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April 2012Vol. 13, No. 3Preventing Maltreatment in High-Risk Families

A home visiting program modified for high-risk rural families demonstrated mixed results in reducing risk factors and subsequent child welfare reports in a recent study published in Children and Youth Services Review. The study examined the effectiveness of SafeCare+ (SC+), a version of the SafeCare home visiting program in which professionals are trained to identify risks for immediate child maltreatment and use motivational interviewing to address issues unique to high-risk families (e.g., substance abuse, domestic violence, mental health problems, and multiple other risks). SC+ was also adapted for rural families by employing home visitors from within the community who know and have access to formal and informal networks and services.

The study included 105 families with children under age 5 who were not involved in active child welfare cases, had two or fewer previous reports of child maltreatment, and had at least one risk factor (parental substance abuse, mental health issues, or interpersonal violence). Families were randomly assigned to receive either SC+ or standard home-based community mental health services. When compared to families receiving standard services, SC+ families:

  • Received more services and were more engaged in and satisfied with services
  • Reported better parenting skills, such as addressing home hazards, reducing child health and behavior problems, and using nonviolent parenting strategies
  • Reported fewer depressive symptoms and more family resources and social supports
  • Received the same number of subsequent child welfare reports, although time to first report was twice as long
  • Received fewer reports related to domestic violence

Although SC+ families experienced positive outcomes immediately after receiving services, the authors suggested those outcomes were temporary because services were not offered long enough to sustain improvements. One encouraging finding is that families who fully completed the SC+ program achieved better outcomes than those who partially completed the program. To improve SC+ results in rural communities, the authors recommended the program provide services for longer periods of time, offer "booster sessions" after intervention, and connect families to informal sources of support to help them sustain positive outcomes.

"Prevention of Child Maltreatment in High-risk Rural Families: A Randomized Clinical Trial With Child Welfare Outcomes," by J. F. Silovsky, D. Bard, M. Chaffin, D. Hecht, L. Burris, and A. Owora et al., was published in Children and Youth Services Review, 33(8), and is available on the ScienceDirect website: