close a session. Problem-solving and communication are used across the three SafeCare modules as needed.

Common Elements of All Modules

All modules involve baseline assessment, intervention (training) and follow-up assessments to monitor change. Staff members conduct observations of parental knowledge and skills for each module by using a set of observation checklists. The SafeCare training format is based on well-established social learning theory and evidence from previous research. Service providers and parents are trained using a general seven step format:

  • Describe desired target behaviors
  • Explain the rationale or reason for each behavior
  • Model each behavior (demonstrate desired behavior)
  • Ask parent to practice behavior
  • Provide positive feedback (point out positive aspects of performance)
  • Provide constructive feedback (point out aspects of performance needing improvement)
  • Review parent’s performance, have them practice areas that need improvement, and set goals for the week.

Using this format, parents are trained so that skills are generalized across time, behaviors, and settings. Each module is implemented in approximately one assessment session and five training sessions and is followed by a social validation questionnaire to assess parent satisfaction with training. Home Visitors work with parents until they meet a set of skill-based criteria that are established for each module.

Entrance Criteria

  • One child age 0 – 5
  • Identified caretaker to work with (parent or kin)
  • Child(ren) at home or returning home soon
  • Court involved