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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 2
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 Overview
Strength-based and structured curriculum
Home Safety Module
Module 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
hazards
Training
– 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 Sharp
Activity 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 Process
Includes 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 min
Train
• 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 Overview
Before 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
Belarus
Spain
Australia
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
Professor
Associate Dean of Public
Health
Director, Center for Healthy
Development
Email: jlutzker@gsu.edu
404-413-1284
Fax: 404-413-1284
http://publichealth.gsu.edu
www.safecare.org
Shannon R. Self-Brown, Ph.D.
Associate Professor, School of
Public Health
Director, School of Public Health
Ph.D. Program
Associate Director, National
SafeCare Training and Research
Center
Georgia State University
Phone: 404-413-1283
Email: sselfbrown@gsu.edu

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Safe Care: History, Outcomes, Dissemination

  • 1. SafeCare®: History, Outcomes, Dissemination Shannon Self-Brown and John R. Lutzker Georgia State University
  • 2. 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 2
  • 3. 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
  • 6. Home Safety Module Module 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 hazards Training – Teach parents about hazards – Begin removing or securing accessible hazards in one room – Turn responsibility over to the parent – Always discuss supervision Re-Assessment
  • 7. Safety Skills: Hazard Categories Suffocation Drowning Fire/Electrical Choke Fall/ Poison Firearm Sharp Activity Restriction Crush Organic/Allergen
  • 9. 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 Process Includes 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 min Train • LoTTS in PII • Planned Activities Training in PCI Re-Assess • Re-observe three situations
  • 10. PII Skills: LoTTS of Bonding Behaviors **These behaviors are done in any activity at any time with infants SmilingTouching TalkingLooking
  • 11. 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
  • 12. PCI Skills: cPAT Overview Before During End
  • 13. 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
  • 15. 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
  • 16. 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
  • 18. 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
  • 19. John R. Lutzker, Ph. D. Distinguished University Professor Associate Dean of Public Health Director, Center for Healthy Development Email: jlutzker@gsu.edu 404-413-1284 Fax: 404-413-1284 http://publichealth.gsu.edu www.safecare.org Shannon R. Self-Brown, Ph.D. Associate Professor, School of Public Health Director, School of Public Health Ph.D. Program Associate Director, National SafeCare Training and Research Center Georgia State University Phone: 404-413-1283 Email: sselfbrown@gsu.edu

Editor's Notes

  1. The use of structured assessment allows the provider to “see” change and measure it objectively Validated tools exist for measuring change Working towards mastery or success in demonstrating parenting skills
  2. Teaches parents a broad range of skills Parenting Children’s health needs Home safety Trainees learn all 4 modules but families receive 3
  3. 2014 early projections: (1) Forth Worth, TX (Parenting Center); (2) Portland, OR (NAYA Family Center); (3) Ithaca, NY (Thompkins County); and (4) Australia