Type of services provided:
Child FIRST is a home-based, mental health intervention for children, parents and families who have or are likely to have involvement with child protection services. Child FIRST is designed for young children who have been exposed to violence and other forms of trauma and/or have social-emotional, behavioral, developmental and/or learning problems. The intervention begins with a comprehensive assessment including a history of the child’s and family’s trauma and adversities, parental challenges such as intimate partner violence, maternal depression, homelessness and substance abuse, the child’s and family’s strengths and resilience factors, the child’s past and current health and development and the caregiver-child relationship as well as other important relationships in the child’s life.
The Child FIRST model uses a team approach composed of a clinician to provide psychotherapeutic services (Child-Parent Psychotherapy) to improve the mental health of the parents, to build safe, nurturing relationships between the parents and child and promote socio-emotional and cognitive development for the child. Scaffolding of play and routines using the Abecedarian Approach are used to help the child with self-regulation and promoting executive function. The other team member, a care coordinator, facilitates connections between the family and a wide range of community-based services to stabilize families and provide ongoing support.
Birth family home, adoptive home, foster/kinship care, school settings including day care and day treatment programs, domestic violence shelters, homeless shelters, other shelters and places where children spend significant time
Length of program/number of sessions:
The intervention is usually 6-12 months. Home visits are 60-90 minute sessions twice per week during the assessment phase (first month) and then at least once a week during the intervention phase. Service intensity provided by each team member is designed to meet the unique needs of each family.
Type(s) of trauma/concerns addressed:
Children who are experiencing emotional/behavior problems including externalizing and internalizing behaviors, PTSD, difficulties in the parent-child relationship, high risk of involvement with child protection services, a child with developmental/learning problems and/or children living within families with challenges that are likely to impede a child’s emotional or cognitive development including intimate partner violence (IPV), child abuse, neglect or other forms of trauma including homelessness or a caregiver with maternal depression, substance abuse, PTSD
Education level of providers:
Master’s or Doctoral level degree, licensed mental health clinician with extensive child development background and five years of therapeutic experience with children ages 0-5 years old, or minimum Bachelor’s degree with a minimum of three years of experience working with young children, families with multiple challenges and expertise in community-based services.
Child FIRST has detailed protocols, tools and monitoring strategies for implementation and maintaining fidelity; Child FIRST accreditation is required within two years of full implementation
Data is collected in real time from all sites and technical support for data collection is available
Intimate partner violence is part of the baseline assessment and a targeted risk factor for Child FIRST intervention; several other issues that frequently co-occur in homes with intimate partner violence are also addressed including maternal depression, PTSD, substance abuse and homelessness
Mental health clinicians and care coordinators on the Child FIRST team receive 3.5 hours of clinical, reflective supervision weekly
Child FIRST implements a wraparound approach that provides hands-on assistance to access, coordinate and overcome barriers to community-based services
The Child FIRST approach is family-driven and asks families “How would you like us to help you and your family?”