Family-Based Services

Family support programs address a wide range of family types and problems including the prevention of child abuse and neglect and placement into foster care. The establishment of a family support program such as “Healthy Start” (e.g., Breakey & Pratt, 1991; Roebuck, 2007) or a family-based treatment service like Homebuilders (see https://www.institutefamily.org/) refl ects a philosophical stance that a society should be willing to invest as many or more resources in prevention of problems in parenting as it would spend treating those problems or placing children in out of home care. Implementing these programs also rests on the assumption that they can actually achieve their noble goals (the evidence base for these programs will be discussed later). The distinguishing feature of many of these programs is the provision of a wide variety of selective or indicated preventive interventions to children and families in the home and community setting. (Both of these programs will be described in the next section.)

Within the broad framework of Family Support or FBS programs there is wide variation across the nation in the kind of interventions, duration of services, size of caseloads, and components of service that characterize these programs. Even the goals are not always the same as some are specifi cally aimed at preventing child abuse (e.g., Healthy Families America) and others support broader health and developmental outcomes, with child abuse prevention a hoped for byproduct (e.g., Nurse Family Partnership). Perhaps this is one of the reasons why research fi ndings on family support and family-based service programs have appeared inconsistent-despite some common purposes, there is considerable variation in the service characteristics of these programs. This chapter endeavors to explore that variation.