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April 2019Vol. 20, No. 3Spotlight on National Child Abuse Prevention Month

This month's issue of CBX highlights National Child Abuse Prevention Month. Read a message from Jerry Milner, Associate Commissioner of the Children's Bureau, that highlights the need to reflect on what can be done within our professional and private lives to help create the conditions for strong and thriving families and communities where children are safe from abuse and neglect. The issue also includes a variety of resources and publications for professionals and families that focus on the importance of preventing child maltreatment.

Issue Spotlight

  • Strong and Thriving Families and Communities Are Our Best Prevention Strategy

    Strong and Thriving Families and Communities Are Our Best Prevention Strategy

    Written by Jerry Milner

    Every April, we pause to reflect on the importance of preventing child maltreatment. Across the nation events are held, stories are shared, and often calls to service or action are made. Our heartstrings are pulled by photos of children with forlorn expressions and sad eyes. For many, the month offers a look at life conditions and experiences that are much different from our own. To those outside the field—and unfortunately for a good number of those within the field—this causes a rush to judgement. How could a parent mistreat a beautiful child like the one on the poster, brochure, or film? What kind of person would do physical harm to a child of any age? It is unfathomable to most of us that a parent might hurt his or her child.

    The prevailing narrative is that children are in foster care because they have bad parents that have hurt them.

    That judgment is often inaccurate.

    The truth is, most parents with children in foster care have not hurt their children physically. Data tell us that neglect is a factor for more than 60 percent of children placed in foster care. Physical abuse and sexual abuse are the cause for placement for approximately 15 percent of cases.

    Neglect is not always intentional; it is largely preventable; and its effects can often be mitigated. This should give us hope and reason to believe we can help prevent maltreatment if we focus our energy and resources in the correct places. The Children's Bureau strongly believes that families and communities are the precise places we need to focus our energy and resources if we are serious about preventing child maltreatment. 

    Neglect is not caused by poverty, but there are deep associations. Poverty can leave families vulnerable due to lack of resources, increased stressors, social isolation, and inadequate access to support services. Often, neglect occurs when a parent or parents simply do not have the skills or knowledge to meet their child's needs due to lack of experience or abilities that have been eroded due to a combination of other difficult circumstances that may be present in their lives.

    Yet, in order to take the issue on, we rally around the idea of the bad parents who do harm and take pseudocriminal approaches. We rally around the idea of preventing a tragic event. We usually do not rally around confronting intergenerational cycles of trauma, concentrated poverty, and the lack of family and community supports. We do not rally around actions being guided by the social determinants of health, which we know impact the long-term health, resiliency, and well-being of children and families. In each of our professional positions, we touch upon the social determinants of health in one way or another. In each of our professional positions, our acts can either help alleviate or exacerbate trauma, and in each of our professional positions, we can rush to judgement or rush to provide support.

    Life can be hard, even when we have all the resources we need, and not everyone has chosen the life circumstances they are confronting. Knowing that people are affected by what happens to them should influence our practices in child welfare, including child protective services investigations and interviews, legal representation, the manner in which parents and youth are treated by the bench, interactions with caseworkers, and parent-child engagement in case planning and placement decisions.

    The availability of nonstigmatic, universally available basic family supports—including, for example, mentoring programs, after school programs for youth, Early Head Start programs coupled with parent skill building and/or adult education programs, nurse home visiting, and high-quality legal representation for parents and families—can serve to normalize the process of asking for help and offer the hope of strengthening protective factors in families and communities.

    This prevention month, I ask that we all reflect on what we can do within our professional and private lives to help create the conditions for strong and thriving families and communities where children are free from harm.


  • Rethinking How We Promote Child and Family Well-Being

    Rethinking How We Promote Child and Family Well-Being

    Written by Jerry Milner

    We are at a crossroads in child welfare. For generations, we have removed children from their families and placed them in foster care as our primary intervention in the hopes that we were doing the right thing. We know, now, that although we may have prevented children from experiencing one kind of harm, in many cases we caused other forms—including loss and trauma—which are considered adverse childhood experiences.

    I believe that we can change the way we protect and support children in this country and that the best way to support children is to support their families. 

