Safe Start:

 Promising

 Approaches

 Communities Working Together

 to Help Children

 Exposed to Violence

Safe Start:

Promising Approaches Communities 

Working Together to Help Children 

Exposed to Violence

January 2008
This publication is supported by Contract No. GS-10F-0285K awarded by the Office of Juvenile Justice and Delinquency Prevention 

(OJJDP), Office of Justice Programs, U.S. Department of Justice. Points of view or opinions in this document do not necessarily represent 

the official position or policies of OJJDP or the U.S. Department of Justice.

2 Safe Start: Promising Approaches Communities
Contents

Introduction................................................................................................................................................................. 1

The Safe Start Promising Approaches Communities..................................................................................................... 4

Bronx, New York ...................................................................................................................................................... 4

Chelsea, Massachusetts............................................................................................................................................. 6

Dallas, Texas ............................................................................................................................................................ 8

Dayton, Ohio.......................................................................................................................................................... 10

Erie, Pennsylvania................................................................................................................................................... 12

Kalamazoo, Michigan ............................................................................................................................................. 14

Miami, Florida ........................................................................................................................................................ 16

New York, New York.............................................................................................................................................. 18

Oakland, California................................................................................................................................................. 20

Pompano, Florida ................................................................................................................................................... 22

Portland, Oregon .................................................................................................................................................... 24

Providence, Rhode Island ....................................................................................................................................... 26

San Diego, California.............................................................................................................................................. 28

San Mateo, California.............................................................................................................................................. 30

Toledo, Ohio .......................................................................................................................................................... 32

Evidence-Based and Promising Interventions............................................................................................................. 35

Safe Start Center........................................................................................................................................................ 40

Introduction 3

E

very year, millions of children and adolescents are exposed 

to violence—either as direct victims or as witnesses of violent 

events—in their homes, schools, and communities. In the past 

15 years, researchers and practitioners have come to recognize that 

such exposure can negatively impact a child’s development and 

functioning. Children and young people who face early and prolonged 

exposure to violence are at greater risk for a range of learning and 

social difficulties as well as for perpetuating violence within their 

own families. 

Children confront tense and frightening events all the time, whether it 

is going to school for the first time, experiencing the death of a beloved 

grandparent, or becoming hospitalized. According to the National 

Scientific Council on the Developing Child at Harvard University1, 

worrying situations fall on a continuum, ranging from short-term, 

tolerable, and even beneficial stress to prolonged, uncontrollable 

stress, that is toxic to the child’s development. How a child responds 

to uncontrollable stress, such as being exposed to violence, may be 

sudden or gradual, visible or invisible, transitory or long lasting. The 

response depends on the frequency, intensity, and history of exposure 

as well as on environmental supports.

Most of the time adults can protect children by creating environments 

that help them manage stressful situations and learn to cope. Protective 

adults and environments build children’s resilience and can decrease—

or even prevent—the negative effects of their exposure to violence. 

In practice, this means that families, teachers, police officers, judges, 

pediatricians, child protection workers, and others can join forces and 

adopt a comprehensive system of care to confront this serious issue. 

It means that, by providing supports and specialized services to children and families who have been exposed to violence, we can reduce 

the impact violence will have on their lives.

Safe Start: Working Together to 

Help Children Exposed to Violence

In 2000, the Office of Juvenile Justice and Delinquency Prevention 

(OJJDP) and its Federal partners in the Department of Justice and the 

Department of Health and Human Services launched the Safe Start 

initiative to address the needs of children exposed to violence. The 

initiative seeks to prevent and reduce the negative consequences of 

children’s exposure to violence, as well as to create conditions that 

enhance the well-being of all children and adolescents through 

preventive interventions.

The initiative’s approach acknowledges the need to raise the awareness 

of both the problem of childhood exposure to violence and its solutions. It recognizes that we need to learn more about the prevalence 

and consequences of exposure to violence, and it calls on communities 

to put in place a “continuum of services” including prevention, early 

intervention, treatment, and crisis response. 

The Safe Start 

initiative envisions 

Federal, State, and 

local communities 

working together 

to prevent and 

reduce the impact 

of violence for all 

children. 

Safe Start’s definition of exposure 

to violence includes direct exposure 

(usually in the form of child physical, 

sexual, and emotional abuse or 

neglect) or indirect exposure (usually 

when a child witnesses family and 

community violence). 1

National Scientific Council on the Developing Child. (2005). Excessive stress 

disrupts the architecture of the developing brain (Working Paper No. 3). 

Cambridge, MA: Author.

Introduction 1
The Safe Start 

Vision...

A future in which Federal, 

State, and local communities work together to 

provide access to evidencebased services and supports 

for children exposed to 

violence and their families.

Expanding the Knowledge Base

To promote investment in the development and application of 

evidence-based practices for children exposed to violence, Safe Start 

was designed as a comprehensive national framework. The core of 

the framework is the development of phased practice components. 

Phase I—Safe Start Demonstration—engaged communities in creating 

a continuum of care. Phase II—Safe Start Promising Approaches—

draws on the findings, innovations, and experiences of the Safe Start 

Demonstration sites along with continued advancements in evidencebased practices in the exposure-to-violence field. These sites are 

engaged in a rigorous quasi-experimental evaluation that will inform 

Phase III. Phase III will replicate findings and experiences of the 

Promising Approaches sites to further evaluate and confirm results. 

Phase IV will broadly spread the effective interventions and practices 

by seeding the practice knowledge gained in Phase III in as many 

communities as possible. This final phase will continue as the knowledge transfer builds and practices are strengthened and expanded to 

effectively prevent and reduce the impact of children’s exposure to 

violence. These phases ultimately 

depend on the level of funding 

appropriated for the initiative. 

From 2000 to 2006, OJJDP funded Phase I demonstration sites in 

11 communities, tasking them with creating a comprehensive service 

delivery system to improve the accessibility, delivery, and quality 

of services for children exposed to violence and their families at any 

point of entry into the service system. Each community implemented 

a locally driven approach, using innovative strategies based on its 

unique cultural and geographic strengths and needs and service 

delivery structure.

The Safe Start demonstration communities implemented their 

strategies across five domains: 

1) Policies, procedures, and protocols 

2) Service integration activities

3) Resource development, identification, and reallocation

4) Expanded and enhanced programming 

5) Community action and awareness

2 Introduction

KNOWLEDGE BUILDING

KNOWLEDGE TRANSFER

Phase I: Safe Start Demonstration Sites

Phase II: Safe Start Promising Approaches

Phase III: Safe Start Replication

Phase IV: Seed Sites

What We Will 

Accomplish:

Understanding how 

communitities can 

successfully develop and 

implement innovative 

policy and practice 

interventions to reduce 

children’s exposure to 

violence.

What We Will Accomplish:

Provide prescriptive instructions 

for replicating proven strategies 

for reducing children’s exposure 

to violence. Assess the success 

of the replications in order to 

operationalize plans for seeding 

new sites in Phase IV.

What We Will 

Accomplish:

Understanding the impact 

of specific intervention 

strategies on outcomes 

for children and families. 

Phase II will be the first 

Phase to achieve childlevel outcome data.
A national evaluation of the sites broadened our understanding 

of how communities can successfully implement a comprehensive 

system of care to minimize the negative consequences of exposure 

to violence. 

The 11 Phase I Safe Start demonstration communities were 

Baltimore, MD; Bridgeport, CT; Chatham County, NC; Chicago, IL; 

Pinellas County, FL; Pueblo of Zuni, NM; Rochester, NY; 

San Francisco, CA; Sitka Tribe of Alaska; Spokane, WA; and 

Washington County, ME. 

Phase II began in 2005 and will run through 2009. OJJDP is funding 15 Promising Approaches communities in this phase, with each 

site implementing and measuring evidence-based practices for 

children exposed to violence within the context of the systems that 

serve them. Each of the sites integrates and sometimes expands interventions that have empirical support and/or demonstrate promising or recommended practices. A national evaluation of these sites 

will broaden our understanding of the impact of specific intervention strategies on outcomes for children and families.

The 15 Phase II communities are Bronx, NY; Chelsea, MA; Dallas, 

TX; Dayton, OH; Erie, PA; Kalamazoo, MI; Miami, FL; New York, 

NY; Oakland, CA; Pompano, FL; Portland, OR; Providence, RI; 

San Diego, CA; San Mateo, CA; and Toledo, OH. 

This booklet describes each of the 15 Safe Start Promising 

Approaches communities and outlines how these programs are 

integrating evidence-based or promising practices as well as other 

complementary interventions within their geographical, agency, 

and community contexts. An asterisk in text identifies an evidencebased or promising practice. The final section provides a brief 

description of each evidence-based and promising practice and 

lists the Safe Start Promising Approaches communities that are 

implementing the practice.

Introduction 3
At just 5 years old, Kristi has already experienced many medical 

problems. When she was 3, her doctor diagnosed her with asthma. 

A year later, she began experiencing sporadic seizures. 

Kristi’s symptoms have always been controllable, but in her first 2 weeks of 

kindergarten, she suffers three asthma attacks and a seizure. Her mother, 

Sharon, doesn’t know what to do. She doesn’t understand why her daughter’s 

health is worsening. 

But Kristi’s pediatrician, Dr. Edwards, suspects a likely cause. He knows that 

Sharon survived ongoing domestic violence while Kristi was only a toddler, 

and he thinks Kristi’s symptoms may be related to the emotional stress of 

witnessing that violence—even though it was several years ago. 

