Family Preservation Services: Primary and Secondary Prevention

Primary prevention programs are directed at the general population with the goal of preventing child abuse and neglect. Secondary prevention programs focus on individuals or families who are at high risk for maltreating their children.

Being removed from your family and placed in foster care is a traumatizing experience which can result in lifelong negative impacts. Even before a case begins, prevention programs can be effective in reducing the need for further system involvement. Effective prevention of child abuse and neglect requires both primary and secondary prevention approaches. Primary prevention programs, often called “universal” prevention programs are directed at the general population with the goal of preventing child abuse and neglect from occurring in the first place. Some examples of evidence-informed primary prevention approaches include: Nurse-Parent Partnership programs, Parent-Child Assistance Program and Safe Environment for Every Kid.1 Secondary prevention includes programs focused on individuals or families who are at high risk for maltreating their children and may include parent education and training, respite care and home visiting programs.2 Many of these can are considered early intervention programs. 3

For families struggling with mental or behavioral health issues, putting their children at risk for abuse or neglect, intensive family preservation services (IFPS) can prevent the unnecessary separation of families. IFPS are family-focused, community-based crisis intervention services designed to maintain children safely in their homes. IFPS are characterized by small caseloads for workers, short duration of services, 24-hour availability of staff, and the provision of services primarily in the family’s home or in another environment familiar to the family. They are often offered to families as an alternative to their children’s out-of-home placement.4

Behavioral management programs can also be an instrumental part of both prevention and permanency interventions. On the front end, they can prevent the need for a youth to be placed in out of home care due to his or her behaviors. On the back end, they can be used to help stabilize child and youth behaviors, leading to improved permanency outcomes. Two such programs that are well-supported by research evidence include Multidimensional Family Therapy and Multisystemic Therapy.

Some programs used as in-home supports to families looking to prevent removal to foster care, can also help support and stabilize foster placements, or address reunification. Other programs, such as HOMEBUILDERS® can be used to address adoption disruption and support the post-permanency needs of children in foster care.

Universal prevention programs are directed at the general population, with the goal of preventing child abuse and neglect from occurring in the first place.

  • Educate yourself on benefits of the different types of primary and secondary programs that can help prevent foster care placement and/or re-entries and dissolution.
  • Learn about programs in your community that are available to help families stay intact. Create a resource list that can be shared with others. Visit these programs to learn about what they do and who they serve. Building a relationship with coordinators and directors can help expedite future services. Ask your program to invite staff from these programs to trainings or seminars.
  • Determine whether participation in an intensive family preservation program would benefit families who are struggling with their child’s behavioral and/or mental health challenges.
  • Advocate for these programs for families and children who would benefit and if they aren’t available in your community, utilize elements of the programs that can help families.

Keeping Families Together, Corporation for Supportive Housing New York City

Keeping Families Together is an innovative program bringing together housing providers and child welfare agencies to strengthen society’s most vulnerable families and protect children. CSH’s Keeping Families Together initiative uses supportive housing to offer stability to families with children who are in danger. By providing essential supports (housing plus services) to vulnerable families, this program shows real promise in reducing public costs and reuniting children with their families in a safe, stable environment.

Outcomes from Keeping Families Together Study (2010) include:

  • 91% housing retention rates
  • 20% increase in school attendance
  • 61% reduction in open CPS cases

To learn more:

Primary Prevention Programs

Nurse-Family Partnership 5

This program provides home visits by registered nurses to first-time, low-income mothers, beginning during pregnancy and continuing through the child’s second birthday.

Parent-Child Assistance Program 6

The goals of this program are: To assist mothers in obtaining alcohol and drug treatment and staying in recovery; link mothers and their families to community resources that will help them build and maintain healthy and independent family lives; and, help mothers prevent the births of future alcohol- and drug-affected children.

Safe Environment for Every Kid (SEEK)7

SEEK utilizes pediatric primary care as an opportunity to help 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.

Triple P – Positive Parenting Program 8

As a prevention program, System Triple P helps parents learn strategies that promote social competence and self-regulation in children. Parents become better equipped to handle the stress of everyday child rearing and children become better able to respond positively to their individual developmental challenges. 

Secondary Prevention Programs

Family Connections 9

Family Connections is a multifaceted, community-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. Individualized family intervention is geared to increase protective factors, decrease risk factors, and target child safety, well-being, and permanency outcomes.

Functional Family Therapy (FFT) 10

This is a family intervention program for youth struggling with serious behavioral challenges. FFT has been applied to a wide range of problem youth and their families in various multi-ethnic, multicultural contexts. Target populations range from at-risk pre-adolescents to youth with very serious problems such as conduct disorder, violent acting-out, and substance abuse. 

The Incredible Years (IY) 11

The Incredible Years is a series of three separate, multifaceted, and developmentally based curricula for parents, teachers, and children. This series is designed to promote emotional and social competence; and to prevent, reduce, and treat behavior and emotional problems in young children. 

Parent-Child Interaction Therapy (PCIT) 12

PCIT is a dyadic behavioral intervention for children (ages 2.0 – 7.0 years) and their parents or caregivers that focuses on decreasing externalizing child behavior problems (e.g., defiance, aggression), increasing child social skills and cooperation, and improving the parent-child attachment relationship. 

SafeCare® 13

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.

Intensive Family Preservation Programs

Institute for Family Development, HOMEBUILDERS® 14

This page provides an overview of HOMEBUILDERS® and its application in mental health.  The program provides intensive, in-home crisis intervention, counseling, and life-skills education for families who have children at imminent risk of placement in state-funded care. It is the oldest and best-documented Intensive Family Preservation Services (IFPS) program in the United States. Our goal is to prevent the unnecessary out-of-home placement of children through intensive, on-site intervention, and to teach families new problem-solving skills to prevent future crises.

Multi-dimensional Family Therapy 15

MDFT is a family-based treatment system for adolescent substance use, delinquency, and related behavioral and emotional problems. Therapists work simultaneously in four interdependent domains: the adolescent, parent, family, and community.

Multi-systemic Therapy 16

Multisystemic Therapy (MST) is an intensive family and community-based treatment for serious juvenile offenders with possible substance abuse issues and their families. The primary goals are to decrease youth criminal behavior and out-of-home placements.

National Family Preservation Network, 2011 IFPS Nationwide Survey 17

The 2011 IFPS Survey Report includes findings from exemplary programs nationwide, as well as a directory of resources training and technical assistance.

Sobriety Treatment and Recovery Teams (START) 18

START is an intensive child welfare program for families with co-occurring substance use and child maltreatment delivered in an integrated manner with local addiction treatment services. START pairs child protective services (CPS) workers trained in family engagement with family mentors (peer support employees in long-term recovery) using a system-of-care and team decision-making approach with families, treatment providers, and the courts.