    Right now, we typically respond only after families have lost much of their protective capacity, and children have been harmed. We need to create environments where families get the support they need before harm occurs. This calls for a reconceptualization of the mission and functioning of child welfare systems.

    Tweaking what we already have in place won't solve the problems. By working together and pooling our ideas and creative energies, we can change child welfare to create environments where children and families thrive. Child welfare can and should be a support for families, not a substitute for parents, and not a source of trauma and loss. Strengthening the well-being of children and their parents so that we have strong and thriving families is what child welfare should be all about.

    The 21st National Conference on Child Abuse and Neglect, which will be held April 24-26 in Washington, DC, brings together more than 1,400 child welfare staff, child maltreatment prevention partners, parents, and community members from around the country to explore strategies for making this vision for strong and thriving families a reality. Workshops, skills seminars, and poster presentations are just a few of the session formats that will be featured during the 3-day event.

    Visit the conference website at to learn more.


  • Community-Based Child Abuse Prevention Programs: Collaborating to Strengthen Families

    Community-Based Child Abuse Prevention Programs: Collaborating to Strengthen Families

    Written by Julie Fliss, M.S.W., child welfare program specialist, Office on Child Abuse and Neglect, Children's Bureau

    When families are able to meet their basic and emotional needs and access supports within their communities, it promotes healthy child development and well-being. Families face stressors every day—including dealing with a sick child, single parenting, lacking quality child care, having unstable housing, being unemployed, and more—that challenge their ability to care for their child, making them vulnerable to child abuse and neglect. The presence of protective factors, or attributes of individuals, families, communities, or the larger society, mitigate this risk and help to safeguard child from maltreatment.

    Throughout the nation, states and communities are working together with parents and community leaders to identify and implement effective services that build protective factors and prevent child abuse and neglect. This includes Community-Based Child Abuse Prevention (CBCAP) programs, authorized by title II of the Child Abuse Prevention and Treatment Act (as amended by Public Law 111-320). The purpose of the CBCAP program is to support community-based efforts to implement resources and activities that strengthen families and reduce the likelihood of child maltreatment. Examples of funded programs include family resource or support, voluntary home visiting, respite care, parent education, mutual support, and other community programs or networks of programs to support families.

    CBCAP is currently the only source of federal funding for primary prevention, with $37.7 million allocated to states in fiscal year 2018. All 50 states, the District of Columbia, and Puerto Rico currently receive CBCAP funding. The governor of each state designates a lead agency to oversee the implementation of the CBCAP program. In addition, 1 percent of funding is set aside for tribal and migrant programs, of which three were funded in fiscal year 2016 for 5 years.

    Given the limited funding available for prevention services, CBCAP programs build upon existing interagency collaborative efforts and seek new partnerships with other public and private organizations serving the same populations and sharing the same goals and objectives. CBCAP programs further emphasize the importance of parent leadership and the inclusion of parents as full partners in collaborative efforts. This includes strategic, long-term, and outcome-focused planning to promote systems change to enhance the well-being of families and prevent child maltreatment.

    The Children's Bureau (CB) oversees the CBCAP program and identifies CBCAP lead agencies as key partners in its efforts to prioritize the primary prevention of child abuse and neglect. CB's vision is to reorient child welfare to focus on strengthening families through prevention at the community level. Because the provision of prevention services and emphasis on parent engagement are strong components of the CBCAP program, enhanced coordination between the state's child welfare agency and the CBCAP lead agency will greatly contribute to overall child welfare system improvement. Thus, CBCAP lead agencies are uniquely positioned to help make CB's vision a reality.

    One example of this is Kentucky, where the CBCAP funds are used for Community Collaborations for Children (CCC), a program targeting families with children at risk for neglect. CCC is a partnership between child welfare, community-based services, schools, and parents to implement parent engagement meetings, during which participants work together with the family to identify barriers to the child's school attendance, as well as proactive strategies to address them. This initiative has proven quite effective and deferred 74.5 percent (195) of families who participated in a parent engagement meeting from being referred to the child welfare agency. As a result of the success of this collaboration, Kentucky is in the process of expanding the program to other communities.   

