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Take CARE: Enhance the Caregiver-Child Bond

Growing up, your child will interact with countless adults who may have a profound impact on their lives, including you as the parents. In an ideal world, all caregivers in a child’s life would have the skills to interact positively with children and encourage improved behavior. When it comes to children’s mental health, the responses they get from adults in their lives can greatly impact their daily well-being and behaviors. Knowing the ways to positively interact with your children can be a gamechanger for your whole family, and a gamechanger for other adults in their lives!

Child-Adult Relationship Enhancement (CARE) is an intervention designed to coach participants in skills for improving attachment, strengthening relationships with children, and reducing mild to moderate behavior concerns. While this intervention is not therapy, CARE providers aim to coach parents and caregivers in how to use safe, consistent, and effective skills that result in improved child compliance and reduced conflict. CARE principles are trauma-informed and sourced from reputable evidence-based parenting interventions proven to be effective through decades of research. This means that the skills included in the CARE intervention are safe to use with children who have experienced traumatic events, and we know that they are effective when implemented correctly.

The intervention was designed with the knowledge in mind that child maltreatment impacts a significant portion of children and adolescents across the United States and worldwide. In 2022, there were approximately 500,000 victims of child abuse and neglect nationally. CARE intends to provide all adults with the skills to improve interactions with kids, even if they are not their own. Spreading the knowledge about how to have positive interactions with children can help to protect kids and adolescents across all settings. Since 2006, over 2,000 individuals have participated in CARE training with a focus on supporting and interacting with kids who have experienced traumatic life events. Adaptations of CARE have been developed and successfully implemented for natural disasters and other atrocities like gun-violence and mass casualty events.

This intervention has been successfully implemented with adults in a variety of settings. This includes medical professionals, foster parents, child life specialists, child victim advocates, day care providers, teachers and school counselors, law enforcement officials, coaches, and many more. CARE is a single session intervention, which makes it accessible for caregivers in all settings to attend and implement. When caregivers outside of the home engage in CARE training, and implement the skills with the children they see, they’re increasing the positive reinforcement that children get across all settings for appropriate behavior. These caregivers' bonds with children will be enhanced because of skill use, which naturally increases the number of adults that children can identify as safe people in their lives.

Each CARE training includes a supportive combination of psychoeducation, activities, and live practice with a trainer and the other participants. Throughout the one-day training, the trainer will help you identify ways to use CARE skills with kids and teens to increase positive bonds and decrease maladaptive behaviors, and they will help you identify how you can integrate these skills into the settings where you often work with youth.

While CARE is not a clinical intervention, there is some emerging research that it can support children and families in need of behavioral health care. With children’s mental health waitlists growing longer than ever, CARE provides effective strategies for supporting kids in the interim and could potentially reduce symptoms prior to starting treatment. This in turn might make psychotherapy interventions shorter so kids with less acute symptoms do not need more intensive clinical care.

If you are an adult with your own kids, who works with kids, or who has young relatives, participating in CARE training could be beneficial for you! Stay tuned for more information about CARE offerings here at our Center for Effective Therapy for the Summer of 2024.

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.
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, skillsbuilding training for foster caregivers to increase positive parenting practices. Children and Youth Services Review, 90, 74-82.
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.
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.