CARE: Child-Adult Relationship
Enhancement

 

By Jack Komer, 12/2021.

What is CARE?                                                                                     

Child-Adult Relationship Enhancement (CARE) is a trauma-informed, field-initiated training for general usage by non-clinical adults who interact with children with a history of trauma. CARE is not a therapy, but uses similar skills taught in Parent-Child Interaction Therapy. CARE utilizes the 3 P skills (Praise, Paraphrase and Point-Out Behavior) to connect with children, a set of techniques for giving children effective positive commands, and selective ignoring technique to redirect problematic behaviors. CARE also contains a trauma education component to contextualize the use of these skills with the kinds of behaviors and problems exhibited by children with a history of trauma. CARE has the following adaptations: Primary Care settings (PriCARE), Integrated care settings (I-CARE), School Settings (CARE in the Classroom, versions for pre-K- elementary and middle/high school), Military (CARE for Families who Serve), and Autism (CARE Connections).

Components of CARE

Target Population: Any adult who interacts with children and teens who have experienced trauma.

Materials: Handouts

Cost: $100/person trained. Once trained you can teach CARE to others 1:1

Research Describing Components and Administration of CARE:

  • Gurwitch, R.H., Messer, E., Masse, J., Olafson, E., Boat, B.W., & Putnam, F.W. (2016). Child-Adult                       Relationship Enhancement (CARE): An evidence-informed program for children with a history of trauma         and other behavioral challenges. Child Abuse & Neglect, 53, 138-145.                                                               https://doi.org/10.1016/j.chiabu.2015.10.016

Evidence of CARE

Pilot Trials/Feasibility Trials (NCTSN, 2020) :

  • Wood, J., Dougherty, S. L., Long, J., Messer, E. P., & Rubin, D. M. (2017). A pilot investigation of a novel          intervention to improve behavioral well-being for children in foster care. Journal of Emotional and                 Behavioral Disorders. https://dx.doi.org/10.1177/1063426617733715

Randomized Controlled Trials (NCTSN, 2020) :

  • Messer, E.P., Greiner, M., Beal, S., Cassedy, A., Eismann, E., Gurwitch, R.H., Boat, B., Bensman, H., Bemerer, 
      J., Greenwell, S., Eiler-Sims, P. (2018). Child Adult Relationship Enhancement (CARE): A brief, skills                  building training for foster caregivers to increase positive parenting practices. Children and Youth Services    Review, 90, 74-82. https://doi.org/10.1016/j.childyouth.2018.05.017

  • Schilling, S., French, B., Berkowitz, S. J., Dougherty, S. L., Scribano, P. V., & Wood, J. N. (2017). Child-Adult 
      Relationship Enhancement in Primary Care (PriCARE): A randomized trial of a parent training for child            behavior problems. Academic Pediatrics, 17, 53–60. http://dx.doi.org/10.1016/j.acap.2016.06.00

Research Results:

  • Studies have shown that CARE can strengthen child/adult relationships, reduce mild/moderate behavior concerns and increase compliance.  

CARE
in the Classroom
 

National Child Traumatic Stress Network Fact Sheet on CARE
 

References

Gurwitch, R.H., Messer, E., Masse, J., Olafson, E., Boat, B.W., & Putnam, F.W. (2016). Child-Adult Relationship              Enhancement (CARE): An evidence-informed program for children with a history of trauma and other behavioral      challenges. Child Abuse & Neglect, 53, 138-145. https://doi.org/10.1016/j.chiabu.2015.10.016

NCTSN. (2020). CARE: Child-Adult Relationship Enhancement [Fact sheet].                                                        https://www.nctsn.org/sites/default/files/interventions/care_general_012120.pdf

Messer, E.P., Greiner, M., Beal, S., Cassedy, A., Eismann, E., Gurwitch, R.H., Boat, B., Bensman, H., Bemerer,
J., Greenwell, S., Eiler-Sims, P. (2018). Child Adult Relationship Enhancement (CARE): A brief, skills- building training      for foster caregivers to increase positive parenting practices. Children and Youth Services Review, 90, 74-                          82. 
https://doi.org/10.1016/j.childyouth.2018.05.017

Schilling, S., French, B., Berkowitz, S. J., Dougherty, S. L., Scribano, P. V., & Wood, J. N. (2017). Child-Adult         Relationship Enhancement in Primary Care (PriCARE): A randomized trial of a parent training for child                  behavior problems. Academic Pediatrics, 17, 53–60. http://dx.doi.org/10.1016/j.acap.2016.06.00 

Wood, J., Dougherty, S. L., Long, J., Messer, E. P., & Rubin, D. M. (2017). A pilot investigation of a novel                intervention to improve behavioral well-being for children in foster care. Journal of Emotional and                        Behavioral Disorders. https://dx.doi.org/10.1177/1063426617733715