Like the many other children exposed to violence who experience physical 

symptoms, Kristi needs help soon. The earlier the root cause of her health 

problems is addressed, the better off she will be. So Dr. Edwards immediately 

refers the family to the St. Barnabas Hospital Safe Start program. 

After learning more about Sharon and Kristi’s family history through a multidisciplinary assessment, the Safe Start “medical home” team at St. Barnabas 

concludes that some of Kristi’s recent symptoms may stem from the fact that, 

having just started school, she feels insecure, scared, and cut off from her 

mother. The team educates Sharon about the possible connections between 

the emotional triggers of Kristi’s current physical symptoms and the long-term 

emotional effects of the domestic violence she witnessed as a baby. 

Safe Start staff also accompanies Sharon to meetings with Kristi’s teacher and 

guidance counselor, and mother and daughter participate in weekly parentchild psychotherapy sessions. Together, Kristi and Sharon begin the process 

of restoring a sense of safety and rebuilding the foundation of a healthy family 

that will allow Kristi to develop to her maximum potential.

4 Restoring a Sense of Safety
St. Barnabas Hospital

Family Safety Center

260 East 188 Street, 5th floor

Bronx, NY 10468

Focus:

Children exposed to community and 

family violence 

Age range:

0–6 

Interventions:

• Medical Home*

• Child Parent Psychotherapy*

• Community capacity building

BRONX, NEW YORK BRONX, NEW YORK

Interventions

Medical Home*: The Family Safety Center 

at St. Barnabas Hospital (the Center) provides 

needed medical and nonmedical services for 

the child and family. An interdisciplinary team 

comprising a general pediatrician, a developmental pediatrician, a child psychologist, and 

social workers provide medical and pediatric 

care, parenting education, counseling, 

advocacy with schools, and referrals to other 

services. The team also conducts medical, 

developmental, and psychosocial evaluations. 

The medical home maintains a centralized, 

comprehensive record of services to facilitate 

continuity and coordination of care, thereby 

expanding access and making possible more 

family-centered, culturally competent, and 

compassionate service delivery.

Child Parent Psychotherapy (CPP)*: The 

program provides an hour of weekly dyadic 

psychotherapy over 12 months. The goal of 

the CPP model is to restore the child-parent 

relationship as well as the child’s mental health 

and developmental progression, which may 

have been damaged by the experience of 

violence. Child-parent interactions are the 

focus of six intervention modalities aimed at 

restoring a sense of mastery, security, and 

growth as well as promoting congruence 

among bodily sensations, feelings, and thinking on the part of both child and parent in their 

relationship with each other. 

Community capacity building: The Center 

has developed a directory of resources and 

provides ongoing training for community 

pediatricians and others to improve the 

identification of children exposed to violence. 

It also publishes a brochure of information 

on medical home concepts for domestic 

violence providers.

St. Barnabas Hospital, Family Safety Center 5

*Evidence-based or promising practice
6 Healing Begins in a Safe Place

J

ulia picks up her 9-year-old son, Eric, from his afterschool program. As they 

approach their housing complex, a group of teenagers are fighting. One 

of them has a knife. Another has blood on his leg. People watching on the 

street make room when they hear the siren and see the lights of the police car. 

The three young men are thrown to the ground and searched. They are handcuffed and taken away. The youngster with the knife is Eric’s cousin, George. 

When Eric asks Julia about the incident, she is too upset to respond. Eric later 

finds out that his cousin was selling drugs. 

The following month, Julia gets called to school. Eric is not doing his homework 

and seems to barely be there mentally. The teachers wonder why a child with so 

much potential is slipping out of reach.

Like many other elementary-school-aged children exposed to violence, Eric is 

old enough to express what he is going through, but he needs someone who 

can understand what he is feeling. The school counselor finds the right outlet 

for him at the Safe Start program at Massachusetts General Hospital’s Chelsea 

HealthCare Center. 

Eric enters the Cool Youth program, a group therapy program for children, ages 

7 to 11, who have been exposed to violence. Meeting once a week with specially 

trained therapists, Eric and the other children share how the violence they’ve 

witnessed makes them feel and discuss how to understand and deal with those 

feelings. 

At the same time, Julia joins a group for mothers with children in the Cool Youth 

program. The mothers exchange personal stories and learn how to help their 

children overcome the effects of witnessing violence. 

By giving Julia and Eric safe spaces and separate forums in which to air their 

feelings, the Cool Youth program has helped them understand each other better.
Massachusetts General Hospital

Chelsea HealthCare Center

151 Everett Avenue

Chelsea, MA 02150

Focus:

Children exposed to violence and 

their families

Age range:

0–17

Interventions:

• Comprehensive assessment 

• Attachment, Self-Regulation, and 

Competence*

• Institutional change

Interventions

Comprehensive assessment: A multidisciplinary team conducts comprehensive 

assessments of mental and physical health and 

connects the family with community services 

and supports. The team conducts an in-home 

safety assessment for families with children 

from birth to 17 years of age.

Attachment, Self-Regulation, and Competence*: Based on the results of the comprehensive assessment, a multi-disciplinary team 

determines which model of care each family 

and child receives. Treatment focuses on 

attachment, regulation, and competence and 

is grounded in trauma-informed interventions 

strategies. 

Clinicians from 

the mental health 

unit provide 

individual, 

group, and family 

therapy. Based 

on the child’s 

or adolescent’s 

needs and 

strengths, the 

practitioner 

chooses an 

appropriate

intervention from a menu. Therapeutic 

procedures include psycho-education, 

relationship strengthening, social skills, and 

parent-education training as well as psychodynamic, cognitive, behavioral, relaxation, 

art/expressive, and movement techniques.

Institutional change: Various hospital units 

(mental health, social services, pediatric, 

Ob/Gyn, and school-based health programs), 

police action counseling teams, the school 

system, the Department of Social Services, and 

family violence advocates work together to 

create policies and procedures that expand 

access to psychiatric intervention and ensure 

quality services for children and families.

CHELSEA, MASSACHUSETTS CHELSEA, MASSACHUSETTS

Massachusetts General Hospital, Chelsea HealthCare Center 7

*Evidence-based or promising practice
148 Supporting Family Transitions Program Title

Andrea, 29, and her son Steven, 5, literally have nothing but each other. No 

belongings, no place to live, no family or friends to support them.

They are taking their first steps out of the Dallas/Fort Worth area domestic 

violence shelter where they’ve been living for the past month. They had to leave 

behind all of their things when they fled Andrea’s abusive husband, and now they 

are on their own. 

The shelter helps Andrea locate an apartment near the bus line, and she manages to find a job that pays a little more than minimum wage. With so much on her 

mind, she’s had little time to stop and worry about Steven, who seems to have 

withdrawn into himself. 

But she knows that Steven’s problems will likely worsen if he doesn’t get help. 

She turns to the Safe Start program, called Project SUPPORT, at Southern Methodist University. True to its name, Project SUPPORT gives her the aid she and 

Steven need.

Andrea is assigned a clinical service provider and a mentor for Steven. Over the 

next 6 months, the two visit weekly with mother and son in their home, making 

sure they have everything they need. Soon Andrea and Steven have furniture, 

clothing, and other necessities. 

Once the family’s basic needs have been met, the Project SUPPORT clinician 

begins to work more intensively with Andrea. Together, they practice parenting 

strategies she can use to help Steven overcome the damaging effects of his 

exposure to violence. 

Just as important, at each home visit the mentor provides one-on-one attention 

to Steven. Since the mentor is trained in the same parenting strategies that Andrea is learning, Andrea can observe those strategies in use. 

Gradually, Steven comes back out of his shell, and that, to Andrea, is everything. 
Southern Methodist University

Department of Psychology

Box 0442

Dallas, TX 75275

Focus:

Children exposed to extreme violence 

(domestic violence and child 

maltreatment) 

Age range:

3–9

Interventions:

Project SUPPORT*

Motivational interviewing*

Community capacity building

•

•

•

DALLAS, TEXAS DALLAS, TEXAS

Interventions

Project SUPPORT*: Families who seek 

refuge at domestic violence shelters and whose 

children exhibit clinical levels of adjustment 

problems begin receiving services during the 

transition period, beginning shortly after leaving a shelter. For an hour a week for at least 6 

months, the family receives joint visits at their 

home from a service provider and mentor. 

The service provider works one-on-one with 

the mother while the mentor interacts with the 

children. Once the family has gained stability, 

the second component of intervention begins, 

during which the service provider and mentor 

model mother-child management skills through 

interactions with the children that are based 

on the strengths and weaknesses of the mother 

and child. Interventions (including mentoring 

and treatment for children with elevated 

adjustment problems) are also available for 

children.

Motivational interviewing*: The program 

engages mothers in two sessions of motivational interviewing designed to enhance their 

motivation to learn and apply effective child 

management strategies.

Community capacity building: Project 

SUPPORT emphasizes expanding the Dallas/

Fort Worth capacity to respond to the needs 

of young children exposed to violence by providing training to domestic violence agencies. 

It also seeks to build the skills necessary for 

addressing children’s exposure to violence by 

providing undergraduate and graduate courses 

and practicum experiences.

Southern Methodist University, Department of Psychology 9

*Evidence-based or promising practice
16 Program Title

Maggie doesn’t feel safe in her own home.

She’s spent the past 3 weeks in a domestic violence shelter to escape 

her abusive husband, Dwayne. Now that she has obtained a protection order forbidding Dwayne from further contact, she and her infant daughter, 

Lucille, have returned home. But Maggie’s still scared. 

