Programs

Child-Adult Relationship Enhancement (CARE)

Type of Approach:

  • Group
  • Individual
  • Mixed

Provider Education Level:

  • Bachelors Degree
  • Masters Degree
  • Other
  • Para-professional

Length:

  • Greater than 12 weeks
  • Less than 12 weeks

Trauma Type:

  • Child Abuse
  • Disrupted Attachment
  • Domestic Violence
  • Multiple
  • Other

Trauma Symptom:

Setting:

  • Day Care
  • Domestic Violence Shelter
  • Headstart and Early Education Programs
  • Home
  • Homeless Shelter
  • Hospital-based
  • Other
  • Other Community Settings
  • School

Notes:

Type of services:

This intervention utilizes live coaching of adult caregivers and their children based on a modification of Parent-Child Interaction Therapy (PCIT). CARE is a skill-based intervention to enhance the adult-child relationship. Skills are taught by live coaching and caregivers practicing skills in pairs and small groups while trainers observe and coach. When children are available, direct practice is done with the child instead of role-play.

CARE is not appropriate for extreme disruptive behavior or aggression; it is not a stand-alone “treatment” intervention.

Types of providers:

Developed to be used by non-clinical professionals working with traumatized children and their adult care- givers. Providers working with CARE include:

  • domestic violence advocates
  • home visitors
  • graduate students in education, social work and
  • psychology; medical students and residents
  • social service caseworkers
  • staff at homeless shelters
  • day care providers
  • medical care providers, residents, fellows
  • foster parents
  • child protection workers
  • teachers
Program setting:

Wide variety of settings including domestic violence shelters and homeless shelters

Length of program/number of sessions:

Ongoing service (versus specified number of treatment sessions); CARE skills can be taught in approximately 3-6 hours and can be done in a group setting.

Type(s) of trauma addressed:

Interpersonal complex trauma, acute trauma, exposure to domestic violence

Theoretical basis/core principles:

CARE uses the three P principles (Praise, Paraphrase, and Point-Out Behavior) to connect children with their caregivers. CARE teaches effective positive commands and strategies for caregivers to redirect problematic behaviors. CARE includes a trauma education component to help caregivers understand behaviors associated with trauma and the appropriate application of these skills within the context of trauma.

Additional information:

The National Center on Family Homelessness and the Trauma Center at the Justice Resource Institute (JRI) worked collaboratively to adapt CARE for use in homeless shelter settings.

Unique/Innovative Characteristics:

Domestic violence advocates are being trained to use this intervention.

This intervention can be delivered by non-clinical professionals in a variety of settings.

While there are a limited number of professionals qualified to conduct PCIT, CARE allows broader access and application of core PCIT principles that have been shown to be effective with children experiencing behavioral problems/trauma. In addition, some families can not commit to the average 14-20 sessions for PCIT.

* Information for this summary was abstracted from the NCTSN publication, Trauma-Informed Interventions: Clinical and Research Evidence and Culture-Specific Information Project, www.cinncinnatichildrens.org, and other documents.

Date Added/Updated:

6/15/12

Age:

  • 0-5 (Early Childhood)
  • 13-17 (Adolescent)
  • 18-25 (Young Adult)
  • 25 and up (Adult)
  • 6-12 (Childhood)

Language:

  • English
  • Spanish

Ethnic Racial Group:

  • Unspecified
  • White

Caregivers Included:

  • Extended Family
  • Father
  • Foster Parent
  • Mother
  • Other
  • Step Parents

Population Adaptations:

Age range of children:

2-12 years old

Adult caregiver included in intervention:

Adults who have contact with children

Ethnic/racial and other groups served:

No specific information provided

Languages available:

English and Spanish

Foundation:

CARE uses the three P principles (Praise, Paraphrase, and Point-Out Behavior) to connect children with their caregivers. CARE teaches effective positive commands and strategies for caregivers to redirect problematic behaviors. CARE includes a trauma education component to help caregivers understand behaviors associated with trauma and the appropriate application of these skills within the context of trauma.

Evaluation Studies:

There is no evaluation research of the CARE adaptation of parent-child interaction therapy. There are numerous evaluations of PCIT (refer to the PCIT review for more information).

Evaluation studies in progress:

Dr. Erica Pearl and colleagues are conducting a trial to evaluate CARE in the Philadelphia foster care system.

Rated/Reviewed by Evidence Based Registries:

National Child Traumatic Stress Network Empirically Supportive Treatments and Promising Practices

Training Contact:

Erica Pearl, PsyD; e-mail: erica.pearl@cchmc.org

Training Notes:

Training manuals/protocols:

Yes

Child Adult Relationship Enhancement Manual, Trauma Treatment Training Center, Cincinnati Children’s Hospital (www.cincinnatichildrens.org)

Contact:

Erica Pearl, PsyD; e-mail: erica.pearl@cchmc.org

Training available:

Through the Trauma Treatment Training Center at Cincinnati’s Children’s Hospital and the National Center on Family Homelessness

Training costs:

Contact for individual/agency rates

Languages:

English; being adapted in Spanish

Program Contact