SafeCare+

About the program

SafeCare+ is an adaptation of the standard SafeCare structured training program for parents of children aged 0 to 5 years, reported for child abuse and/or neglect. The main adaptation in SafeCare+ is the addition of motivational interviewing and training home visitors on identification and response to imminent child maltreatment and various risk factors.

SafeCare is premised on an eco-behavioural model to address the causes of physical abuse and neglect. This model recognises the need for interventions of differing levels to address maltreatment, and the need to target skills and behaviours in ways that serve to sustain change. This can involve ongoing measurement of observable behaviours, skills modelling, practice and feedback, and training parents to criterion in observable skills. SafeCare is delivered by specifically trained personnel.

See also SafeCare+ Program Summary in the Preventing Child Maltreatment Evidence Review.

See also SafeCare and SafeCare Dad to Kids Program Summaries in the Reducing Child Harm and Maltreatment Evidence Review.

Who does it work for?

One study of  SafeCare+ was identified. The program was delivered to families living in rural communities in the USA.

The study was a randomised clinical trial with a sample of 105 parents who had an identifiable risk of intimate partner violence, or substance abuse (Silovsky et al. 2011). Of the 48 families allocated to the SafeCare+ group, only 40 received the intervention. Of the 57 families allocated to the control group, 19 received the service as usual intervention. All but one parent in the sample were women, the average age was 27 years, and there was an average of two children per family. In the intervention group, 15% were Black, 15% Native American, 2% Hispanic or Latinx and 68% White; 25% did not complete high school.

This review did not identify any evidence that the program has been evaluated in Australia.

What outcomes does it contribute to?

Positive outcomes:

Child abuse potential: Silovsky et al. (2011) detected a positive, but marginally significant, improvement in the child abuse potential inventory scores of the intervention group.

Domestic violence: There were no reports made due to domestic violence for the intervention group, compared to seven reports for the control group (Silovsky et al. 2011).

Harsh and neglectful parenting: Silovsky et al. (2011) found a significant positive program effect in the intervention group, but it was not maintained at the follow-up assessment.

No effect:

None.

Negative outcomes:

None.

Is the program effective?

Overall, the program had a positive effect on client outcomes.

How strong is the evidence?

Promising research evidence:

• At least one high-quality RCT/QED study reports statistically significant positive effects for at least one outcome, AND
• Fewer RCT/QED studies of similar size and quality show no observed effects than show statistically significant positive effects, AND
• No RCT/QED studies show statistically significant adverse effects

How is it implemented?

SafeCare involves an 18 to 24-week program comprised of three modules: health training, safety training, and parenting skills. Although each module is typically offered in parents’ homes over six sessions, this can vary to reflect a parent’s preferred location and their progress. A parent’s progress is assessed via direct observation in role-play situations. SafeCare+ includes the addition of motivational interviewing and training home visitors on identification and response to imminent child maltreatment and various risk factors.

How much does it cost?

Information not available

What else should I consider?

The program has been tailored to different target groups, for example fathers and rural families. These modifications introduce considerable variation to the program and limit comparability.

Where does the evidence come from?

One study conducted in the USA:

• A randomised clinical trial with a sample of 105 parents (Silovsky et al. 2011)

Further resources

• https://safecare.publichealth.gsu.edu
• Silovsky, JF, Bard, D, Chaffin, M, Hecht, D, Burris, L, Owora, A, Beasley, L, Doughty, D and Lutzker, J 2011, ‘Prevention of child maltreatment in high-risk rural families: A randomized clinical trial with child welfare outcomes’, Children and Youth Services Review, vol. 33, pp. 1435-1444.