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Framework for Prevention of Child Maltreatment

Professionals working to prevent child abuse and neglect have borrowed from other disciplines, including public health, education, and mental health, to influence and guide practice. However, public health has had the greatest influence in organizing a framework of prevention services. That framework consists of three levels of services: primary prevention programs, directed at the general population (universal); secondary prevention programs, targeted to individuals or families in which maltreatment is more likely (high risk); and tertiary prevention programs, targeted toward families in which abuse has already occurred (indicated).

Distinctions among primary, secondary, and tertiary prevention do not necessarily reflect the way prevention-related services are actually organized and provided. Rather than sorting prevention initiatives into mutually exclusive categories, prevention is increasingly recognized as occurring along a continuum. A comprehensive system of care for improving outcomes for children and families needs to include strategies that coordinate resources across the entire continuum, from primary to secondary to tertiary prevention.

• Primary prevention
• Secondary prevention
• Tertiary prevention
• Ecological framework for prevention

Primary prevention

Primary prevention activities are directed at the general population and attempt to stop maltreatment before it occurs. All members of the community have access to and may benefit from these services. Primary prevention activities with a universal focus seek to raise the awareness of the general public, service providers, and decision-makers about the scope and problems associated with child maltreatment. Universal approaches to primary prevention might include:

• Public service announcements that encourage positive parenting
• Parent education programs and support groups that focus on child development, age-appropriate expectations, and the roles and responsibilities of parenting
• Family support and family strengthening programs that enhance the ability of families to access existing services, and resources to support positive interactions among family members
• Public awareness campaigns that provide information on how and where to report suspected child abuse and neglect

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Secondary prevention

Secondary prevention activities with a high-risk focus are offered to populations that have one or more risk factors associated with child maltreatment, such as poverty, parental substance abuse, young parental age, parental mental health concerns, and parental or child disabilities. Programs may target services for communities or neighborhoods that have a high incidence of any or all of these risk factors. Approaches to prevention programs that focus on high-risk populations might include:

• Parent education programs located in high schools, focusing on teen parents, or those within substance abuse treatment programs for mothers and families with young children
• Parent support groups that help parents deal with their everyday stresses and meet the challenges and responsibilities of parenting
• Home visiting programs that provide support and assistance to expecting and new mothers in their homes
• Respite care for families that have children with special needs
• Family resource centers that offer information and referral services to families living in low-income neighborhoods

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Tertiary prevention

Tertiary prevention activities focus on families where maltreatment has already occurred (indicated) and seek to reduce the negative consequences of the maltreatment and to prevent its recurrence. These prevention programs may include services such as:

• Intensive family preservation services with trained mental health counselors that are available to families 24 hours per day for a short period of time (e.g., 6 to 8 weeks)
• Parent mentor programs with stable, nonabusive families acting as "role models" and providing support to families in crisis
• Parent support groups that help parents transform negative practices and beliefs into positive parenting behaviors and attitudes
• Mental health services for children and families affected by maltreatment to improve family communication and functioning

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Ecological framework for prevention

An ecological framework for prevention is based on the following assumptions:

• Children and families exist as part of an ecological system. This means that prevention strategies must target interventions at multiple levels: the individual, the family, the community, and society.
• Primary responsibility for the development and well-being of children lies within the family, and all segments of society must support families as they raise their children.
• Assuring the well-being of all families is the cornerstone of a healthy society and requires universal access to support programs and services.

CBCAP Conceptual Framework (PDF - 42 KB)
FRIENDS National Resource Center for Community-Based Child Abuse Prevention (2006)
The Community-Based Child Abuse Prevention (CBCAP) program is a formula grant program for States authorized by Title II of the Child Abuse Prevention and Treatment Act. The CBCAP conceptual framework provides an overview of the primary purposes of the legislation and describes the relationship between the underlying conditions the program seeks to address; the main activities funded (direct and indirect); the outputs; and the program's short-term, intermediate, and long-term outcomes.

Developing a Comprehensive Approach to Child Abuse and Neglect Prevention: Strategies for State and Social Policymakers (PDF - 172 KB)
Finance Project (2005)
Outlines the three levels of child abuse and neglect prevention and reviews State and local approaches that can be used to address each level.

Module 1: Orientation to Violence Prevention
PREVENT Institute
An online training module to help the user learn about primary prevention, the public health approach to violence prevention, and how that approach can be used to develop primary violence prevention programs.

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Updated on January 5, 2009