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In-Home Services in 

Child Welfare

ISSUE BRIEF

March 2014

WHAT’S INSIDE

What are in-home 

services?

Importance of 

in-home services

In-home services 

delivery

In-home services 

funding

Evaluation

Examples of promising 

programs and practices

Conclusion

References

In-home services play an important role in safety and 

permanence for the majority of families that receive 

a report of child maltreatment and for other families 

also at risk. This issue brief provides an overview of 

child welfare in-home services and examines issues 

related to service delivery, funding, and program 

evaluation. The brief is designed to provide child 

welfare administrators, policymakers, and related 

professionals with information about the types of 

child welfare in-home services that are being used in 

the field and what the evidence shows about them.

The majority of children who come to the attention 

of child welfare agencies because of possible abuse 

or neglect are not removed from their families 

but, instead, receive services in their homes and 

communities. Research shows that families whose 

children remain in the home after a maltreatment 

investigation often have significant service needs 

(U.S. Department of Health and Human Services, 

Administration for Children and Families, Office of 

Planning, Research and Evaluation, 2013). In-home 

services can play an important role in supporting 

the safety, permanence, and well-being of children in 

child welfare. These services also can be provided to 

families whose children have been placed in out-ofhome care, both to promote reunification and prevent 

future disruption and reentry into care (Sangmoo, 

Jonson-Reid, & Drake, 2012).
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The U.S. Department of Health and Human Services 

(HHS) reports that the number of children in foster care 

decreased by about 23 percent between Federal fiscal 

year (FFY) 2002, when the total number of children 

in care was around 523,000, and FFY 2011, when the 

number was around 401,000 (HHS, 2012a). This decline 

can partially be attributed to increasingly lower national 

child maltreatment rates (Finkelhor, Jones, & Shattuck, 

2009). However, there has also been a growing emphasis 

on keeping children in their homes, whenever it is safe to 

do so, by providing support and services to strengthen 

families. Data indicate that 79 percent of children who 

came to the attention of a child welfare agency during 

FFY 2011 received in-home services (HHS, 2012b). Due 

to this increased emphasis on providing services geared 

toward maintaining children with their families, field 

professionals must have an understanding of how these 

programs and practices are being used.

What Are In-Home Services? 

In-home services are provided to children and families 

who have been reported to child protective services 

(CPS) for possible child abuse or neglect and who are 

assessed as being able to benefit from services delivered 

in the home. These are generally families who have an 

“open case” with the child welfare agency and whose 

children remain at home or have returned home from 

out-of-home care. The services may be voluntary or courtordered, and they encompass an array of interventions 

and supports provided directly by, or on behalf of, a 

child welfare agency to all children in a family to ensure 

their safety and promote well-being (HHS, 2009). In some 

cases, the allegations of child maltreatment have been 

substantiated, but the child is not in immediate danger. 

In other cases, allegations have not been substantiated, 

but services are offered to help the parents improve the 

home situation. Other cases involve children who return 

home after a stay in foster care; in these cases, the child 

welfare agency strives to ensure that parents can provide 

the safety and care that children need to live at home and 

prevent reentry of the children into care.

The term “in-home” refers to the location where the child 

and family are residing and not necessarily to the place 

where services are delivered; therefore, in-home services 

may be provided in the community, a relative’s home, 

or such places as a counseling center or child welfare 

agency. 

Home visiting programs can be included as part of 

an in-home services plan; however, it is important to 

distinguish them from in-home services. Home visiting is 

generally used as a preventative approach with high-risk 

populations, such as teen parents and families with infants 

and young children. Such programs do not necessarily 

focus on issues associated with child maltreatment. 

However, some home visiting programs do address the 

needs of families receiving in-home services and can be 

used or adapted for a child welfare population. (See Child 

Welfare Information Gateway’s Home Visiting web section 

at https://www.childwelfare.gov/preventing/programs/

types/homevisit.cfm for more information.) 

