SafeCare®: History, Outcomes, Dissemination

Shannon Self-Brown and John R. Lutzker

Georgia State University

SafeCare History• Project 12-Ways (1979)

– Rural Southern Illinois– 12 services – DFCS referred families – Still going strong

• 1980s, SafeCare in California– From 12-Ways to 3-ways– Safety, Health, Parent-child interactions– Service and research model

• 2001: Oklahoma adopts SafeCare • 2007: National SafeCare Training and Research

Center – Demand for training began to rise

• 2015– 23 states, UK, Belarus, Canada, Spain, Israel, Australia

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SafeCare: An Evidence-Based Program for Child Neglect and Physical Abuse Prevention

• Behavioral, in-home parent-training curriculum targeting child neglect

• Targets high-risk parents with children ages 0-5 years• 3 modules:

• Child Safety, Child Health, Parent-Child Interaction• Each module is conducted over 6(±) sessions, 18

sessions in all• Use structured teaching model across 3 modules

Assess (session 1)

Train (sessions 2-5) Assess (session 6)

Explain Model Practice Feedback

Overview of SafeCare

SafeCare Curriculum OverviewStrength-based and structured curriculum

Home Safety ModuleModule Goals

• Teach parents skills to:– Understand the

importance of a safe home

– Know the types of hazards in homes

– Know ways to remove household hazards

– Understand the importance of supervision

Module Process

Assessment– Consent – Measure tallest child under 5– Choose 3 rooms and count

hazardsTraining

– Teach parents about hazards – Begin removing or securing

accessible hazards in one room– Turn responsibility over to the

parent– Always discuss supervision

Re-Assessment

Safety Skills: Hazard Categories

Suffocation Drowning Fire/Electrical Choke

Fall/ Poison Firearm SharpActivity Restriction

Crush Organic/Allergen

Safety Training Session

Parenting Module: Parent-Child Interaction

Module Goals

• Teach parents skills to: – Positively interact with

their children– Enhance their parent-

child relationships– Use incidental teaching– Plan and organize daily

and play activities– Prevent challenging

child behavior

Module ProcessIncludes 2 curricula

• PII for parents of infants• PCI parents of children up to age 5

Assessment• Daily Activities Checklist • Observation of mother/child in

three different situations for 5 minTrain

• LoTTS in PII• Planned Activities Training in PCI

Re-Assess• Re-observe three situations

PII Skills: LoTTS of Bonding Behaviors

**These behaviors are done in any activity at any time with infants

SmilingTouching

TalkingLooking

PII Skills: Other Bonding Behaviors

**Only be done when appropriate to the activity (e.g. hard to rock a baby during bath time)

Imitating RockingHolding

PCI Skills: cPAT OverviewBefore During End

Health Module

Health Module Goals

• Teach parent skills to:– Keep children as healthy as

possible– Prepare for when child is sick

or injured – Recognize when symptoms

need emergency care, need a doctor’s appointment, or can be cared for at home

– Use health reference materials

– Keep good health records

Health Module Process

Assessment– Introduce health and give

manual– Role plays using age appropriate

scenarios Training

– Use age appropriate Scenarios: Treat at home; Call Dr.; Go to ER

– Look up symptoms in health manual

– Record symptoms & treatments – Identify appropriate response – Demonstrate behaviors

Re-Assess

Health Materials

SafeCare Research:Does SafeCare Reduce Child Maltreatment?

• Within child welfare samples, SafeCare has reduced child maltreatment recidivism by rates of 26%-63% compared to services as usual

• Within at-risk parent samples SafeCare compared to Services as Usual reported:– Less Child Abuse Potential– Lower Depression

Silovsky et al., 2012

SafeCare Return on Investment

From Washington State Institute of Public Policy, April 2012

SafeCare $14.85 return for every $1 invested in SC

http://www.wsipp.wa.gov/pub.asp?docid=12-04-1201

BelarusSpainAustralia

Statewide Implementation

Local Implementation

SafeCare 2015

International Implementations:

United Kingdom

Israel

Canada

SafeCare Adaptations• Diverse populations

– American Indians– Latinos

• Fathers• Children with behavior problems• Children ages 5-11• SafeCare Augmented

– Motivational Interviewing• PATSCH

– Braiding 2 EBP• Parents with Intellectual Disabilities• International

– 6 countries

John R. Lutzker, Ph. D.Distinguished University ProfessorAssociate Dean of Public HealthDirector, Center for Healthy DevelopmentEmail: jlutzker@gsu.edu404-413-1284Fax: 404-413-1284

http://publichealth.gsu.eduwww.safecare.org

Shannon R. Self-Brown, Ph.D.Associate Professor, School of Public HealthDirector, School of Public Health Ph.D. ProgramAssociate Director, National SafeCare Training and Research CenterGeorgia State UniversityPhone: 404-413-1283Email: sselfbrown@gsu.edu