SafeCare is an evidence-based parenting program developed in the 1970s that targets child neglect and physical abuse prevention. It consists of three modules - child safety, child health, and parent-child interaction - delivered over 18 sessions. Research shows SafeCare reduces child maltreatment recidivism rates by 26-63% compared to services as usual. It has been implemented in 23 U.S. states and other countries. SafeCare has a return on investment of $14.85 for every $1 spent based on a Washington state study. Adaptations have expanded SafeCare to diverse populations and other evidence-based programs.

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

4. Overview of SafeCare

5. SafeCare Curriculum Overview
Strength-based and structured curriculum

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

8. Safety Training Session

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

14. Health Materials

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

17. Belarus
Spain
Australia
Statewide
Implementation
Local Implementation
SafeCare 2015
International Implementations:
United Kingdom
Israel
Canada

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