Importance of In-Home Services 

The primary goal of in-home services is to strengthen and 

support the family in order to maintain children with their 

families whenever it can be done safely. Providing such 

services also keeps children near their support system of 

friends, siblings, extended family, and school. Through 

in-home services, appropriate resources can help parents 

focus on addressing the issues that led—or could lead—

to abuse or neglect.

Removing children from their families is disruptive and 

traumatic and can have long-lasting, negative effects. 

There are a number of stressors for a child that are 

associated with removal and can add to the initial 

trauma of maltreatment, including dealing with the 

substantiation of abuse and/or neglect findings and 

having to cope with parental loss (Schneider & Phares, 

2005). One research study found that when children 

were assigned to CPS investigators with relatively high 

rates of removing children from home, they were more 

likely to be placed in foster care, and they eventually 

had higher delinquency and teen birth rates and lower 
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earnings than similar children assigned to investigators 

with low removal rates (Doyle, 2007). Another study, 

which examined posttraumatic stress symptoms among 

children referred to child welfare agencies for abuse and 

neglect investigations, found that there were higher rates 

of symptoms among children placed in out-of-home 

care than those who received in-home services (Kolko et 

al., 2010). Given the added trauma and poor outcomes 

associated with a child’s removal from his or her family, 

it is important for the child welfare field to develop and 

deliver effective in-home services that can contribute to 

stabilizing and strengthening the family to prevent the 

need for out-of-home care whenever possible.

In-Home Services Delivery 

There is significant variety in both the delivery and 

types of in-home services that a family may receive. In 

addition, a distinction should be made between in-home 

programs and services: Services may be provided 

through basic agency practice, while programs are 

often an enhancement for specific types of families. An 

agency may offer an in-home service or services without 

contracting for or providing specific programs.

When Are In-Home Services Initiated? 

When a report of child maltreatment is filed with CPS, 

intake workers screen the report to determine if there 

is a valid safety concern, and, if so, recommend that 

the family receive either an investigation or a family 

assessment. In either case, a safety and risk assessment 

is done to determine how safe children are in their 

homes and the level of risk for future harm. These safety 

and risk assessments, often accompanied by a more 

comprehensive family assessment, are used to determine 

a family’s needs for in-home services and to develop a 

case plan.

Some child welfare agencies use a differential or 

alternative response approach to child abuse reports, 

in which the agency conducts either a traditional 

investigation (investigation track) or an assessment 

alternative (assessment track) with families, depending on 

a number of factors (Child Welfare Information Gateway, 

2008). This is primarily determined by the severity of 

the allegation, with low- to moderate-risk cases being 

more likely to follow an assessment track. Research has 

found that children and families on assessment tracks 

are more likely to receive in-home services (Shusterman, 

Hollinshead, Fluke, & Yuan, 2005; Loman & Siegel, 2004a; 

Hernandez & Barrett, 1996), participate in a higher 

number of services (Loman & Siegel, 2004a; Loman & 

Siegel, 2004b), obtain services earlier (Siegel & Loman, 

2000), and take advantage of community resources (Siegel 

& Loman, 2000; Loman & Siegel, 2004b; Hernandez & 

Barrett, 1996). In some States, families can be referred to 

in-home services without CPS involvement.

Who Delivers In-Home Services? 

Caseworkers initiate service delivery by first engaging 

families and working with them to assess strengths, 

needs, and resources. This collaboration is intended 

to develop a plan that addresses the issues that have 

brought the family to the attention of CPS and to identify 

relevant services. In some instances, caseworkers may 

provide in-home services directly to families. Caseworkers 

can also facilitate contact between community-based 

service providers and families. 

Who Receives In-Home Services? 

