Prevention of Child Abuse and Neglect (Secondary) Programs

Child First is a two-generation, home-based mental health intervention for the most vulnerable young children (prenatal through age five years) and their families, who likely have current or past Child Welfare Services involvement. It is designed for young children who have usually experienced trauma and/or have social-emotional, behavioral, developmental, and/or learning problems. Most live in environments where there is violence, neglect, mental illness, substance abuse, or homelessness. The goals of Child First are to help them heal from the effects of trauma and adversity; improve child and parent mental health; improve child development; and reduce abuse and neglect.

The model uses two team members:

• A Clinician provides a psychotherapeutic, two-generation intervention designed to build a nurturing, responsive, protective parent-child relationship, fostering the child's cognitive and social-emotional development and improving parent mental health.
• A Care Coordinator facilitates connections to broad community-based services and supports for all family members with the aim of achieving family stabilization, decreased parental stress, and improved executive functioning.

Early Start is a home visitation program that originated in New Zealand. It focuses on providing tamariki (children) in whānau (families) facing multiple disadvantages with supports and practical assistance.

The key features of the program are:

• Families are enrolled when their child is under one year, and ideally during the antenatal period. The primary focus is the child, providing family support and education to ‘nurture the baby early’ and encourage improvements in lifelong experiences.
• Families receive a comprehensive program which is provided by trained Family Support Workers with qualifications in Nursing, Social Work, Education, Early Childhood Education, or an allied profession.
• The service consists of a modular program of home visiting which may last up to five years.
• The frequency of home visiting varies according to family need and ranges from Level 1 home visiting (weekly) to Level 4 home visiting (one visit every four months).
• The aims of the program are to address a range of issues relating to the well-being of the enrolled child and their family.

The PuP program is designed for families in which there are many difficult life circumstances that impact on family functioning. Such problems may include mental health challenges including trauma, substance misuse, family conflict, and severe financial stress. The program is individually tailored to suit each family. Parents are given their own Parent Workbook. For many parents, this becomes a personal journal documenting their strengths and achievements. The PuP program can be delivered in families’ homes, community settings, residential treatment facilities or a combination of any of these.

SEEK utilizes pediatric primary care as an opportunity to help address social determinants of health and to prevent child maltreatment in families who may have risk factors for child maltreatment. Most children receive this care and there are frequent visits in the first 5 years. Also, the generally good relationship between health professionals and parents offers an opportunity to identify and help address prevalent psychosocial problems. By addressing these problems, SEEK aims to also help strengthen families, support parents and parenting, and promote children's health, development, and safety.

SEEK begins with training professionals to play this role. Online videos and other materials are available on the SEEK website. Continuing Medical Education (CME) credit is offered as well as Maintenance of Certification (MOC) Categories 2 and 4 and Performance Improvement (PI) credits (through the American Board of Pediatrics and the American Board of Family Medicine). The revised SEEK Parent Questionnaire-R (PQ-R) is a tool to screen for the targeted problems: parental depression, substance abuse, major stress, intimate partner violence, food insecurity, and harsh punishment. It is completed in advance and given to the professional at the start of a regular checkup.

The trained professional then briefly assesses and initially addresses identified risk factors and makes necessary referrals to community resources, ideally with the help of a behavioral health professional. Principles of Motivational Interviewing have been incorporated into SEEK. SEEK Parent Handouts are available as adjuncts to advice offered in the visit.

SafeCare® is an in-home parent training program that targets risk factors for child neglect and physical abuse in which parents are taught skills in three module areas: (1) how to interact in a positive manner with their children, to plan activities, and respond appropriately to challenging child behaviors, (2) to recognize hazards in the home in order to improve the home environment, and (3) to recognize and respond to symptoms of illness and injury, in addition to keeping good health records. All three modules should be used in the implementation of SafeCare®; any modifications to or elimination of modules need to be discussed with the program developers.