    The development of 2020-2024 Child and Families Services Plan (CFSP) is another opportunity where CBCAP can inform state efforts to focus more on prevention. As active participants in the development of the CFSP, CBCAP lead agencies offer expertise on effective practices to strengthen families to prevent child maltreatment. This will prove valuable as states work to create a shared vision to better partner with families and support them with achieving positive outcomes.

    For more information on CBCAP, including how to identify the CBCAP lead agency in your state, please visit the website for the FRIENDS National Center for CBCAP at

    Recent Issues

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    Spotlight on National Child Abuse Prevention Month

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News From the Children's Bureau

Read about what's new for this year's National Child Abuse Prevention Month; a Child Welfare Information Gateway podcast that discusses how a Washington, DC, agency improved its community prevention response to child abuse and neglect; and a list of the latest additions to the CB website.

  • CB Website Updates

    CB Website Updates

    The Children's Bureau website hosts information on child welfare programs, funding, monitoring, training and technical assistance, laws, statistics, research, federal reporting, and much more.

    Recent additions to the site include the following:

    Visit the Children's Bureau website often to see what's new.

  • Podcast Looks at DC's Effort to Improve, Streamline Community-Based Prevention

    Podcast Looks at DC's Effort to Improve, Streamline Community-Based Prevention

    A Child Welfare Information Gateway podcast details how the Washington, DC, Child and Family Services Agency (CFSA) reorganized its community collaboratives to improve local child abuse and neglect prevention efforts.

    In an interview with Information Gateway, CFSA deputy director of community partnerships Robert Matthews discusses how CFSA partnered with the Department of Behavioral Health (DBH) and the Department of Human Services (DHS) to improve the community prevention response across DC's city wards. This partnership is called the DC Cross-Connect program. Under CFSA's Community-Based Child Abuse Prevention program, the city had previously organized community collaboratives around the Promoting Safe and Stable Families program. CFSA reorganized after a recent assessment suggested those collaborative arrangements were not serving DC families well, particularly with regard to case management and clinical interventions.

    As CFSA deputy director Matthews explains, the city wanted to develop a more flexible service array. The assessment was based on a community survey, CFSA's geographic information system, and a partnership with Casey Family Programs to study family resource centers across the United States. The process revealed that CFSA families needed access to more quality mental health services to address issues such as substance use, depression, and domestic violence. The assessment also showed that there was only one grocery store in one of the city's larger wards. "It's really about identifying services, finding the service gaps, then identifying the additional partners you need to bring to the table to then develop a more robust prevention model," Matthews says. This led to the agreement that CFSA should rewrite its contracts with its community partners to more clearly spell out its expectations. This in turn resulted in an increase in the number of family support workers from different collaboratives, which allowed for an expansion of services to families. 

    "If you're looking at a family that needs to be connected to TANF [Temporary Assistance for Needy Families] benefits, or if you have a family that needs to be linked with mental health services, and then you have a family that also has an open case with CFSA because of abuse and neglect. All of those case plans could overwhelm the family," Matthews explains. To remedy this, CFSA has proposed moving to one universal case plan that would "bring all of your community partners together" to prioritize what the family should work on first based on social worker recommendations. When this is done, families avoid having to do everything at once and can instead take gradual steps toward certain goals. When they complete goals with one agency, that agency can "step out," and the family can continue working with the other two.

    To learn more about how DC Cross-Connect works to identify priorities and implement universal case plans for families in need, listen to the podcast at

  • April Is National Child Abuse Prevention Month

    April Is National Child Abuse Prevention Month

    Every April, the Children's Bureau observes National Child Abuse Prevention Month to raise public awareness of child abuse and neglect, recommit efforts and resources aimed at protecting children and strengthening families, and promote community involvement through activities that support the cause. The theme of this year's National Child Abuse Prevention Month initiative mirrors the theme of the 21st National Conference on Child Abuse and Neglect, "Strong and Thriving Families," and focuses on helping individuals and organizations in every community strengthen families and prevent child abuse and neglect.

    This year's initiative also highlights 2019 Prevention Resource Guide: Strong and Thriving Families, which is intended to support child welfare service providers in their work with parents, caregivers, and children to strengthen families and prevent child maltreatment. It was developed through a partnership between the Office on Child Abuse and Neglect within the Children's Bureau, Child Welfare Information Gateway, and the FRIENDS National Center for Community-Based Child Abuse Prevention (CBCAP).