With a baby to worry about, Maggie wants to move forward with divorce proceedings. But she doesn’t know how Dwayne will react to the news, and even worse, 

he has keys to the apartment. Add to that her concerns over money—she has 

only limited job prospects and can’t afford childcare.

Maggie is a participant of the Brighter Futures Family Partnership in Dayton, Ohio. 

This home visitation program works to prevent child abuse and neglect. To obtain 

specialized services for exposure to violence for Maggie and Lucille, the nurse 

home visitor refers her to the Safe Start program at the Artemis Center. By agreeing to participate, Maggie gets one step closer to the safety and security she and 

her daughter need, without setting foot out of her apartment. 

A client advocate and a therapist from Safe Start visit Maggie and Lucille at home. 

For an hour, the Safe Start team sits at the kitchen table and listens as Maggie 

describes her situation. The advocate suggests Maggie ask her landlord about 

changing the locks and also recommends several community groups that can 

help with childcare, employment, and legal services. 

The therapist asks Maggie questions about her goals as a parent, laying the foundation for a trusting and committed relationship. Over the next 10 months, she will 

help Maggie identify potential problems in her relationship with Lucille, as well 

as effective ways to address them. Their sessions together will give Maggie the 

knowledge and confidence she needs to raise a healthy child in a loving, safe, 

and secure home. 

With the locks changed and her life changing, too, Maggie isn’t fearful anymore.

10 Family Support at Home
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 17

Artemis Center

310 West Monument Avenue

DAYTON, OHIO DAYTON, OHIO

Dayton, OH 45402

Focus:

Young children and their mothers who 

witness or experience domestic violence 

Age range:

0–3

Interventions:

Home visitation*

Case management 

Child Parent Psychotherapy*

•

•

•

Interventions

Home visitation*: The Artemis Center for 

Alternatives to Domestic Violence provides ongoing training on domestic violence to nurses 

who provide home visits. This training aims to 

build the nurses’ capacity to identify, assess, 

and respond to the needs of young mothers of 

children from birth to 3 years of age who are 

at risk of or have been exposed to domestic 

violence. During home visits, the nurses place 

special emphasis on attaining and maintaining 

safety and advocacy, as well as on assessing 

the progress of both parent and child.

Case management: The program provides 

intensive case management in the home 

through a personal family advocate. This case 

management emphasizes supports and linkages 

with community resources.

Child Parent Psychotherapy*: In addition 

to the traditional home visiting services, the 

program offers weekly in-home dyadic therapy 

that focuses on the relationship between 

mother and child.

Artemis Center 11

*Evidence-based or promising practice
18 Program Title

Something is wrong with Maria’s 7-year-old daughter Hannah. The normally 

outgoing and friendly little girl has become sullen and withdrawn. Her 

teacher reports that the first-grader is missing assignments and not paying 

attention in class. 

Maria, 26, looks for a cause. Her boyfriend, Hector, recently moved in with her, 

and she worries that Hannah might feel jealous. She sits her daughter down for 

a heart-to-heart talk. At first, Hannah refuses to say anything, but when Maria 

presses the issue she learns a terrible secret: Hector has been sexually abusing 

Hannah for nearly 3 weeks. 

Maria feels her world collapsing around her. Numb, she calls the police, who 

take her and Hannah to the Erie County Children’s Advocacy Center (CAC). 

Maria doesn’t know it yet, but CAC will give her and her daughter a nurturing 

new start.

After CAC’s forensic team has gathered the facts of the abuse, the Safe Start 

manager invites Maria to bring Hannah back for further assessment and 

specialized interventions to address issues related to her exposure to violence. 

Specialized services include in-home therapy designed to help Hannah—and 

her mother—recover from the effects of the sexual abuse through conversations, 

play therapy, and safety training. 

Maria also joins a parent group that meets for 12 weeks to discuss the effects of 

violence as well as other real-life issues, such as how to have a social life and a 

safe and stable home. Later, the parents and children come together, engaging 

in joint activities designed to develop honest communication. 

All the while, an integrated team meets regularly to discuss Maria and Hannah’s 

progress and link them to other support services. When the in-home therapy 

ends, the team continues to follow Maria and Hannah’s progress for 2 years, 

providing additional support as needed. Over time, mother and child rebuild the 

feelings of safety and trust that had been shattered.

12 After Abuse, a Nurturing New Beginning
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 19

Children’s Advocacy Center 

 of Erie County

2005 West 8th Street

Suite 103

Erie, PA 16412

Focus:

Children exposed to violence 

(defined as physically or sexually 

abused; a witness to domestic 

violence; or exposed to any 

violent crime)

Age Range: 

0–12

Interventions: 

Developmental screening

Children’s Advocacy Center*

Case management

Parenting education

Child, parent, and family mental 

health interventions 

•

•

•

•

•

Interventions

Developmental screening: The CAC pediatrician and case manager provide screening and 

in-depth assessment of children exposed to 

violence to determine areas of risk, guide 

appropriate treatment, and oversee the referral 

process.

Children’s Advocacy Center*: Staff representing multiple systems of care provide an integrated program to children who have been 

exposed to violence. The integrated treatment 

program includes case management and 

parenting education as well as child, parent, 

and family mental health interventions.

• Case management: A team of providers 

develops safety plans and provides support 

and crisis management services. The team 

also links families to early intervention, 

provides support and crisis counseling, 

assists with court-related activities, and 

offers mental health services. This team 

of providers meets weekly to review each 

family’s progress.

• Parenting education: Parents complete a 

psycho-educational course consisting of 

weekly 90-minute sessions lasting 12 weeks. 

The goals of these psycho-educational groups 

are to expand parent knowledge, improve 

parent-child bonding, and provide child 

management and child protection skills.

• Child, parent, and family mental health 

interventions: The program provides mental 

health interventions based on the needs of 

the family during 16 in-office, in-home, or 

at-daycare visits. Child-focused interventions 

concentrate on reducing the impact of 

exposure to violence. The interventions 

follow a parent-child dyadic model with 

infants to re-establish bonding and use play 

therapy and expressive art approaches with 

children from 2 to 12 years of age. Mental 

health interventions with mothers focus on 

identifying and addressing the dynamics 

and behaviors set into motion by exposure 

to violence and seek to address those issues 

that continue to leave the child at risk. Family therapy is used to address issues such as 

blaming the child for the loss of a home or 

family, divided loyalties among siblings, and 

difficulty in managing child behavior.

ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Children’s Advocacy Center of Erie County 13

*Evidence-based or promising practice
2014 Program Title Making Teachers Part of the Equation

One child woke to gunshots last summer and learned that a neighbor had been shot 

and killed. 

Another lives in a domestic violence shelter because his mother was assaulted. 

A third has been removed to a foster home because his parents physically abused an older 

sibling. 

All three are students in the same Head Start class. All three fidget and talk too much—

behaviors typical for preschoolers, but now occurring at a disruptive rate.

Frustrated with her inability to reach the three children, their teacher, Laurie, decides she 

needs help. She gets it from the School Intervention Project, a collaboration between the 

Kalamazoo Safe Start program, Kalamazoo County Head Start, and the Southwest Michigan 

Children’s Trauma Assessment Center (CTAC).

The project trains teachers to understand how exposure to violence affects the social and 

emotional development of young children. It also gives them tools they need to work more 

effectively with students exposed to all kinds of violence.

In a 2-day training session, Laurie and her colleagues learn a curriculum centered on five 

core elements: teaching children ways to feel safe, make and keep friends, calm their 

minds and bodies, feel good about learning, and make meaning of their experiences. In 

coordination with the Head Start program, the School Intervention Project convenes parent 

education groups and provides individualized case management services to the families. 

The School Intervention Project’s aid to Laurie doesn’t end with the training. CTAC sends a 

trained staff member and a graduate assistant to her classroom to support her as she puts 

her new knowledge into practice.

Throughout the school year, Laurie continues to meet with the other teachers. They talk 

about specific problems they have encountered and come up with solutions. 

The behavior of the three children who spurred Laurie’s interest in the School Intervention 

Project has slowly improved. By employing teaching strategies specifically developed for 

children exposed to violence, Laurie has been able to help them learn again.
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 21

KALAMAZOO, MICHIGAN

Southwest Michigan Children’s Trauma 

 Assessment Center (CTAC)

Western Michigan University

1000 Oakland Drive

Kalamazoo, MI 49008

Focus:

Head Start children, parents, and 

teachers 

Age Range: 

3–5

Interventions: 

Head Start School Intervention 

Project*

Teacher education

Parent education

Parent Child Interactive Therapy* 

training to build community capacity

•

•

•

•

KALAMAZOO, MICHIGAN

Interventions

Head Start School Intervention Project 

(HSSIP)*: Southwest Michigan CTAC developed and is currently evaluating a preventive 

intervention that equips children with personal 

strategies to manage stress and respond to 

potentially traumatizing events. CTAC is 

working with Kalamazoo County Head Start 

to implement the HSSIP trauma-sensitive curriculum for Head Start preschool classrooms. 

A team of graduate students from the fields of 

education, occupational therapy, and speech 

and language pathology support interventionists who implement the curriculum in Head 

Start classrooms. The curriculum is based on 

core elements of trauma intervention, including 

feeling safe, making and keeping friends, 

calming my mind and body, feeling good 

about learning, and making meaning of my 

experiences. It includes three 30-minute 

sessions offered over 26 weeks.