As noted, in-home services are provided to children 

and families who have open cases with the child 

welfare agency and whose children remain at home 

or have returned home from out-of-home care. The 

majority receive some type of in-home services. Child 

Maltreatment 2012 includes national and State statistics 

on children and families who received prevention services 

or postresponse services other than foster care (HHS, 

2013). In 2012, 45 States reported that approximately 

3.2 million children received prevention services. In 

addition, 46 States reported that 232,517 victims of 

child maltreatment (61.4 percent of all victims) received 

in-home services only, and 45 States reported that 709,377 

nonvictims (87.5 percent of nonvictims) received in-home 

services only.
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Research has indicated that there are racial and economic 

disparities for in-home service provision, such that some 

populations are more likely to receive in-home services 

and less likely to experience foster care, when compared 

to other populations. For example, compared to other 

racial groups, Asian and White families are more likely 

while African-American families are less likely to receive 

in-home services (U.S. Government Accountability Office, 

2007). A Texas study showed that Hispanic children are 

less likely to receive in-home services than White children 

(Texas Health and Human Services Commission, 2006). 

Additionally, lower income families are less likely to 

receive services than families with higher incomes (Fluke, 

Chabot, Fallon, MacLaurin, & Blackstock, 2010).

What Types of Services Are Included? 

In-home services are geared toward meeting the 

following goals: 

 Ensuring children’s safety

 Strengthening parental capacity

 Improving caretaking and coping skills

 Supporting healthy and nurturing relationships

 Fostering physical, mental, and educational well-being 

(HHS, 2009)

 Enhancing the potential for permanency

These goals may be achieved by targeting family-specific 

challenges, such as parental substance abuse, parental 

depression, supervision issues, negative parent-child 

interactions, poor physical conditions in the home, and 

economic challenges. 

The in-home services to address these challenges may 

include information or referrals for tangible and intangible 

support, such as the following: 

 Support with parenting, including parent training, 

coaching, or skill-building 

 Individual and/or family therapy 

 Referral for substance abuse treatment and skillbuilding to enhance coping/replacement behaviors

 Referral for mental or behavioral health treatment 

and support in applying treatment gains to family 

management and child safety

 Information and referral for job training

 Assistance with child care, transportation, budgeting, 

etc.

 Concrete assistance, such as food, clothing, furniture, 

or housing

Services can be delivered in the home or in another 

environment that is familiar and comfortable for the 

family.

Voluntary vs. Court-Ordered In-Home 

Services 

In-home services can be delivered either on a voluntary 

basis—meaning that family members have agreed to 

participate of their own accord—or as the result of a court 

order—meaning that a judge has mandated a family’s 

participation. When services are mandated by a court 

order and parents refuse to cooperate, the result is usually 

the removal of the child or children from the home and 

placement into out-of-home care. Policies regarding 

whether services can be delivered on a voluntary and/or 

court-ordered basis vary by State.

Research indicates that service utilization and 

engagement can be influenced by whether participation 

is voluntary or court-ordered. Caseworkers may encounter 

difficulties when attempting to engage families in 

voluntary services because potential participants may 

view the services as either intrusive or unlikely to provide 

useful benefits (Daro, McCurdy, & Nelson, 2005). On 

the other hand, research has found that caregivers 

receiving mandated services express feeling a lack of 

empowerment regarding their abilities to influence the 

service plan and that case plans with service receipt 

mandates are not designed to take into account systemic 

family issues or the unique stressors faced by individual 

parents (Fuino, Coulter, VandeWeerd, Armstrong, & 

Gorski, 2012). However, research has shown that case 

outcomes do not differ solely based on whether services 
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are voluntary or court-ordered (Jones, Becker, & Falk, 

1999; Jones & Becker, 2000). 

In-Home Services Funding 

Currently, funding is more available for out-of-home 

services than in-home services, despite the cost savings 

that can result from in-home services.

Funding Sources for In-Home Services 

Most States use multiple Federal funding sources 

to support in-home services. Federal programs that 

provide funding for in-home services include Medicaid, 

Temporary Assistance for Needy Families (TANF), the 

Child Abuse Prevention and Treatment Act (CAPTA) 

Community-Based Child Abuse Prevention (CBCAP) 

program, the Promoting Safe and Stable Families subprogram of title IV-B, and the title V Maternal and Child 

Health Services Block Grant (NGA Center for Best 

Practices, 2002).

In 1994, Congress authorized the Department of Health 

and Human Services to approve waivers to title IV-E funds, 

which had previously only been allocated for use for foster 

care placement and maintenance and adoption funding. 

