There have been numerous studies conducted to develop and validate SafeCare or extensions of the model. The three primary modules of SafeCare have each been validated with single-case studies: parent-child interaction and use of planned activities (Lutzker, Megson, Webb, & Dachman, 1985; Dachman, Halasz, Bickett, & Lutzker, 1984; Cordon, Lutzker, Bigelow, & Doctor, 1998); home safety to reduce home hazards (Tertinger, Greene, & Luztker, 1984; Barone, Greene, & Lutzker, 1986; Metchikian, Mink, Bigelow, Lutzker, & Doctor, 1999); and health-care skills (Delgado & Lutzker, 1988; Bigelow & Lutzker, 2000). Additionally, an uncontrolled group trial of SafeCare found that parents showed significant change in the behaviors targeted by the SafeCare model, that is, improved safety, health, and parenting skills (Gershater-Molko, Lutzker, & Wesch, 2003). In this study, the number of home hazards was reduced by 78% for maltreating families, and there was an 84% increase in the use of the parenting skills taught.
In terms of child maltreatment outcomes, Lutzker and colleagues (Gershater-Molko, Lutzker, & Wesch, 2002; Wesch & Lutzker, 1991) compared families receiving SafeCare services to families receiving standard family preservation services in California, and found that SafeCare families were significantly less likely to have a recurrence of child maltreatment (15% over three years) compared to services-as-usual families (44% over three years). Similar reductions in neglect were found in an evaluation of Project 12-ways, the predecessor of SafeCare (Wesch & Lutzker, 1991).
Four randomized trials of SafeCare have recently been completed, and each has found benefit of SafeCare relative to other services or to a no treatment control. The largest study was a statewide comparative effectiveness trial of SafeCare in the Oklahoma child welfare system. In that trial, the six service regions of Oklahoma were matched and randomized to continue with services as usual (SAU), a six-month intensive family preservation program with a case management focus or to deliver SafeCare as part of family preservation services. Over 2100 families were enrolled in the study, and were followed for up to seven years post-enrollment. SafeCare reduced child maltreatment recidivism by about 26% relative to SAU (Chaffin, Hecht, Bard, Silovsky, & Beasley, 2012) among parents of children ages 0-5 (the primary target of SafeCare).
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