Teacher education: Implementation of the 

curriculum is supported by a transdisciplinary 

teacher professional development model that 

seeks to change teacher attitudes and behaviors 

toward the most challenging students, who 

are most likely to have a history of traumatization. The program offers ongoing professional 

development for teachers with an initial 2-day 

training on the impact of exposure to violence, 

followed by 45 minutes of critical incident 

meetings offered every other week for 26 

weeks. The content of the teachers’ curriculum, 

connecting the impact of exposure to violence 

with real-life classroom and home experiences, 

mirrors the core components of the children’s 

curriculum.

Parent education: Parent groups meet every 

other week in 90-minute sessions to discuss 

issues including the impact of exposure to 

violence, the core elements of the curriculum, 

and stress management skills.

Parent Child Interactive Therapy* training 

to build community capacity: The Safe Start 

steering committee provided a 3-day training 

on Parent Child Interactive Therapy (PCIT) to 

mental health interventionists working with 

young children exposed to violence. Trainees 

include collaborative members of the steering 

committee as well as other clinicians who are 

committed to working with children exposed to 

violence. The goal of the training is to develop 

a network of providers in Southwest Michigan 

trained in PCIT and available to families in Kalamazoo and its surrounding areas. A long-term 

goal of PCIT training is to sustain the availability of evidence-based, trauma-focused therapy 

for young children through the establishment 

of a regional training center (Western Michigan 

University) that includes community partners.

Southwest Michigan Children’s Trauma Assessment Center 15

*Evidence-based or promising practice
2216 Program Title Starting Over in a Caring Community

L

ife has been chaotic and scary for 8-year-old Tonya. Her father has abused 

her mother for years, and Tonya never knows when things will get bad. 

Finally, a beating pushes Claire, Tonya’s mother, over the edge. 

Claire waits for her husband to leave for his night job. Then, at nearly one o’clock 

in the morning, she gets Tonya out of bed. Without bothering to pack, the two 

race outside to a waiting cab, which takes them to the Inn Transition South, a 

women’s shelter and transitional housing site in Miami. 

After arriving safely at the shelter, mother and daughter are exhausted and 

scared. Over the next few weeks, Claire settles in, but Tonya begins to change. 

She wakes up with nightmares, and she won’t interact with the other children at 

the shelter. Claire worries that Tonya is blaming herself for the violence they have 

experienced. She longs to see her daughter’s beautiful smile again.

The case manager refers the family to the Safe Start program at the University of 

Miami Consortium for Children in Crisis, located at the Linda Ray Center. At the 

center, Tonya is invited to participate in the Heroes program, a children’s support group operated by the Safe Start program on site at Inn Transition South. The 

program helps children like Tonya overcome their feelings of guilt and fear.

For an hour each week over the next 3 months, Tonya joins a group of children 

her age who also live at the shelter, taking part in structured activities led by a 

specialized therapist. 

The children talk about the domestic violence they have experienced and learn 

that the violence was not their fault. After a few weeks in the group, Tonya asks to 

play with her new friends. She’s started smiling again.
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 23

University of Miami Linda Ray Center

750 Northwest 15th Street

MIAMI, FLORIDA MIAMI, FLORIDA

Miami, FL 33136

Focus:

Children who have been exposed 

to domestic violence or child 

maltreatment 

Age Range: 

6 months–11 years

Interventions: 

Infant Mental Health*

Heroes program*

Working with the Dependency 

Court* 

Case management

•

•

•

•

Interventions

Infant Mental Health*: Clinical staff provide 

psychotherapy for young children and their 

parents at domestic violence shelters and 

transitional housing sites. In collaboration 

with Louisiana State University Professor Joy 

Osofsky, the staff provides up to 25 weeks 

of treatment and assessments. In addition to 

helping develop appropriate parenting skills, 

the clinical model focuses on helping a 

mother respond more empathically to her 

child’s needs and support her child’s emotional 

development. It also helps to heal relationships 

that have suffered from violence, whether the 

exposure was child neglect, abuse, abandonment, or witnessing violence in the home.

Heroes program*: The Heroes program is 

used with children from 5 to 11 years of age 

who have witnessed domestic violence. These 

groups meet 10 times to focus on breaking the 

intergenerational cycle of abuse by learning 

nonviolent conflict resolution skills, developing 

nurturing relationships, and identifying and 

expressing feelings.

Working with the Dependency Court*: The 

program works with the Juvenile Court in 

Miami-Dade County offering assessments of 

children between the ages of 1 and 5 who are 

under the court’s jurisdiction for child maltreatment and/or family violence and their primary 

caregivers. First, children and their parents 

participate in a relationship-based assessment. 

Then, recommendations are drafted to assist 

judges in developing the case plan and to 

order appropriate treatment. Training is provided to judges and child welfare staff on early 

development and mental health issues for 

infants and toddlers.

Case management: A wide range of partners 

provide collaborative case management for 

families with issues of violence and/or child 

maltreatment. The goal is to create a seamless community response among the juvenile 

justice system, law enforcement, domestic 

violence shelters, and transitional housing 

sites. The program provides training for shelter 

and community childcare program staff about 

the effects of violence on young children. 

This training includes information on warning 

signs for children under 3 years of age who 

have been exposed to violence and the referral 

processes for 

assessment 

and treatment within 

the project 

and across 

the provider 

network.

University of Miami Linda Ray Center 17

*Evidence-based or promising practice
24 Program Title

Michelle has a lot on her mind. Four months pregnant, the 24-year-old 

lives in New York City with her son Ben, 7. She’s separated from her 

abusive boyfriend. Her new part-time job as a home health aide pays her 

just enough money to rent a small apartment and cover basic living expenses. 

The combination of work and single motherhood leaves Michelle exhausted. Ongoing legal battles with her children’s father drain her even more. And then Ben 

gets into a fight at his afterschool program and is suspended for a week. Michelle 

is frustrated, but she doesn’t want to take her problems out on Ben. She also 

doesn’t want his behavior to get worse. She seeks help from the Safe Start Family 

PEACE Program at New York Presbyterian Hospital’s Ambulatory Care Network. 

In the program’s Kids’ Club, Ben learns to express his feelings while also 

acknowledging the needs of others, meets other boys and girls with stories 

similar to his own, and learns relaxation exercises he can use to cope with 

everyday stress.

Meanwhile, Michelle attends a mothers’ group in which she shares her 

experiences and learns techniques for seeing things from Ben’s perspective. 

As she begins to more fully understand how the abuse she suffered affects her 

ability to parent, Michelle feels ready to begin a year of intensive child-parent 

psychotherapy with her new baby. 

These days, Michelle has a greater feeling of peace than ever before. She’s 

learned to respond positively to Ben’s needs and to make good decisions for 

herself and her family. 

18 Learning From Peers
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 25

NEW YORK, NEW YORK

Ambulatory Care Network Family 

 PEACE Program

New York Presbyterian Hospital

534 West 135th Street

New York, NY 10031

Focus:

Children exposed to violence and 

their mothers 

Age Range: 

0–12

Interventions: 

Child Parent Psychotherapy* 

Kids’ Club*

Reflective Parenting

Coordinating Council

•

•

•

•

NEW YORK, NEW YORK

Interventions

Child Parent Psychotherapy (CPP)*: The 

program provides CPP for families with 

children from birth to 5 years of age. Motherchild dyads meet with a therapist an hour a 

week for a year and focus on intervention 

strategies that address conduct disorder, 

post-traumatic stress disorder, anxiety, and 

depression.

Kids’ Club*: The program provides Kids’ 

Club groups to children from 6 to 12 years 

of age. These groups meet once a week for 

90 minutes over 12 weeks. The Kids’ Club 

intervention provides children with information 

about domestic violence and allows them to 

discuss attitudes and beliefs about families, 

relationships, and family violence. Children 

work on developing appropriate social 

behavior in small-group settings. 

Reflective Parenting: The program offers 

Reflective Parenting groups to parents at the 

same time that the children participate in 

the Kids’ Club group. Parents learn how to 

strengthen and improve the parent-child 

relationship, communicate more effectively 

with their children, and feel more confident 

in their parenting.

Coordinating Council: A range of communitybased private and public providers serve on 

a Coordinating Council that developed and 

implements a strategic plan for reaching 

children exposed to domestic violence and 

linking them to services of the Ambulatory 

Care Network and the Safe Start Family PEACE 

Program. 

Family PEACE Program—New York Presbyterian Hospital 19

*Evidence-based or promising practice
26 Program Title

Miguel is hiding under his bed for the third time in a week. He is 4 years 

old and is scared, not of monsters or ghosts that may come out at night; 

rather, Miguel is hiding again from the constant yelling and fighting 

between his parents. Miguel hears his mother, Carmen, scream and a plate being 

thrown. He can also hear his father, Francisco, hitting her. 

The police arrive at the scene and Francisco is taken into custody as Miguel 

watches. Police Officer Russell tries to communicate with Carmen but she 

speaks only Spanish. He then hands Carmen a card with the Oakland Safe Start 

phone numbers for her to call and seek help for the family. 

Carmen is at first apprehensive to call the number on the card but hopes that 

the person on the other end will understand her plea. The call is answered by 

a bilingual intake coordinator who patiently listens to her story and makes an 

appointment to visit Miguel and his mother in their home.

After listening to Carmen explain the history of violence in her household and of 

her immediate basic and emotional needs, the intake coordinator refers her to a 

Spanish-speaking case manager/therapist at the Jewish Family and Children’s 

Services. 