Waivers allow States to use title IV-E foster care funds as 

needed. Some States are opting to use IV-E funding for 

preventive in-home services.

Some in-home services may be reimbursable under 

a family’s personal health insurance plan, and that 

possibility may be explored before State, county, or local 

dollars are used. Insurance-covered services are primarily 

focused on reunification and crisis stabilization (before 

or after residential placement) but may also be used 

for intensive in-home services with a strong therapeutic 

component targeted at preventing placement of children 

outside the home. Most agencies that provide in-home 

services have been working to increase staff licensure in 

order to build their pool of reimbursable practitioners.

Costs 

A large proportion of Federal funding for child welfare 

programs goes toward maintaining children in foster care. 

In 2012, $4.3 billion of Federal funding went to States for 

foster care, while $900 million was provided to States 

through the Social Services Block Grant (SSBG) for States 

to use for a range of social services, including prevention 

and in-home services. These SSBG funds also needed to 

cover daycare, housing, adoption, Independent Living 

services, and much more for vulnerable families. Another 

$2.2 billion of Federal funds went to States for other 

social services, including family preservation and support, 

juvenile justice, child welfare services and training, and 

a variety of other children and family services program 

(Isaacs, Edelstein, Hahn, Toran, & Steuerle, 2013). Because 

so much of the Federal funding goes to maintaining 

children in foster care, States often provide much of 

their own funding for in-home services. For instance, in 

2011, Arizona spent $11.5 million on contracted in-home 

services; 91 percent of that amount came from State 

general funds, while only 9 percent came from Federal 

funds (Office of the Auditor General, State of Arizona, 

2012).

Investing more money in foster care prevention services 

may alleviate the financial burdens of funding outof-home care (Casey Family Programs, 2009). One 

cost-savings analysis of an evidence-based parenting 

education program in Louisiana showed that statewide 

implementation led to cost neutrality in a short period of 

time, meaning that the child welfare department should 

be able to absorb all costs through reductions in repeat 

maltreatment, which would lead to greater savings in the 

long run (Maher, Corwin, Hodnett, & Faulk, 2012). 
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The National Resource Center for 

In-Home Services

The National Resource Center (NRC) for In-Home 

Services is a service of the Children’s Bureau 

and a member of the Bureau’s national Training 

and Technical Assistance (T&TA) Network. The 

NRC serves as a central repository for up-to-date 

information on in-home services. It also provides 

free, onsite technical assistance and training 

to States and Tribes to assist them in building 

systemic capacity to provide effective family 

preservation and post-reunification services, 

through the implementation of evidence-based 

practices and by strengthening systems of care. In 

addition to offering ongoing technical assistance 

to States and Tribes, the NRC for In-Home 

Services develops new resources on pertinent 

in-home services issues and continues to facilitate 

peer-to-peer networking and knowledge 

exchange. More information on the NRC for 

In-Home Services can be found on the center’s 

website:

http://nrcinhome.socialwork.uiowa.edu/

Three other NRCs in the T&TA Network also offer 

relevant training and support:

 The NRC for Child Protective Services provides 

T&TA to help public child welfare agencies 

improve child protection practice (see http://

nrccps.org). 

 The FRIENDS NRC for Community-Based Child 

Abuse Prevention (CBCAP) provides T&TA to 

CBCAP organizations and serves as a resource 

to the child abuse prevention community (see 

http://friendsnrc.org/).

 The NRC for Permanency and Family 

Connections offers T&TA to build capacity in 

child welfare systems to enhance child and 

family outcomes pertinent to permanency 

achievement, placement stability, and a wide 

range of other foster care and well-being 

issues (see http://www.nrcpfc.org).

Evaluation 

Evaluation of in-home services has proven to be 

challenging because these services generally include a 

number of practices and programs provided “in milieu”—

in the context of an overall child welfare services effort. 

In addition, in comparison to out-of-home services such 

as foster care, there has been less information gathered 

about in-home services delivery; less consensus about 

in-home definitions, terminology, and measures; and 

fewer reporting requirements, resulting in a mixed picture 

of in-home services provision at State and local levels. 