    This year, the Prevention Resource Guide features the following updates:

    • New CBCAP state examples that highlight a different protective factor
    • Hard copy versions of the tip sheets, "Finding Housing Help for Your Family" and "Preparing Your Family for an Emergency," which previously were only available online
    • Updated child maltreatment statistics

    The information and resources available in this year's Prevention Resource Guide can be used all year to help professionals and families prevent maltreatment and work toward improved child and family well-being. For more information on National Child Abuse Prevention Month and to view or order a copy of the 2019 Prevention Resource Guide, visit the National Child Abuse Prevention Month website at

    Additional information and resources on child abuse and neglect prevention, protecting children from risk of abuse, and strengthening families can be accessed on the Preventing Child Abuse and Neglect section of the Child Welfare Information Gateway website at

Child Welfare Research

We highlight a recent study that aimed to evaluate the efficacy of interventions in preventing child maltreatment and a review of parenting education programs and their effectiveness in reducing repeat cases of child physical abuse.

  • Review Shows Parenting Programs Reduce Recurrence of Physical Child Abuse

    Review Shows Parenting Programs Reduce Recurrence of Physical Child Abuse

    An article in Clinical Child and Family Psychology Review presents a comprehensive review and meta-analysis of 14 randomized control trials (RCTs) for parenting programs. The  review was conducted to provide an updated synthesis of the research on the role of parenting programs in preventing recurrence of physical child abuse and to overcome the methodological limitations of prior analyses. The RCTs evaluated eight different social learning theory-based behavioral parent training programs that seek to increase child health and safety and break the cycles of coerciveness in parent-child interactions. The review findings showed that evidence these programs are effective in reducing repeat cases of child physical abuse.

    The authors emphasized the importance of sharing these findings with policymakers and practitioners given the serious long-term health effects and enormous societal costs of child maltreatment and its potential for intergenerational transmission.

    "Parenting Programs for the Prevention of Child Physical Abuse Recurrence: A Systematic Review and Meta-Analysis," by Kristina Vlahovicova, G.J. Melendez-Torres, Patty Leijten, Wendy Knerr, and Frances Gardner (Clinical Child and Family Psychology Review, 20), is available at

  • Review of Primary Care Interventions to Prevent Child Maltreatment

    Review of Primary Care Interventions to Prevent Child Maltreatment

    Child maltreatment can have long-lasting, negative physical and mental health outcomes for children and youth. It can also contribute to worse outcomes well into adulthood, such as lower performance in school and increased chance of drug use and alcohol abuse. Many agencies and organizations across the country focus on prevention or interventions to stop child maltreatment. 

    A recent review in the Journal of the American Medical Association aimed to evaluate the efficacy of interventions in preventing child maltreatment by assessing existing studies on the topic. The review assessed the following: (1) whether programs to prevent child maltreatment that could occur in a primary care setting or through a referral from a primary care clinician could reduce exposure to maltreatment, improve well-being, or reduce mortality and (2) what the harms of those interventions are. The evidence base spans over three decades, and almost all studies included had a home visiting component.

    The review found there was no significant association between interventions and reports to child protective services within 1 year of completion. Neither were there any significant associations between interventions and outcomes for emergency room visits, school performance, child development, or mortality. There was insufficient evidence of any effect on other outcomes or on any potential harm interventions can cause.

    "Primary Care Interventions to Prevent Child Maltreatment: Updated Evidence Report and Systematic Review for the U.S. Preventative Services Task Force," by Meera Viswanathan et al. (Journal of the American Medical Association, 320) is available at (505 KB).

Strategies and Tools for Practice

This section of CBX offers publications, articles, reports, toolkits, and other resources that provide either evidence-based strategies or other concrete help to child welfare and related professionals.

  • Helping Communities Leverage Public, Private Resources to Fight Child Neglect

    Helping Communities Leverage Public, Private Resources to Fight Child Neglect

    The FRIENDS National Center for Community-Based Child Abuse Prevention (CBCAP) offers multiple resources to help communities combat child neglect by partnering with public and private organizations and agencies that address the problems often at the root of neglect—extreme poverty, substance use, mental health disorders, and domestic violence.