Although Carmen is nervous about involving other people, she agrees to go 

when the coordinator offers to attend the initial meeting with her. At this meeting, 

Carmen says she needs housing, food, clothing, legal help, and a job. Stabilizing 

the mother is the most important first step in situations like Carmen and Miguel’s, 

so the case manager/therapist immediately outlines with her a family plan and the 

community services that are available. Together they also create a treatment plan 

so that they can address the behavior symptoms that Miguel is expressing as a 

result of the family violence. The case manager/therapist therefore not only helps 

Carmen and Miguel with crisis stabilization but also helps them repair the disruptions in the parent-child relationship and restore a sense of safety for Miguel.

20 Nurturing Trust Through Relationships
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 27

Safe Passages

250 Frank H. Ogawa Plaza

Suite 6306

Oakland, CA 94612

Focus:

Children and families in communities 

of color that are exposed to violence 

Age Range: 

0–5

Interventions: 

Integrated case management/mental 

health*

Dyadic therapy

•

•

OAKLAND, CALIFORNIA OAKLAND, CALIFORNIA

Interventions

Integrated case management/mental health*:

Safe Passages integrates community-based, 

culturally competent intensive case management with mental health services provided by 

the same person. Case managers are licensed 

therapists from Jewish Family and Children’s 

Services who help caregivers understand the 

effects of trauma on themselves and their 

children while assisting with stabilizing the 

family’s urgent needs. Case management 

services include assistance with securing 

public services (medical, housing, transportation, childcare, emergency funds, legal, and 

food) and coordinating with other public 

agency workers. Mental health interventions 

include dyadic therapy. Multi-language 

services (in Spanish, Cantonese, Mandarin, 

Korean, Vietnamese, Cambodian, Laotian, 

and Japanese) are provided in the home or 

in community-based organizations depending 

on the family’s preference and safety issues.

A minimum of 2 hours of case management 

and mental health clinical supervision are 

provided to the clinicians each week by a 

psychotherapist with expertise in children 

from birth to 5 years of age who have been 

exposed to trauma and/or violence.

Safe Passages 21

*Evidence-based or promising practice
282 Program Title Preserving Families With Services and Support

Haley just can’t seem to catch a break.

A survivor of domestic violence, she divorced her husband a year ago 

and started a new life with her children, Jonas, 5, and Erica, 7. Though 

she works hard, Haley has financial problems. She has had problems collecting 

child support from her ex-husband. Plus, the childcare options she has been able 

to find are proving too expensive for her single income. 

It doesn’t help that Jonas has begun hitting other children at the childcare 

center—if he does it again, he’ll have to leave the program. So while Haley’s 

been thinking about taking a second job, she worries that having to spend 

more time out of the house will only make Jonas’ problems worse. 

She needs advice, financial help, emotional support—the list goes on. At the 

Institute for Family Centered Services’ Safe Start program, she gets assistance 

that addresses the needs of every member of the family.

A clinical specialist from the Institute visits Haley, Jonas, and Erica in their home 

and together they assess the family’s needs. Over the next 3 months, trained 

mental health workers meet with Haley 4 hours a week in her home. They discuss 

effective parenting practices and explain that Jonas’ current behaviors might 

stem from his exposure to the violence at home. They work with Haley to encourage her to seek the support of extended family members and to connect with her 

ex-husband’s family to enlarge her circle of support.

The mental health workers also help Haley locate a new childcare center better 

suited to Jonas’ needs and connect her to organizations that provide legal aid 

and financial assistance for childcare. Before their time with her ends, they point 

her to a local single mother’s support group, where Haley can begin building a 

supportive network of people who are struggling with similar issues. 
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 29

POMPANO, FLORIDA

Institute for Family Centered 

 Services, Inc.

4101 Ravenswood Road

Suite 323

Dania Beach, FL 33026

Focus:

Children exposed to domestic and 

community violence 

Age Range: 

0–6

Interventions: 

Intensive family-centered treatment*

Project Support

Project Foundation

Project Hope

•

•

•

•

POMPANO, FLORIDA

Institute for Family Centered Services, Inc. 23

Interventions

Intensive family-centered treatment*: The 

Institute provides three levels of familycentered services that focus on creating a safe 

and stable environment for young children 

exposed to violence through consistent, 

supportive interactions with a primary caregiver in the family’s home. All levels of care 

implement play therapy with young children 

in a context that allows the primary caregiver 

to observe the play and learn about the child’s 

needs through what is observed. The program 

also provides around-the-clock crisis intervention for the duration of services at all three 

levels.

• Project Support. Higher functioning families 

receive crisis intervention and stabilization, 

information on the impact of violence on 

child development, parenting skills training, 

child and family assessments, and linkages 

with community supports as needed. This 

intervention is provided for 3 to 5 hours 

per week over a period of 4 to 6 weeks, 

depending on need.

• Project Foundation. Families struggling 

with multiple stressors, who require education on child development, safety planning, 

and crises intervention, as well as families 

with children who display high levels of 

depression, developmental delay, or other 

problems receive a more intensive intervention. Crisis intervention and stabilization, 

parenting skills training, and linkages with 

community supports are offered for 5 to 7 

hours a week over 2 to 3 months. Additional 

services focus on working with the nonoffending parent (or both parents when 

safety is ensured) in a group setting 

to discuss gender and identity roles and 

responses to violent experiences. These 

support groups last for 4 to 6 months.

• Project Hope. Families struggling with 

multiple stressors who are willing to attend 

to their coparenting relationship are offered 

the same services as families in Project 

Foundation, with an additional focus on 

cycle-of-violence interactions.

*Evidence-based or promising practice
3024 Program Title Advocating for Families, Every Step of the Way

Meg, a domestic violence advocate at the Safe Start program in Gresham, 

Oregon’s Child Welfare Office, is used to working with families who’ve 

reached rock bottom. Today, she gets an emergency referral from Child 

Protective Services (CPS) of a family that requires immediate intervention. Over the 

weekend, the police were called to a family dispute. The police report notes that a 

4-year-old boy named Josh witnessed his father assault his mother; police suspect 

Josh is also being physically abused.

Meg accompanies the CPS worker on the initial home visit to meet with Heather, 

Josh’s 20-year-old mother. The CPS worker discusses the risks domestic violence 

poses to Josh’s safety and begins assessing concerns about Josh being physically 

abused. Heather feels desperate. What if CPS takes Josh away from her? Even if CPS 

doesn’t, how will she get what she needs: a place to live, a job, legal advice, a restraining order, childcare? 

Heather has no idea where to begin.

It’s Meg’s job to help Heather navigate a scary situation. Meg helps Heather and Josh 

get into a domestic violence shelter, then goes with Heather to the family decision 

meeting at the Child Welfare Office. Over the following weeks, Meg helps Heather 

negotiate the maze of nonprofits and government agencies that offer services and 

supports she needs to establish a safe living environment for her and her son. 

Later, a Safe Start parent-child specialist begins meeting with Heather and Josh in 

their apartment, teaching them ways to talk about the domestic violence they have 

experienced and cope with its lingering effects. Meg continues to monitor Heather’s 

progress, helping her establish a robust support network of community organizations. 

As a direct result of Meg’s careful case management and advocacy, Heather and 

Josh gain a level of stability and safety in their family that, only months before, seemed 

impossible.
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 31

PORTLAND, OREGON PORTLAND, OREGON

Multnomah County

421 Southwest Oak Street

Suite 630

Portland, OR 97204

Gresham Child Welfare

355 N.W. Division

Gresham, OR 97030

Focus:

Children who experience child abuse 

and witness domestic violence

Age Range: 

0–6

Interventions: 

Child Welfare/Domestic Violence 

Collaboration*

Child Parent Psychotherapy*

Case consultation and coordination

•

•

•

Multnomah County 25

Interventions

Child Welfare/Domestic Violence 

Collaboration*: Domestic violence advocates 

are co-located in the Child Welfare Office to 

help provide safety planning, referral to and 

advocacy for other needed services, accompaniment to court, team decision meetings, and 

other child welfare meetings. They also provide consultation and technical assistance to 

the child welfare workers and others involved 

in the CPS system regarding domestic violence 

issues and system responses.

Child Parent Psychotherapy*: A parent-child 

specialist provides interventions to the motherchild dyad with the goal of reducing the impact 

of exposure to violence. Services include 

home visits, parenting support, and coaching 

for mothers who need additional parenting 

support because of their domestic violence 

experiences.

Case consultation and coordination: Domestic 

violence and child welfare staff work together 

to develop a collaborative case plan that jointly 

addresses domestic violence and child abuse 

and neglect issues.

*Evidence-based or promising practice
3226 Program Title Police-Social Services Partnership Supports Families in Crisis

A15-year-old boy has been shot and lies on the sidewalk next to a busy 

Providence intersection. He is bleeding and yelling for help. The ambulance 

arrives and takes the injured youth. Melissa, a 4-year-old girl, observing 

everything that is happening, sobs and huddles behind her mother, Rosa. Eric, 

a rookie police officer, assesses the situation. He attempts to speak with Rosa, 

but she cannot understand him: she only speaks Spanish. Eric calls the Police 

Go Team and it sends Eileen, a bilingual social worker on staff, to meet Melissa 

and Rosa at the crime scene. A second social worker is dispatched to the hospital 

to work with the wounded boy and his family. 