Researchers have had greater success in evaluating 

specific in-home services programs. Evidence-based 

programs are those that have been evaluated for 

effectiveness and shown to produce positive outcomes. 

Programs can be evaluated in controlled settings but 

also must lead to positive results when implemented 

on a larger scale, across multiple communities. While 

real-world program evaluation is essential, it presents 

challenges because it occurs in a more complex, less 

controlled, and less resource-rich environment (Matone et 

al., 2013). 

Supporting Effective In-Home Services 

Results from Round Two of the Child and Family Services 

Reviews (CFSRs)1 indicated that, overall, States are 

performing poorly with regard to the provision of in-home 

services. More specifically, an aggregate report of Round 

Two findings showed that foster care cases were more 

likely than in-home services cases to substantially achieve 

positive outcomes and to be rated as a “strength” on 

measured items (HHS, 2011). These results have spurred 

initiatives in the field aimed at improving the overall 

approach that child welfare agencies use to provide 

in-home support to families. 

1 The CFSRs are periodic Federal reviews of State child welfare systems 

to (1) ensure conformity with Federal child welfare requirements, (2) 

determine what is actually happening to children and families engaged in 

child welfare services, and (3) assist States in helping children and families 

achieve positive outcomes. See http://www.acf.hhs.gov/programs/cb/

monitoring/child-family-services-reviews. 
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In-home services must be implemented within an 

effective child welfare system in order to increase the 

likelihood that they will lead to positive results for children 

and families. In order to form a strong foundation for 

delivering effective in-home services, agencies need to 

provide high-quality social work practice and supervision, 

a well-trained and supported workforce, an array of strong 

and diverse services, and good community partnerships.

Quality in-home social work practice should be familycentered, engaging children and families as active 

partners in strengths-based assessments and shared 

decision-making. Engagement through family team 

meetings allows caseworkers to better understand 

specific needs, connect families to appropriate services, 

and utilize interpersonal and community supports. 

Once in-home services are implemented, caseworkers 

should monitor and track progress so that they can work 

with families to adjust case plans to maximize service 

effectiveness. 

A diverse service array is necessary in order for child 

welfare agencies to meet the unique needs of the children 

and families that they serve. Being able to provide an 

array of family support, family preservation, and postreunification services enables agencies to provide 

individualized treatment so that children can remain safely 

in their homes. A diverse service array includes programs 

that can address physical, emotional, social, mental, 

developmental, and educational needs of children, 

youth, and families while taking into account key systemic 

factors, such as individual, family, and community 

circumstances that affect service delivery.

Finally, active community partnerships are important 

for effective in-home services delivery, as families often 

can benefit from support and assistance of multiple 

community providers working together to provide the 

needed services.

Examples of Promising Programs and 

Practices

While a solid agency framework is necessary for quality 

in-home services delivery, certain programs and casework 

practice approaches fit well within the above-outlined 

framework and have shown to be effective for producing 

positive outcomes in children and families. This section 

provides some examples of in-home services practices 

and programs being used by States in order to keep 

children safely with their families. 

[Ratings from the California Evidence-Based 

Clearinghouse (CEBC) are provided where available. The 

CEBC evaluates child welfare programs and assigns them 

a score on a scientific rating scale of 1 (well supported by 

research evidence) to 5 (a concerning practice). See http://

www.cebc4cw.org/ratings/scientific-rating-scale.] 

Solution-Based Casework is an approach to assessment, 

case planning, and ongoing casework that encompasses 

many of the tenets of high-quality practice. This approach 

combines problem-focused relapse prevention with 

solution-focused techniques to address everyday 

events in the life of a family that present difficulties. 

This integration of approaches can foster partnerships 

between families, caseworkers, and service providers, 

and these relationships can address each family’s unique 

needs. In a retrospective case review of 4,559 public child 

welfare cases, researchers found that cases that showed 

high fidelity to the Solutions-Based Casework model also 

had significantly better outcomes in safety, permanency, 

and well-being—even exceeding Federal standards—

compared to cases that showed low fidelity to the model 

(Antle, Christensen, van Zyl, & Barbee, 2012). 