    The CBCAP program directs lead agencies to marshal the resources of other entities serving the same populations and sharing the same goals. The FRIENDS webpage Leveraging Public Systems to Prevent Neglect ( identifies the following sectors as potential partners in preventing child neglect and providing early intervention when needed:

    • Medical and behavioral health
    • Early childhood education and schools
    • Economic aid/poverty reduction
    • Housing/homelessness
    • Job training/employment skills
    • Financial literacy
    • Domestic violence

    The webpage also discusses the role of community initiatives, intergenerational approaches, and the use of differential or alternative response in combatting child neglect.

  • Implementation Planning: Myth vs. Reality

    Implementation Planning: Myth vs. Reality

    Written by the Children's Bureau's Capacity Building Center for States

    When an agency is ready to implement a new program or set of practices (i.e., an intervention), crafting an implementation plan with clear steps for preparing the agency, building capacity, and rolling out the intervention lays the groundwork for success. However, many agencies are unclear about what a comprehensive implementation plan contains and how it can help them achieve their goals.

    This article debunks common misconceptions about implementation planning and shares tips based on research and practice experience. (A Center brief Change and Implementation in Practice: Implementation Planning and Capacity Building contains more information and strategies that can help agencies develop a comprehensive implementation plan as part of their change and implementation processes.)

    Myth #1: An implementation plan is just another name for a work plan or schedule for implementing the selected intervention.

    Reality: While an implementation plan includes a work plan, it goes beyond a schedule of activities to "tell the story" of how implementation is expected to play out. An implementation plan reflects critical thinking about how the intervention is expected to lead to desired outcomes, what types of support and capacity building (e.g., training, system partnerships) are needed to strengthen implementation, and how testing and piloting can inform improvements before the full rollout. Suggested plan elements include the following:

    • Background and contextual information (problem statement, theory of change, and description of the target population)
    • Intervention overview (description of the intervention, its purpose, underlying principles, core components, and evidence base)
    • Implementation team (team members, their roles, and the teaming structure)
    • Readiness assessment (key findings from a prior assessment of organizational readiness for the intervention, including strengths and needs)
    • Work plan (document that outlines activities for before and during implementation), which includes activities for the following:
      • Completing the adaptation or design of the intervention
      • Building capacity for implementation and strengthening motivation and buy-in
      • Usability testing and piloting the intervention
      • Staging and scaling up the intervention
    • Data collection, evaluation, and continuous quality improvement plans (preliminary information on how implementation will be monitored and how data will be used to adjust implementation and make improvements)
    • Engagement and communication strategies (explanation of how the team will keep leadership and stakeholders at all levels informed and engaged)
    • Anticipated challenges and approaches to address them (proactive identification of how to overcome potential barriers)

    Myth #2: A team can write an implementation plan before figuring out what the intervention will look like and what needs to be tested.

    Reality: Although not all the elements (listed above) must be finalized before an implementation plan can be created, teams should have done some critical thinking about selecting a well-defined intervention, its purpose and core components, and its initial testing. Beginning work on an implementation plan even if some preparatory work isn't complete can help the agency identify gaps and begin to understand where additional work needs to be done. For example, if the agency doesn't yet have an evaluation plan or communication strategies, the implementation plan can spell out the steps needed to create them.

    Myth #3: Once an agency has created an implementation plan, it is reckless to deviate from what has already been thoughtfully planned out.

    Reality: We simply don't know everything that should inform the implementation plan up front. Implementation plans are dynamic and evolving documents. Teams may develop their plans incrementally, adding sections as additional information becomes available (e.g., evaluation plan details, communication strategies). Teams also may need to modify plans over time to respond to new developments.

    Taking the time to mindfully craft an implementation plan and adjusting it in response to new information can save time in the long run and avert wasted resources. With a thoughtful and nimble implementation plan in place, agencies can pave the way to a successful implementation process.

    For more information on implementation planning as part of a change and implementation process, visit the Change and Implementation in Practice webpage on the Center for States website.