Eileen walks with Melissa and Rosa to their nearby apartment. Once inside, she 

helps calm Melissa. Rosa explains that 3 months ago Melissa heard gunshots 

and screams outside her daycare center. Ever since, she has been afraid to sleep 

and refuses to leave her mother’s side. Rosa, too, is afraid. She is very concerned 

about the potential impact of this new scary incident on Melissa. 

Eileen speaks to Rosa about the impact of exposure to violence on young 

children and some of the strategies that she may use to talk to Melissa about the 

incident and help her to sleep better. Eileen continues to visit the family over the 

next few weeks. Ultimately, she refers Rosa to the Family Service of Rhode Island’s 

Child Parent Psychotherapy program. Over the next few months, the program 

helps them re-establish a trusting relationship.

Throughout the process of working with Melissa and Rosa, Eileen provides followup information to the police, through phone reports and at their weekly command 

staff meetings. 

Thanks to the partnership between the Providence Police Department and Family 

Service of Rhode Island, Melissa and Rosa are served in a coordinated manner. 

Through the specialized training that he received as part of the Providence Go 

Team project, Eric is able to provide much more than handcuffs and arrests. He 

can also give understanding, empathy, and access to needed resources. Eileen 

referred the child to the Safe Start program, where the family was helped to heal.
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 33

PROVIDENCE, RHODE ISLAND

Family Service of Rhode Island

PO Box 6688

Providence, RI 02940

Focus:

Children who are exposed to domestic 

or community violence

Age Range: 

0–18

Interventions: 

Crisis intervention, identification, 

assessment, and referrals

Child Development-Community 

Policing (CD-CP) Program*

Case management 

Child Parent Psychotherapy*

•

•

•

•

PROVIDENCE, RHODE ISLAND

Family Service of Rhode Island 27

Interventions

Crisis intervention, identification, assessment, 

and referrals: A crisis response worker on the 

scene identifies families, addresses immediate 

crisis needs, and initiates followup and 

service referrals after an incident. 

Child Development-Community Policing 

(CD-CP) Program*: The Providence Police Go 

Team, which has been trained in the CD-CP 

program, provides crisis intervention 24/7 to 

children and families. The program, a national 

model of collaborative alliances among law 

enforcement, the juvenile justice system, 

medical and mental 

health professionals, 

child welfare agencies, schools, and 

other community 

groups, includes 

cross-training, 

followup home 

visits, and shortand long-term treatment interventions 

held in homes, 

neighborhoods, 

and schools.

Case management: The program plans and 

implements community supports for children 

and families exposed to violence. Family 

progress is reviewed and coordinated in 

weekly interdisciplinary case consultation 

meetings that include staff from domestic 

violence shelters, police, youth and family 

departments, and the Rhode Island Family 

Court.

Child Parent Psychotherapy*: The program 

provides child-parent psychotherapy to 

children and families in 12 sessions.

*Evidence-based or promising practice
3428 Program Title Helping a Family to Heal Itself

Carlos and Lucia Menendez have been arguing a lot lately. Fueled by 

unemployment and subsequent drinking, Carlos has begun to turn his 

rage on Lucia, shouting that it’s all her fault and hitting her. Their 5-yearold son, Jorge, is terrified of his father. He’s not sleeping or eating well, and he 

cries frequently. 

Everything comes to a boil one night when a screaming match between Carlos 

and Lucia leads to a physical fight. Carlos repeatedly hits Lucia and then hits 

Jorge, who jumps in to try to protect his mother. A concerned neighbor calls 

911. When the police arrive, the investigating officer finds Jorge hiding beneath 

his bed. 

Concerned about the young boy’s situation, the officer calls the San Diego Child 

Welfare office. Carlos and Lucia reluctantly agree to voluntary services. As a 

“family maintenance case,” the family voluntarily separates until they are considered stable enough for reunification. Carlos moves in with a cousin, and 

Lucia and Jorge receive a referral to the Safe Start San Diego program.

Safe Start helps Carlos, Lucia, and Jorge begin to heal—both as a family and 

as individuals in relationship to one another.

A Safe Start child advocate connects Lucia and Jorge with nonprofit and faithbased organizations that provide a wide range of services, including language 

classes and job training. After putting in place all of the safety precautions, a 

community-based clinician begins meeting with the Menendez family in his office. 

While his parents work to resolve the issues underlying their domestic problems, 

Jorge works with a therapist to learn to cope with his exposure to violence. He 

makes a storybook about his experiences in a violent home and shares it with his 

parents. Finally, they can see the true impact their actions have had on their son. 

By the time they are reunited, the family members have improved their ability to 

cope with life’s stressors, to listen to one another, and to treat one another with 

love and respect. 
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 35

SAN DIEGO, CALIFORNIA SAN DIEGO, CALIFORNIA

County of San Diego—Health and 

 Human Services Agency

6950 Levant Street

San Diego CA 92101

Focus:

Children exposed to violence and 

their families

Age Range: 

3–8

Interventions: 

Assessment-Based Treatment for 

Traumatized Children: A Trauma 

Assessment Pathway*

Trauma-Focused Cognitive 

Behavioral Therapy Treatment 

Model*

Case management

Capacity building

•

•

•

•

County of San Diego—Health and Human Services Agency 29

Interventions

Assessment-Based Treatment for Traumatized 

Children: A Trauma Assessment Pathway*: 

This model is an assessment framework for 

understanding traumatized children and making informed clinical decisions that enable 

clinicians to gain an in-depth understanding 

of children, their developmental levels, their 

traumatic experiences, and the family, community, and cultural systems in which they live. 

This information assists the clinician in making 

effective decisions throughout the treatment 

process.

Trauma-Focused Cognitive Behavioral 

Therapy Treatment Model*: This model is a 

therapeutic approach for children who have 

had one or more traumas and are demonstrating symptoms of post-traumatic stress. The 

therapist meets with the child each week 

before meeting with the parent/caregiver to 

teach methods for helping the child at home. 

The therapy includes education about trauma 

and common reactions to it, help with parenting and behavior problems, information about 

relaxation and stress management, and other 

strategies.

Case management: A child protection worker 

coordinates case planning and management 

services that include family assessment, safety 

planning, family advocacy, parenting classes, 

and referrals to community-based and other 

services. In addition, a child advocate for case 

planning helps the family with child-focused 

safety planning, provides linkages to support 

services for the child, assists with problem 

solving, and supports the primary caregiver. 

Monthly clinical case consultation meetings are 

used to review progress and plan followup.

Capacity building: To institutionalize an 

improved response to children exposed to 

violence and their families, the project builds 

the capacity of agencies, systems, and professionals interacting with children through a 

countywide community conference, regional 

interagency and community training, and 

specialized training focused on identifying, 

treating, and preventing/reducing children’s 

exposure to violence.

*Evidence-based or promising practice
360 Program Title A More Stable Life for Child and Grandmother

T hough he’s only 4 years old, Jayden has seen a lot.

He’s watched his mother descend into a world of drug addiction, failed 

relationships, and joblessness. 

He’s watched her latest boyfriend assault her. 

He’s watched the police arrest her and take her away.

Now, he lives with his grandmother, Harriett. She doesn’t want Jayden to end up 

in foster care, but she knows that he is a troubled young boy, haunted by his 

exposure to domestic violence and his mother’s chronic drug use. 

Harriett worries about her ability to raise him with her limited finances and her 

health problems. A visiting social worker, noting her concerns, tells Harriett about 

the Edgewood Center for Children and Families and its Kinship Support Network.

The Kinship Support Network gives grandparents like Harriett, and other people 

who take full-time care of their relatives’ children, access to legal assistance, 

parenting education, community resources (like summer camps), and other 

supports. 

With guidance from a legal advisor, Harriett establishes a permanent guardianship 

for Jayden. A community healthcare nurse provides free home visits for her and 

Jayden. And through the Edgewood Center’s Safe Start program, Harriett is able 

to have a therapist assess Jayden and begin weekly in-home visits designed to 

address the effects of his exposure to violence. 

Over the next year, Harriett talks through the issues she is facing concerning the 

safety and stability of her family, and when Jayden begins to exhibit behavioral 

problems, the clinician is there to help her deal with them. 

With so many people to lean on at the Edgewood Center, Harriett can finally give 

Jayden something he’s never experienced before: stability. 
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 37

SAN MATEO, CALIFORNIA

Edgewood Center for Children 

 and Families

1801 Vicente Street

San Francisco, CA 94116

Focus:

Kinship families with children who 

have been exposed to violence

Age Range: 

0–6

Interventions: 

Case management/support

Kinship Caregiver Services*

Child Parent Psychotherapy* 

•

•

•

SAN MATEO, CALIFORNIA

Edgewood Center for Children and Families 31

Interventions

Case management/support: The program offers 

families in the Kinship Support Network with 

children who have been exposed to violence 

comprehensive in-home assessments and 

provides/links them with services required to 

promote family stability. These services include phone calls, home visits, and visits to the 

child’s school. Weekly contact is maintained 

with the family for a year or until the service 

plan needs are met.

Kinship Caregiver Services*: Services to support relative caregivers include support groups, 

advocacy services, and respite on weekends 

and during the week. The program also 

provides parenting, legal, educational, and 

medical education.

Child Parent Psychotherapy*: Every family 

participates in home-based psychotherapy that 

uses the child-parent dyadic approach. This 

psychotherapy is provided in weekly sessions 

averaging an hour and engages both a child 

and a caregiver. Related children in the home 

and a second caregiver (e.g., grandmother/

grandfather) may be included as recommended 

by the assessment. Collateral service providers may also be involved, as needed. The 

key issues addressed in psychotherapy are 

the caregiver’s adoption of developmentally 

appropriate, nonpunitive parenting skills, the 

encouragement of symbolic play, the capacity 

to put feelings into words, and the expression 

of negative feelings in nondestructive ways.