[The CEBC gives Solution-Based Casework a rating of 3 

(promising research evidence).]

Motivational Interviewing is targeted toward caregivers 

of children who have been referred to the child welfare 

system. The program uses a directive, client-centered 

method aimed at enhancing caregiver’s intrinsic 

motivation for behavior change. Research has shown 
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Motivational Interviewing to be effective at improving 

caregiver substance abuse outcomes, and it has been 

found to be especially effective when used prior to other 

treatments as a means of motivating clients to participate 

in other programs. In a meta-analysis of 119 studies of 

Motivational Interviewing—most aimed at addressing 

addictive behaviors—researchers found that it brought 

about “small but significant effects” and significantly 

increased clients’ engagement in treatment and their 

intention to change (Lundahl, Kunz, Brownell, Tollefson, & 

Burke, 2010).

[The CEBC gives Motivational Interviewing a rating of 1 

(well supported by research evidence).]

Signs of Safety is a strengths-based, safety-focused 

practice approach that provides a framework for workers 

to engage professionals, families, and children, with a 

primary goal of child safety. Signs of Safety expands 

the investigation of risk to encompass family strengths 

that can be built on to stabilize and improve the child’s 

and family’s situation. A one-page Signs of Safety 

assessment protocol is used to guide comprehensive risk 

assessment—assessing for both danger and strengths/

safety. Recent research from two Minnesota counties 

suggests that Signs of Safety may be related to a 

reduction in out-of-home placements for new cases, fewer 

children reentering care after being reunified with their 

families, and fewer cases reopening for services within 6 

months of case closure (Rothe, Nelson-Dusek, & Skrypek, 

2013). In Carver County, MN, which began to use a Signs 

of Safety framework in 2004, numbers of out-of-home 

placements and children in long-term care decreased, 

with new placements in 2008 less than half the 2005 rate, 

while recidivism rates trended downward as well (Turnell, 

2013).

SafeCare is an in-home parenting skills training program 

teaching child behavior management, planned activities 

training, home safety training, and child health-care skills 

training. The program was developed for parents who are 

at risk for child abuse and/or neglect and those families 

with a history of abuse and/or neglect. The goal of the 

program is to prevent child maltreatment. In a statewide 

trial of SafeCare in Oklahoma, 2,175 parents who had been 

reported for maltreatment were enrolled in SafeCare 

or services as usual and followed for approximately 6 

years. Two hundred and nineteen home visitors provided 

SafeCare services. Results showed a significantly lower 

recidivism rate for those enrolled in SafeCare compared 

to those who received services as usual (Chaffin, Hecht, 

Bard, Silovsky, & Beasley, 2012).

[The CEBC gives SafeCare a rating of 2 (supported by 

research evidence) in the category of Prevention of 

Child Abuse and Neglect (secondary) and a rating of 3 

(promising research evidence) in the category of Home 

Visiting for Child Well-Being.]

Family Connections is a multifaceted, communitybased program designed to reduce occurrences of 

child emotional and physical neglect in at-risk families. 

Interventions are tailored to family needs and comprise 

emergency assistance services, home-based service 

delivery, coordination of services targeting both risk and 

protective factors, and multifamily supportive recreational 

activities. In a study of 154 inner-city families who met 

risk criteria for child neglect and were assigned to 3 

or 9 months of Family Connections in-home services, 

research showed that the program increased and 

enhanced protective factors (e.g., parenting competence), 

diminished risk factors (e.g., parent depression), improved 

child safety, and improved child behaviors (DePanfilis & 

Dubowitz, 2005).

[The CEBC gives Family Connections a rating of 3 

(promising research evidence).]

