What are some evidence-based programs that help promote safety, permanency, and well-being?

Child protection agencies and their system partners have invested historically in programs that support the needs of children in foster care and their families, with varying attention paid to the effectiveness of these programs. Over the past decade, however, increasing attention has been given to developing, testing, and adopting a growing list of evidence-informed and evidence-based programs aimed at meeting child and family needs at all stages of the child welfare system — and also outside of child protection agency involvement as a prevention strategy.

The demand for evidence-based programs, particularly primary and secondary prevention programs, has been driven by a number of factors, including: a growing recognition of the importance of keeping children safe in their homes and communities; advancing a population-based approach to child welfare; and adhering to the goals and values of the 2018 Family First Prevention Services Act, which heralded a fundamental shift toward investment in effective interventions that prevent children’s entry into foster care.¹

Program clearinghouses and databases

Publicly accessible clearinghouses and catalogs can be useful tools to help identify, navigate, and evaluate the research evidence for child welfare prevention services. The Title IV-E Prevention Services Clearinghouse was developed in concert with Family First to rate the evidence available for prevention-based practices. As of September 2024, the clearinghouse has reviewed 189 programs and service models — 89 of which have been rated as promising, supported, or well-supported. The clearinghouse continues to review submissions of new services — as well as new evidence of existing programs — on a rolling basis.

This information packet highlights a selection of programs that the Title IV-E Prevention Services Clearinghouse has rated as supportive or well-supported.

Primary and secondary prevention

A growing number of child protection agencies and their partners are shifting their services toward a public health model that provides families primary and secondary support for the prevention of child maltreatment. Primary prevention programs are directed at the general population, with the goal of preventing child abuse and neglect from occurring in the first place. Secondary prevention programs focus on individuals or families with child maltreatment risk factors, such as substance use disorders or domestic abuse, making involvement with the child welfare system more likely.

Primary prevention

Examples of primary prevention programs rated as supported or well-supported by research, according to the Title IV-E Prevention Services Clearinghouse, include:

• Family Check-Up^®: This home-based, strengths-based intervention aims to improve parenting skills and family dynamics, and includes an ecological family assessment, tailored feedback, and follow-up services.
• Nurse-Family Partnership: A home visiting program for young, first-time, low-income parents, it focuses on prevention-based health practices, parenting skills, goal setting, and education and career planning.
• Triple P – Positive Parenting Program® – Online (Level 4): Consisting of eight online modules, this intervention provides parents with the tools and support to teach children new skills, manage difficult behaviors, and encourage positive behaviors.

Secondary prevention

Examples of secondary prevention programs rated as supported or well-supported by research, according to the Title IV-E Prevention Services Clearinghouse, include:

• Child First: Through this intervention, home-based psychotherapy and care coordination are provided by a mental health clinician and care coordinator.
• Families First (Utah Youth Village Model): Offering home-based parent education to support family strengths and improve family functioning, Families First provides links to community resources and a focus on social skills, communication, discipline, and healthy boundaries.
• Functional Family Therapy: Offered in a clinic or at home, this intervention is designed for youth with behavioral or emotional challenges, and their families.
• Healthy Families America: This home visiting program for families at risk of adverse childhood experiences or child maltreatment offers screening/assessments, intensive services, and links to medical and community resources.
• Parent-Child Interaction Therapy: This program relies on live coaching by a trained therapist to improve parents’ behavior management, the parent-child relationship, child behavioral and emotional functioning, and parent mental/emotional health.
• Parents as Teachers: This home-visiting parent education program aims to increase understanding of child development, improve parenting skills, identify developmental delays and health issues, prevent child maltreatment, increase school readiness, and increase access to community resources.
• SafeCare: A behavioral parenting program offered in the home to caregivers of young children at risk of child maltreatment, SafeCare promotes a safe home environment, supports positive parent-child interactions, and seeks to increase caregiver responsiveness to child illnesses or injuries.

Tertiary prevention

Tertiary prevention services are provided to families that already have come in contact with a child protection agency, with the goal of preventing unnecessary family separation and recurrence of child maltreatment. Some secondary prevention programs — such as Functional Family Therapy, Parent-Child Interaction Therapy, and SafeCare — also can be tertiary interventions. Behavioral management and family therapy programs play an instrumental role in both prevention and permanency, On the front end, they can prevent the need for a child to be removed from the home, and on the back end, they can help stabilize families to increase the likelihood of permanency. Some tertiary programs rated as supported or well-supported by research evidence, according to the Title IV-E Prevention Services Clearinghouse, include:

• Brief Strategic Family Therapy: Using a structured family systems approach, program counselors aim to promote more effective family interactions in families with children displaying challenging behaviors, including emotional conduct and substance use disorders.
• Dialectical Behavioral Therapy®: A form of cognitive-behavioral treatment, this program is comprised of four different components designed to help adolescents and adults regulate their emotions and improve their interpersonal relationships.
• Multidimensional Family Therapy: This intervention seeks to improve child well-being and family functioning through an integrated therapy model, focusing on adolescents and young adults with substance use and behavioral/emotional health challenges.
• Multisystemic Therapy: Following an ecological assessment of the youth, their family, school, and community, service providers personalize intervention strategies to address the key drivers of the youth’s negative behaviors.

Other tertiary interventions support reunification, especially through home visiting, allowing families to receive services in their natural environment and providing safety supports as children transition back into their families. Some rated as supported or well-supported by research, according to the Title IV-E Prevention Services Clearinghouse, include:

• Homebuilders^®: Through intensive in-home counseling and skill building, Homebuilders has shown positive impacts in preventing out-of-home placement and achieving and maintaining permanency.
• Intercept®: Intensive in-home services are offered through an integrated, trauma-informed approach to children at risk of entry/re-entry into out-of-home placements or who are currently in an out-of-home placement.
• Sobriety Treatment and Recovery Teams: Serving families already involved with child welfare, this program — also known by its acronym, START — combines home visiting with substance use disorder treatment, parent coaching, case management, and counseling.

Additional resources

In addition to the Title IV-E Prevention Services Clearinghouse, other resources share research and analysis of evidence-based programs related to child welfare.

• The Chadwick Center for Children and Families at Rady Children’s Hospital-San Diego hosts the California Evidence-Based Clearinghouse for Child Welfare, which child welfare system across the country use as an important reference and resource. The center also created a Guide to Comparing Clearinghouses for Evidence-based Programs, which includes a list of 12 different clearinghouses for evidence-based programs relevant to child welfare.
• The National Quality Improvement Center for Adoption & Guardianship Support and Preservation has an Intervention and Program Catalog (2024).
• Upbring, in partnership with Casey Family Programs, produced the Evidence-Based and Promising Interventions for Preventing Child Fatalities and Severe Child Injuries Related to Child Maltreatment in 2017.
• Casey Family Programs also produced the new research brief, Interventions Shown to be Effective with Children and Families of Color and LGBTQ2SI+ Persons Who May be Served with Family First Funding (Second Edition).
• The Washington State Institute for Public Policy offers an Updated Inventory of Evidence-Based, Research-Based, and Promising Practices: For Prevention and Intervention Services for Children and Juveniles in the Child Welfare, Juvenile Justice, and Mental Health Systems (dated September 2020).

1 Content of this brief was informed through consultation in July 2024 with researchers at Chapin Hall: Clare Anderson, Senior Policy Fellow; Brian Chor, Research Fellow; Jennifer O’Brien, Senior Policy Fellow; and Gailyn Thomas, Policy Fellow.