*Evidence-based or promising practice
382 Program Title Consistent Support for Families in Need

Sarah trusts Diane a lot. 

It was Diane, a service coordinator with the Help Me Grow program at the 

Family and Child Abuse Prevention Center in Toledo, Ohio, who supported 

Sarah through the birth of her son, Kevin, 2 years ago. Diane helped Sarah escape an abusive relationship and was there for her during the month she spent in 

a women’s shelter after Kevin’s birth. Diane also got Sarah into drug counseling 

and job training programs. 

Recently, Diane noticed the bruise on Sarah’s face after her boyfriend punched 

her. The service coordinator asked whether Kevin witnessed the punch and the 

2 months of abuse leading up to it (he had) and explained the risks posed to 

Kevin by his exposure to violence. She referred Sarah and Kevin to the Safe Start 

program at Toledo Children’s Hospital’s Cullen Center. 

When Sarah learns about Safe Start’s child-parent psychotherapy, she feels 

uncertain. The therapy sounds like a positive step for her and her son, but she 

prefers not to have to work with someone new. She wants to stick with Diane. 

That’s no problem, she’s told. Diane will continue to provide service coordination, in collaboration with a therapist. Over the next year, the therapist visits 

Sarah and Kevin at home once a week and helps the young mom draw up an 

“individual family service plan,” the blueprint for the services mother and son 

will receive. 

Diane remains involved during every facet of Sarah and Kevin’s therapy. Her deep 

knowledge of their case and her close relationship with them is a big part of their 

successful treatment. By Kevin’s third birthday, he and Sarah are well on their way 

to a more stable and secure life.
ERIE, PENNSYLVANIA ERIE, PENNSYLVANIA

Program Name 39

The Cullen Center—Toledo Children’s 

 Hospital

2150 West Central Avenue

TOLEDO, OHIO TOLEDO, OHIO

Toledo, OH 43606

Focus:

Children exposed to domestic violence 

and their families

Age Range: 

0–5

Interventions: 

Screening and assessment

Child Parent Psychotherapy*

Community capacity building 

•

•

•

The Cullen Center—Toledo Children’s Hospital 33

Interventions

Screening and assessment: Staff of collaborating agencies and other professionals in childserving agencies use screening tools to identify 

and refer for further assessment children from 

birth to 5 years of age who have been exposed 

to violence. Through screening, agencies 

respond to children regardless of their point of 

entry into the system. All assessments are used 

in context with parent-child observations made 

during a 1- to 2-hour session that enables the 

therapist to determine the quality and quantity 

of parent interactions over a set period. These 

observations include both strengths and weaknesses of family relationships as well as the 

resiliency of the child and how the adults in 

the child’s environment can be supportive 

of treatment.

Child Parent Psychotherapy (CPP)*: The 

project uses the CPP approach. This model 

integrates psychodynamic, attachment, trauma, 

and social learning theories into a dyadic 

treatment approach designed to restore the 

parent-child relationship and the child’s mental 

health and developmental progression.

Community capacity building: The project provides training to the community, parents, and 

multidisciplinary groups of professionals about 

the impact of exposure to violence on the 

brains and developmental milestones of infants 

and toddlers, as well as on trauma-informed 

developmental screenings and assessments.

*Evidence-based or promising practice
34 Safe Start: Promising Approaches Communities

Safe Start: Promising Approaches omising Approaches Communities mmunities
Evidence-Based and Promising Interventions

Assessment-Based Treatment for Traumatized 

Children: A Trauma Assessment Pathway (TAP)

The TAP framework helps service providers understand and make 

informed clinical decisions about traumatized children 2 to 18 years 

of age. All forms of childhood trauma are addressed within the model, 

which incorporates a multifaceted assessment process that enables 

clinicians to understand a child’s developmental level, traumatic 

experience, and the family, community, and cultural system in which 

he or she lives. The information is used to effectively triage and treat 

the child and family and to assist the clinician in making informed 

decisions throughout the treatment process.

 Site using this approach: San Diego, CA

Attachment, Self-Regulation, and Competence (ARC)

The ARC model provides a component-based framework for intervention 

with children who have experienced complex trauma. The framework 

is grounded both in theory and empirical knowledge about the effects 

of trauma and recognizes the core effects of trauma exposure on a 

child’s attachment, self-regulation, and developmental competencies. 

This model emphasizes the importance of understanding and intervening 

with the child in context, working from the philosophy that systemic 

change can lead to effective and sustainable outcomes. It focuses first 

on developing the relationship between the child and his or her primary 

caretakers in order to establish or re-establish the essential bond, which 

then enables the child to regulate his or her emotions and behaviors. By 

doing so, the child can develop the skills and sense of competence necessary to both resolve the pre-existing trauma and master future life tasks.

 Site using this approach: Chelsea, MA

Child Advocacy Center (CAC)

A CAC is a community-based facility designed to coordinate services 

to victims of abuse and neglect. The key goal of a CAC is to reduce the 

trauma to victims that may result from agency intervention. As such, 

CACs are child-friendly facilities in which all of the key professionals 

are located. Research has shown that CACs enhance positive outcomes 

by bringing professionals together in one location, assigning a child 

advocate who monitors the child’s case through various systems, and 

facilitating case reviews that promote both formal and informal 

discussion of progress.

 Sites using this approach: Bronx, NY; Erie, PA

Child Development-Community Policing 

Program (CD-CP)

This is a collaborative model between law enforcement and child mental 

health professionals designed to respond to children and families in 

the aftermath of crime and violence. Key components of the model 

include training of police officers and clinicians, weekly case meetings, 

a trauma treatment clinic, and consultation services in which clinicians 

are available 24 hours a day to work with police.

 Site using this approach: Providence, RI

Child Parent Psychotherapy (CPP)

CPP is a psychotherapy model for infants, toddlers, and preschoolers 

who have witnessed domestic violence or display symptoms related to 

violence exposure such as post-traumatic stress disorder, defiance, aggression, multiple fears, or difficulty sleeping. In this model, the parent 

and child attend therapy sessions together. The therapist targets both the 

child-parent relationship and the individual child’s functioning, with the 

35
intent of helping the child to gain a sense of security and self-esteem and 

strengthening the ability of parent and child to function as a healthy family unit. This therapeutic approach also has a case management component to help the mother get the services and supports she and her child 

need, such as housing, employment, education, or transportation.

 Sites using this approach: Bronx, NY; Dayton, OH; New York, 

NY; Portland, OR; Providence, RI; San Mateo, CA; Toledo, OH

Child Welfare/Domestic Violence Collaboration

To address the need for a more integrated approach to family violence, 

an interdisciplinary group of professionals from the courts, child welfare, 

domestic violence services, Federal agencies, and the academic community developed recommendations for interventions and ways to measure 

progress in communities seeking to improve their responses to families 

experiencing both domestic violence and child maltreatment. These recommendations were published in Effective Intervention in Domestic Violence and Child Maltreatment Cases: Guidelines for Policy and Practice, 

which is referred to as the “Greenbook.” The Greenbook features recommended policy and practice guidelines that are currently being used 

around the country to promote more effective services. These guidelines 

include fostering and enhancing collaborations among domestic violence 

service providers, child protective services, and juvenile, family, and 

criminal courts. The Greenbook also encourages effective practices that 

require cross-system collaboration in identification, safety planning, case 

management, advocacy, and service provision. 

 Site using this approach: Portland, OR

Head Start School Intervention Project (HSSIP)

This curriculum is developed to equip children with personal strategies 

to manage stress and respond to potentially traumatizing events. It is 

implemented in Head Start classrooms by a multidisciplinary team 

of professionals from education, occupational therapy, and speech and 

language pathology. The curriculum is based on several core elements 

of trauma intervention, including feeling safe, making and keeping 

friends, calming my mind and body, feeling good about learning, and 

making meaning of my experiences. It includes three 30-minute sessions 

offered over 26 weeks. The implementation of HSSIP is supported by 

a transdisciplinary teacher professional development model that seeks 

to change teacher attitudes and behaviors toward the most challenging 

students, who are most likely to have a history of traumatization. This 

professional development model offers an initial 2-day training on the 

impact of exposure to violence, followed by 45 minutes of critical 

incident meetings offered every other week for 26 weeks.

 Site using this approach: Kalamazoo, MI

Heroes Program

The Heroes program offers counseling and group support services that 

help families cope with memories of violence. This intervention helps 

children develop coping skills and find the inner strengths they need to 

survive the impact of a violent home. Children in the 9-week program 

are divided into two groups by age (5 to 7 and 8 to 11) with separate 

groups running simultaneously for mothers. Groups are conducted in 

both English and Spanish and are centered on a weekly theme: 

(1) Getting to Know Each Other, (2) What is Abuse, (3) Anger, 

(4) When Parents Fight, (5) It is Not Always Happy in my House, 

(6) Sharing Personal Experiences with Violence, (7) Sexual Abuse, 

36 Evidence-Based and Promising Interventions
(8) Assertiveness, and (9) Review and Goodbye. The group facilitators 

choose activities that are developmentally appropriate for the children in 

their group yet creative enough to accomplish the delivery of the thematic message set forth in the curriculum.

