Relief Nursery program

About the program

The Relief Nursery program is a comprehensive, integrated array of prevention services designed to support families considered "at risk" for child abuse and neglect. The core components of the program are:

(a) The Therapeutic Early Childhood Classroom Program (TECP)

(b) home visiting

(c) group-based parent education and support services.

The Relief Nursery program aims to prevent the cycle of child abuse and neglect by building successful and resilient children, strengthening parents, and preserving families. The program seeks to:

• broaden and strengthen the network of social systems the family and child are a part of.
• increase positive interactions within the child’s family, and foster the social, emotional, and cognitive development of the child.

See also Relief Nursery Program Summary in the Reducing Child Harm and Maltreatment Evidence Review.

Who does it work for?

The Relief Nursery Program is targeted at parents who have children under the age of four and are considered at risk for child abuse and neglect.

The program has only been tested in the USA (Eddy et al. 2019).

A randomised control trial was conducted with 150 people (70 people in the intervention group and 80 people in the control group). On average, mothers were 29 years old and children were 3 years old. Most mothers were Caucasian and from low-income families.

The program has not been tested in Australia or with Aboriginal Australians.       

What outcomes does it contribute to?

Positive outcomes:

• Parent’s social support: parents who participated in the Relief Nursery program report higher rates of tangible social support, e.g. someone to take them to the doctor or help them if they are confined to bed, compared to parents receiving standard respite care.

No effect:

• Child abuse potential: the program did not have an effect on decreasing the potential for child abuse.
• Parenting attitude: the program did not have an effect on an increase in parents’ self-efficacy, i.e. confidence in their parenting.
• Parent’s mental health: the program did not have an effect on improving depression rates of parents.
• Positive parenting behaviours: the program did not have an effect on increased positive parenting behaviours, such as praising children for behaving well or doing fun things with their children.

Neutral outcomes:

• No neutral effects were found.

Negative outcomes:

• No negative effects were found.

How effective is it?

Overall, the Relief Nursery prevention program has a mixed effect on client outcomes.

How strong is the evidence?

Mixed research evidence (with no adverse effects):

• At least one high-quality randomised controlled trial (RCT) or quasi-experimental design (QED) study reports statistically significant positive effects for at least one outcome, AND
• An equal number or more RCT or QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT or QED studies show statistically significant adverse effects.

How is it implemented?

The core components of The Relief Nursery program are home visiting, parent education, and a therapeutic early childhood classroom. Because both the level of risk for problems and the specific needs varies greatly across families, other aspects of the program are tailored as needed.

The Therapeutic Early Childhood Classroom Program (TECP) serves as the "hub" of the Relief Nursery program. A team of early interventionists (typically 2 trained teachers and 2 or more support volunteers) work with a group of children (typically 8 to 10 per classroom) in developmentally appropriate classroom settings.

Home Visiting provides a direct and ongoing connection between the experiences of the child in the TECP and parents/caregivers. Home visits actively include all parents/caregivers. During home visits early childhood teachers work to enhance parenting skills, promote parent/child relationships, provide referrals, and otherwise support parents in creating a healthy and nurturing home environment.

Group-based Parent Education and Support Services complement individual parent education and support activities within the home visiting program. Small group-based classes are offered on a rotational basis throughout the year and utilise "best practices" in parent education for at-risk families. Classes provide the opportunity to gain knowledge and build skills through brief lectures, small and large group discussions, demonstrations, role plays, and projects. Childcare and snacks are provided.

Additional components include:

• Mental Health and Special Education Services integrated into the classroom (TECP).
• Developmental screening for each child - designed to reveal the need for further assessment and/or specialised services to ensure appropriate and healthy development.
• Teachers, specialists, and parents work together to establish individual goals for each child
• Other Services are provided as needed, including: respite care, provision of child nutrition, transportation for children and families to and from services, and individual and family counseling.

How much does it cost?

Not reported.

What else should I consider?

The Relief Nursery program’s most costly component is the TECP due to the number of staff required and needs to be taken into account for financial consideration when running the program (see Eddy et al. 2019).

Where does the evidence come from?

One RCT conducted in the USA, with 150 participants (Eddy et al. 2019).

Further resources

The Relief Nursery Program website: https://reliefnursery.org

Eddy et al. (2019), Outcomes from a randomised controlled trial of the Relief Nursery Program. Prevention Science, Vol. 21, pp. 36-46.