  • Maltreatment Prevention Strategic Plan

    Maltreatment Prevention Strategic Plan

    The incidence of child maltreatment in Iowa remains above the national rate. Victims of maltreatment and those who are exposed to household dysfunctions, such as domestic violence or substance use, have a higher risk for long-term poor physical, mental, and financial health outcomes. In an effort to reduce the incidence rate, the Iowa Department of Human Services instructed Prevent Child Abuse Iowa (PCA Iowa) to conduct a comprehensive needs assessment and develop a strategic plan for maltreatment prevention in the state. The plan includes principles for implementation and future growth as well as goals and funding notes.

    The needs assessment included the input of over 900 prevention professionals, parents, and youth. From this feedback, PCA Iowa identified the following recommendations:

    • Coordinate maltreatment prevention funding sources across multiple service sectors and work collaboratively to identify common goals, services, and quality standards using the strategic plan as a starting point.
    • Reduce child maltreatment by targeting risk factors within families and making information available and accessible about services that address these risk factors.
    • Increase workforce development in cultural competence, evidence-based practices, and trauma-informed prevention and care.

    These recommendations informed the strategic plan's vision and guiding principles, which include the following:

    • Impact—Prioritize prevention work that has the greatest impact on families and communities.
    • Cultural competence—Engage diverse stakeholders to plan, implement, and evaluate prevention activities and provide services that meet the social, cultural, and linguistic needs of families. 
    • Collaboration—Encourage various disciplines and providers to work together and target interventions based on the needs and risk factors identified by each community.
    • Data-informed decision-making—Use data to evaluate and improve upon prevention services.
    • Innovation—Support new and emerging prevention practices.

    Organizations and other stakeholders can use this strategic plan to inform their own planning goals, activities, and implementation processes. 

    Iowa Maltreatment Prevention Strategic Plan is available at (993 KB)


This section of CBX provides a quick list of interesting resources, such as websites, videos, journals, funding or scholarship opportunities, or other materials that can be used in the field or with families.

  • Child Sexual Abuse Training for Caregivers and Youth-Serving Organizations

    Child Sexual Abuse Training for Caregivers and Youth-Serving Organizations

    Stop It Now!, an organization dedicated to preventing the sexual abuse of children, created Circles of Safety, a collection of trainings ranging from 2-hour workshops to day-long events, live webinars, and on-demand learning. With topics covering healthy sexuality, warning signs, and more, a variety of people—from parents to teachers to child welfare professionals—can educate themselves and help prevent sexual abuse in children.

    Circles of Safety aims to build capacity and effective prevention policies, practices, and programming in organizations; create and share practical education resources and tools; and address barriers and misconceptions that could prevent these tools and policies from being as effective as they could be. Users can watch on-demand training videos on development and warning signs or participate in webinars. A back catalog of webinars and in-person training are also available. 

    Visit Stop It Now! at to learn more about the available online and in-person Circle of Safety trainings.

  • Speak Up Be Safe Prevention Education Curriculum

    Speak Up Be Safe Prevention Education Curriculum

    Childhelp's Speak Up Be Safe is a research- and evidence-based curriculum that aims to teach children and teens from prekindergarten through grade 12 about the how to prevent or interrupt cycles of child abuse and neglect and bullying. The program also encourages engagement from parents and other caregivers, teachers, school administrators, and community stakeholders.  

    As a school-based program, Speak Up Be Safe uses trained and certified facilitators to deliver age-appropriate lessons twice a year via a virtual campus. It also provides online facilitator training modules; teacher reinforcement activities; and resources for parents, teachers, school administrators, and community members to help implement the curriculum in schools.

    To help children be confident regarding their safety and the safety of their peers, Speak Up Be Safe provides them with the knowledge and skills they need to approach a safe adult if they should ever be in an unsafe position, resistance strategies that can be used until he or she can get a hold of a safe adult, key safety rules, and how to recognize unsafe situations. Older youth learn about preventive approaches and their increasing responsibility to care for their own safety in settings where they may be at risk for abuse.

    To learn more about Speak Up Be Safe, go to

    Related Item

    How You Can Help Someone Who Is Being Abused or Neglected is a tip sheet available through Child Welfare Information Gateway that teaches children and youth about the signs of abuse and neglect and what to do if they or someone they know is not safe.

Training and Conferences

Find trainings, workshops, webinars, and other opportunities for professionals and families to learn about how to improve the lives of children and youth as well as a listing of upcoming events and conferences.