 Site using this approach: Miami, FL

Home Visitation

This home visitation model is designed to help low-income, first-time 

parents start their lives with their children on a sound course and 

prevent the health and parenting problems that can contribute to the 

early development of antisocial behavior. One of the program’s several 

key components, and a major factor in its success, is its use of trained, 

experienced nurses. These nurses begin visiting low-income, first-time 

mothers during pregnancy, helping the women improve their health and 

making it more likely that their children will be born free of neurological problems. The nurses continue these visits until the child is 2 years 

old. Through these visits, mothers learn how to effectively care for their 

children and provide a positive home environment.

 Site using this approach: Dayton, OH

Infant Mental Health 

This relationship-based therapeutic intervention engages children ages 

birth to 6 years and their primary caregiver. It is based on the premise 

that the child’s relationship with the mother or primary attachment figure 

represents the best port of entry to alleviate the child’s psychological 

difficulties, promote age-appropriate regulation of emotional expression, 

and restore developmental progress. During the therapeutic sessions, 

parents—many of whom have not had positive, nurturing experiences in 

their own childhoods—are taught to play reciprocally with their children, 

to understand their nonverbal cues, and to follow their lead in support 

of healthy development. The infant mental health approach adds “speaking for the baby” and play therapy to the work with parent-child dyads. 

Parents also receive parental psychoeducation, for example, teaching 

and modeling appropriate expectations and interactions appropriate to 

the child’s developmental needs. Case management may include home 

visits, visits to the childcare setting, helping to arrange transportation, 

and referral for other services.

 Site using this approach: Miami, FL

Integrated Case Management/Mental Health

An integrated case management/mental health approach can address 

concerns related to providing mental health services to families from 

different ethnic and cultural backgrounds. Under this approach, clients 

receive an average of 2 hours per week of individual or child-parent 

psychotherapy and case management services, which include locating 

and accessing linguistically and culturally appropriate resources and 

support systems such as cultural activities, financial counseling, housing, 

transportation, and medical care. The specific goals of this service 

integration are to create a seamless approach that improves client 

engagement and retention, addresses the needs of ethnic and racially 

diverse populations, and focuses on the unique needs of children. One 

of the most significant advantages of this integrated approach is a greater 

flexibility in service delivery.

 Site using this approach: Oakland, CA

Intensive Family-Centered Treatment

Based on an intensive family preservation model, the Institute for 

Family-Centered Services’ approach works with families where the crisis 

and problems occur. This is most often in the home but can also be in 

the community. The goal is to provide services to strengthen families 

by changing systemic, dysfunctional behavior patterns among family 

members. A team of family-centered specialists is available 24 hours 

Evidence-Based and Promising Interventions 37
a day, 7 days a week to conduct ongoing assessment, crisis intervention, 

stabilization, individual and group counseling, education, and life skills 

management and to provide assistance to the family in accessing and 

navigating community resources.

 Site using this approach: Pompano, FL

Kids’ Club 

Kids’ Club is an intervention program designed to create a supportive 

environment for children ages 6 to 13 where they can share their experiences with violence. They learn from this sharing that they are not alone 

in their exposure to violence and also learn to identify sources of worry 

and concern. The program seeks to foster discussions of conflict and 

conflict resolution, the responsibility for violence, and strategies for 

problem solving and coping with violence exposure. Kids’ Club uses 

displacement activities that address family violence through stories, films, 

drawings, puppet plays, and so on. These methods are often comfortable 

for children because they allow children to react openly to the issues 

without feeling pressure to discuss their own particular family. Mothers 

meet in a separate group to share their parenting experiences and 

concerns and provide support for one another.

 Site using this approach: New York, NY

Kinship Caregiver Services

Kinship caregivers are relatives (other than parents) who provide full-time 

care, nurturing, and protection of children because of several reasons 

including functional absence of parents, homelessness, substance abuse, 

child abuse and neglect, incarceration, death, abandonment, family 

violence, or mental health problems. Kinship care helps maintain healthy 

connections to the family and its tradition, enables sibling groups 

to remain intact, provides more stability in living situation, allows 

the child to stay within the same community and school system, and 

helps maintain his or her connection to the cultural norms and 

practices that inform his or her identity. Promising practices that 

respond to the needs of kinship care families include special housing 

facilities, information and referral services, case management, respite 

care, and support groups.

 Site using this approach: San Mateo, CA

Medical Home 

A medical home is an ongoing source of primary care for young 

children and their families that is accessible, comprehensive, 

coordinated, and culturally effective. In a medical home model, the 

pediatrician develops a relationship with his or her clients that is based 

on mutual trust and shared responsibility. Different professionals working 

in the medical home allow for the integration of care (medical, dental, 

behavioral), with services offered either on site or through referrals to 

offsite specialists. This integration creates the opportunity for continued 

health and wellness by allowing for frequent observation as well as for 

the provision of guidance, education, and early intervention for both 

parents and children.

 Site using this approach: Bronx, NY 

Motivational Interviewing

Motivational interviewing is an evidence-based approach to overcoming 

the ambivalence that keeps many people from making desired changes 

in their lives, even after seeking or being referred to services. This 

intervention originated in the substance abuse treatment field but is now 

being extended into other social and health settings. The goal is to prepare people for making the changes needed and to support the journey 

toward making these changes. Strategies of motivational interviewing 

include assessment, brief interventions, reflective and empathic listening, 

and resolving ambivalence.

38 Evidence-Based and Promising Interventions
 Site using this approach: Dallas, TX

Parent Child Interactive Psychotherapy (PCIT)

Originally developed for children with behavior problems, PCIT is a 

highly structured treatment model involving both parent and child. It is 

designed for children ages 2 to 6 who exhibit “externalizing behaviors” 

or disruptive behavior patterns characteristic of oppositional-defiant or 

conduct disorder. PCIT is intended as a short-term intervention and uses 

from 10 to 16 weekly sessions. The emphasis is placed on improving 

the parent-child relationship. Once specific therapeutic goals have been 

reached, the emphasis shifts to implementing consistent discipline with 

the child.

 Site using this approach: Kalamazoo, MI

Project SUPPORT

Project SUPPORT is a home-based intervention that targets victims 

of domestic violence and their children who are living in domestic 

violence shelters. The intervention includes two primary components: 

(1) providing instrumental and emotional support to the mother during her transition from the women’s shelter and (2) teaching the mother 

to implement child management and nurturing skills that research has 

shown to be effective in the treatment of behavioral problems. Therapists 

accompanied by a child mentor visit families weekly to teach mothers 

these skills and to interact with the children and model prosocial behavior. During their transition from the shelter, mothers receive emotional 

and social support, help with building support networks and links to 

community agencies and organizations, and obtain physical resources 

such as financial help, furniture, and household appliances.

 Site using this approach: Dallas, TX

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) 

This clinic-based model addresses behavioral and emotional symptoms 

as well as the negative thought patterns associated with childhood 

trauma. Treatment takes places over 12 to 16 weeks and is targeted at 

both the parent and the child. The sessions focus on reducing the child’s 

symptoms by creating a sense of safety. This sense of safety is developed 

through the use of cognitive training that helps the child restructure his 

or her thoughts and feelings. Children are also taught relaxation techniques and are carefully guided in telling about the traumatic events they 

have experienced. Parents are taught how to encourage these behaviors 

in their children, and in joint sessions the parents and their children 

practice these behaviors with live feedback from the therapist. TF-CBT is 

appropriate for any child who exhibits behavioral or emotional problems 

related to past trauma, such as nightmares, clinging to caregivers, or an 

increased startle response to loud or unusual noises.

 Site using this approach: San Diego, CA

Working with the Dependency Court

This program works with the Miami-Dade County Court system offering 

direct evaluations of children between the ages of 1 and 5 who are under 

the court’s jurisdiction for child maltreatment and/or family violence. 

All children are screened for developmental, emotional, and cognitive 

functioning. Written reports are made to the judges to assist them in 

determining the legal goals of the case (family reunification or placement 

in care outside the family) and to order appropriate treatment. Training 

is provided to judges and child welfare staff on early development and 

mental health issues for infants and toddlers.

 Site using this approach: Miami, FL

Evidence-Based and Promising Interventions 39
Safe Start Center

5515 Security Lane

Suite 800

North Bethesda, MD 20852-5007

1-800-865-0965

www.safestartcenter.org

The Safe Start Center is funded by the Office of Juvenile Justice and Delinquency Prevention to support 

the Safe Start initiative on a national level. The goals of the Center are:

• To broaden the scope of knowledge and resources for responding to the needs of children exposed 

to violence and their families

• To develop and disseminate information about the Safe Start initiative and emerging practices 

and research concerning children exposed to violence

• To raise national awareness about the impact of exposure to violence on children.

 The Safe Start Center works with national partners and a multidisciplinary group

 of experts to provide training and technical assistance to the 15 Safe Start Promising 

Approaches communities; to develop multimedia information, education and training 

resources concerning innovations in the field of children’s exposure to violence; and 

to convene national and regional Safe Start meetings to foster a learning community 

and ensure the efficient sharing of knowledge and skills. The Center maintains an 

up-to-date Web site with general information, new resources, and notifications about 

national events.

 For further information about the Safe Start Promising Approaches communities or the 

Safe Start initiative or to receive Safe Start Center publications, contact the Safe Start 

Center at 1-800-865-0965 or info@safestartcenter.org, or visit the Safe Start Center 

Web site at www.safestartcenter.org. 

40