Project Connect provides home-based counseling, 

substance abuse monitoring, nursing, and service referral 

to families affected by parental substance abuse and 

involved in the child welfare system. The goal of the 

program is to maintain children safely in their homes; 

however, it can also be used to facilitate reunification. In 

an evaluation of the program that involved 66 parents with 

substance use problems who were also involved with child 
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welfare, researchers found a number of improvements 

in measured outcomes in those that received Project 

Connect services. Outcomes associated with Project 

Connect included increased habitability of homes, 

improved caretaker mental health, increased knowledge 

of child care, lowered substance abuse risk, higher rates 

of reunification, and a shorter length of stay in out-ofhome care (Olsen, 1995).

[The CEBC gives Project Connect a rating of 3 (promising 

research evidence).]

Homebuilders is a family preservation program geared 

toward preventing the unnecessary placement of 

children in out-of-home care. The program focuses 

on building family relationships, skills training, and 

addressing concrete needs, all in a family’s natural home 

environment. Examples of relevant case activities might 

include improving the condition of the home, improving 

parental supervision, decreasing parental depression and/

or alcohol and substance abuse, or helping families to 

access community resources. In a study that compared 

Homebuilders programs with other Intensive Family 

Preservation Services (IFPS) programs in Washington 

State, researchers found that the four programs that 

showed fidelity to Homebuilders had a significant 

reduction in out-of-home placements of about 31 percent 

as well as a significant reduction in subsequent reports 

of child maltreatment. The 10 IFPS programs that did not 

show fidelity to Homebuilders showed no effects on outof-home placement numbers or recidivism (Washington 

State Institute for Public Policy, 2006). 

[The CEBC gives Homebuilders a rating of 2 (supported 

by research evidence).]

Parent-Child Interaction Therapy (PCIT) is a program 

developed to prevent physical child abuse among families 

with a history of child abuse or neglect. The program 

treats parents and children together in therapy sessions 

that focus on enhancing parent-child relationships by 

appropriately dealing with negative behaviors and 

reinforcing positive parent-child interactions. Researchers 

studied the effects of PCIT compared to community 

services (group parent training) among 110 parent-child 

dyads in which the parent had physically abused the child. 

Evaluation showed that PCIT was effective in reducing 

the likelihood of physical abuse recurrence (19 percent 

of PCIT parents and 49 percent of community services 

parents were reported for subsequent abuse). A third 

group, parents who received PCIT plus other services, 

showed a recidivism rate of 36 percent (Chaffin et al., 

2004). The program has also been shown to reduce 

parental depression and negative parenting behaviors 

(Chaffin et al., 2003). Initial evidence suggests that the 

program may be equally effective when delivered in the 

home as when done in a more controlled environment 

(Ware, McNeil, Masse, & Stevens, 2008). More information 

on the use of PCIT with at-risk families can be found in 

Child Welfare Information Gateway’s issue brief (Child 

Welfare Information Gateway, 2013):

https://www.childwelfare.gov/pubs/f_interactbulletin/f_

interactbulletin.pdf

[The CEBC gives PCIT a rating of 1 (well supported by 

research evidence).]

Conclusion 

The development and delivery of high quality in-home 

services is becoming increasingly important as States 

continue initiatives to decrease the number of children 

entering foster care. While it is important to keep children 

with their families, this can only be safely accomplished 

when agencies provide children and families with the 

supports and services necessary to address their unique 

needs. In order to prevent foster care entry, agencies 

must have strong practice foundations in which to 

implement effective in-home services and employ 

evidence-based programs that are culturally consistent 

with the families served. Finally, additional work is needed 

to develop commonly agreed upon terms and data 

measures, in order to better document the variety of 

in-home services provided and to evaluate the relative 

effectiveness of various approaches.
In-Home Services in Child Welfare https://www.childwelfare.gov

10

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Available online at https://www.childwelfare.gov/pubs/issue_briefs/inhome_services.cfm

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Suggested citation: 

Child Welfare Information Gateway. (2014). In-home 

services in child welfare. Washington, DC: U.S. Department 

of Health and Human Services, Children’s Bureau.

U.S. Department of Health and Human Services

Administration for Children and Families

Administration on Children, Youth and Families

Children’s Bureau

In-Home Services in Child Welfare https://www.childwelfare.gov