Boys Town In-Home Family Services (BT-IHFS) is an in-home parent skills-based service for parents/caregivers with children at-risk for involvement in the child welfare system or out-of-home placement. The program includes family engagement, assessment, service planning, parent and life skills training using an adapted version of Common Sense Parenting®, assisting with resources and supports, and case closure planning. BT-IHFS was developed to serve families with high caregiver strain, ineffective parenting strategies, difficulty accessing formal and informal supports, and children with significant emotional and behavioral needs. The BT-IHFS program has a hypothesized theory of change that starts with the provision of individualized, needs-driven services to families with a focus on building strong relationships through quick engagement interactions. The primary method is to provide coaching on parenting skills and connect the family to needed community resources or supports.

C.A.R.E.S. is a community-based prevention and diversion program utilizing Wraparound Family Team Conferencing to successfully engage and serve families who are at risk of child abuse and neglect. C.A.R.E.S.' mission is to "Protect Children, Strengthen Families and Change Lives, Whatever it Takes!" C.A.R.E.S.' goal is to engage and build upon families' strengths using the Wraparound Principles of practice to prevent families from entering or penetrating deeper into the formal child welfare and/or juvenile justice system. C.A.R.E.S. engages the family, identifies strengths and needs, convenes customized Family Team Meetings inclusive of natural and community supports, and drafts an individualized and well-coordinated plan of care to improve family functioning, reduce the likelihood of child abuse and neglect with a focus on family strengthening and measurable goals and outcomes that result in family stabilization and preservation.

CPC-CBT: Empowering Families Who Are at Risk for Physical Abuse is a short-term (16-20 sessions), strength-based therapy program for children ages 3-17 and their parents (or caregivers) in families where parents engage in a continuum of coercive parenting strategies. These families can include those who have been substantiated for physical abuse, those who have had multiple unsubstantiated referrals, and those who fear they may lose control with their child. Children may present with PTSD symptoms, depression, externalizing behaviors and a host of difficulties that are targeted within CPC-CBT. The program is grounded in cognitive behavioral theory and incorporates elements (e.g., trauma narrative and processing, positive reinforcement, timeout, behavioral contracting) from CBT models for families who have experienced sexual abuse, physical abuse, and/or domestic violence, as well as elements from motivational, family systems, trauma, and developmental theories. CPC-CBT helps the child heal from the trauma of the physical abuse, empowers and motivates parents to modulate their emotions and use effective non-coercive parenting strategies, and strengthens parent-child relationships while helping families stop the cycle of violence.

DCCTF'S Effective Black Parenting Program (EBPP; Authored by CICC) is a parenting skill-building program created specifically for parents of African-American children. It was originally designed as a 15-session program to be used with small groups of parents. A one-day seminar version of the program for large numbers of parents has been created. EBPP is disseminated via instructor training workshops conducted nationwide.

Exchange Parent Aide program consists of trained, professionally supervised individuals (volunteer or paid) who provide supportive and educational in-home services to families at risk of child abuse and neglect. Agencies elect to use paid and/or volunteer Parent Aides to provide services based on their community needs and resources. Services are strength-based and family-centered. Auxiliary services enhance service delivery (e.g., group-based parenting classes). Model components include:

• An Initial Needs Assessment (INA) describing family dynamics, patterns of coping, abuse histories, and immediate needs
• A family treatment plan focusing on the program’s four goal areas:
• Child safety
• Problem solving skills
• Parenting skills
• Social support
• Matching families with a professionally trained and supervised Parent Aide who provides weekly home visits.

Programs select parenting curricula based on the needs of the families with a priority on using curricula with an evidence-base, when available. An extensive accreditation process is required of Exchange Parent Aide programs.

FC is a multifaceted, home-based service program that works with families in their homes and in the context of their neighborhoods to help them meet the basic needs of their children and prevent child maltreatment. Nine practice principles guide FC interventions: ecological developmental framework; community outreach; individualized family assessment and tailored interventions; helping alliance; empowerment principles; strengths-based practice; cultural competence; outcome-driven service plans with SMART goals; and a focus on the competence of the practitioner. Individualized family intervention is geared to increase protective factors, decrease risk factors, and target child safety, well-being, and permanency outcomes.

MPAP is a comprehensive curriculum designed to strengthen parenting skills and provide support to highly stressed parents of children from birth to 8 years of age. Grounded in the Strengthening Families Protective Factors Framework that aims to reduce the potential for child abuse, MPAP helps parents gain the tools to manage their own life challenges while developing skills to nurture the physical, social, emotional, and cognitive development of their children. MPAP brings parents together to share and normalize their parenting experiences, learn about typical early childhood development and parenting strategies, and develop a support network.

Parents meet in two-hour interactive discussion sessions for 12 weeks in small groups, facilitated by professional parent educators. Topics range from self-care to child development and dealing with challenging behaviors.

Haga de la Paternidad un Placer is a culturally adapted, Spanish-language version of Make Parenting a Pleasure for Spanish speaking families.

The Nurturing Parenting Program for Parents and their School Age Children 5 to 11 Years is a 15-session program that is group-based, and family-centered. During group sessions, parents and their children attend separate groups that meet concurrently. Each session is scheduled for 2.5 hours with a 20-minute break in which parents and children get together and have fun.

The lessons in the program are based on the known parenting behaviors that contribute to child maltreatment:

• Inappropriate parental expectations
• Parental lack of empathy in meeting the needs of their children
• Strong belief in the use of corporal punishment
• Reversing parent-child family roles
• Oppressing children's power and independence

Assessment (pre, process, and post) of parent's parenting and child rearing beliefs, knowledge, and skills allows the program facilitators to measure the attainment of lesson competencies.

Parents Anonymous® is designed to be both a prevention and treatment program that strengthens families that are at risk of becoming (or already are) involved in the child welfare system, have behavioral health challenges, substance use disorders or face other family issues. It is open to any parent or caregiver in a parenting role who is seeking emotional support, personal growth and change, and to improve parent, child and youth well-being regardless of the age or special challenges of their children or youth including severe emotional concerns. Services include weekly support groups, peer parent partner services (such as advocacy, kinship navigator services, in-home parenting, and supportive services including linkages to community resources), and helpline services. The Parents Anonymous® program aims to mitigate the impact of Adverse Childhood Experiences (ACEs) for parents/caregivers and prevent the occurrence of ACEs for their children and teens. The program also aims to build on the strengths of all family members and enhance family well-being by increasing protective factors through trauma-informed practices and decreasing risks, substance abuse, and domestic violence.

Safe Families for Children (SFFC) serves parents of any age by supporting them through temporary hosting of children, mentoring, and friendship through a network of approved volunteer families. Minor children ages 0 to 18 are eligible for hosting with the consent of the parent, and some host families are willing to host a single parent and child together in their home. In order to qualify for services, a parent must be experiencing a crisis such as homelessness, substance abuse, mental health issues, domestic violence, medical problems, incarceration, parental stress, or another situation that makes it difficult for the parent to adequately and safely care for their child. The parent must be willing to comply with requirements and sign the necessary consent forms allowing the Host Family to care for the child, must be willing to maintain contact with the child and work for the child to be returned home, and the crisis presented should be able to be resolved in a reasonable amount of time (less than six months) unless there are extenuating circumstances.

The Step-by-Step Parenting Program® breaks down essential child-care skills for children from birth to about 3 years or age into small steps. A wide-range of parenting skills are covered related to child health, safety, and development, including: newborn care; feeding and nutrition; diapering; bathing; home and sleep safety; first aid; toilet training; parent-child interactions; and positive behavior support. The Step-by-Step Parenting Program® combines the Step-by-Step Parenting Program Manual, instructions, modelling, roleplaying, and performance feedback to help teach the parents the above skills. The 238-page Step-by-Step Child-Care Parenting Program Manual includes over 50 step-by-step child-care checklists developed with the input of pediatric health care professionals and consumers, and corresponding picture books for about half of these skills.