SafeCare in Israel

SafeCare in Israel
Implementation Processes and Dilemmas
Paula David, MSW
Director, Dept. of Learning Programs
Haruv Institute, Jerusalem, Israel

The Haruv Institute, Jerusalem
O established in 2007 by the Lynn and
Charles Family Foundation
O Mission: training and research in the area
of child maltreatment
O Provides training to all professionals
working with abused or neglected children
O Tailor-made programs
O Importation of evidence-based programs
and interventions from overseas

Evidence-based practice (EBP)
in Israel
O The field of child welfare is still heavily influenced
by psychodynamic theory
O EBP, while used in mental health and taught in
various institutes (CBT, TB-CBT, EMDR, PE, etc.),
is not widely recognized in this field, especially in
services for early childhood
O The Haruv Institute is interested in importing
programs that can potentially prevent child
maltreatment, and especially neglect, which has
less focus in Israel
O SafeCare was considered a viable intervention
because it is relatively brief and can be taught in a
short period of time..

Picking a City - Ashdod
O Israel’s fifth largest city
O 62,000 households, 74,760 children
O 10,300 children ages 0-18 known to social
services
O A multicultural city
Ultra-
Orthodox,
25%
New
Immigrants,
33%
Born in
Israel, 42%

The implementation model
O Haruv Institute supports and finances the
training of three potential leaders of
SafeCare
O Haruv provides translation of all materials
O Ashdod Municipality provides time for the
leaders to be trained as home visitors,
coaches, and trainers, and to work with
clients
O Ashdod Municipality will hire home visitors
to work with clients, whom the Israel trainers
will train.

Key Stakeholders – Ashdod
Municipality
Director, Dept.
of Social
Services
Deputy director
Director, Agency
1
Director, Agency
2
Social worker 1
(child protection
officer)
Social
worker 2
(director of
intake)
Social worker 3
(family social
worker)
Director, Agency
3

Key Stakeholder – Haruv
Institute
O One senior professional from the Institute to
coordinate and accompany the process
O My main task: to remind the Ashdod group of
their motivation and commitment to SafeCare
1. Emails, phone calls and site visits to
providers and senior administrators to check
progress of implementation
2. Reminding senior administrators about the
providers’ needs, and what was promised to
them (a day a week for SafeCare)
3. Working with providers to edit and adapt
translations of materials

Ashdod provider’s training
program
O Home visitor training in Atlanta, GA.
O Two families each in Ashdod, coaching by
their Atlanta coach
O An implementation adaptation:
accelerated coaching training so they
could coach one another in Hebrew (not
previously a problem in SafeCare
implementation, even in Spain)
O Another five families to practice HV skills
before learning to become trainers

Translations – language,
pictures, culture
Yo Ch d
The sections below will help you take your baby’s temperature in his
bottom. This is the best way to see if your baby has a fever. Make sure
to always use a digital thermometer.
When do I take a rectal temperature?
 Your child seems sick and you are not sure what is wrong or how
serious the sickness is
 Rectal temperature is best for newborn babies to 3 months.
 Rectal temperature can be used for children up to 5 years
How do I take a rectal temperature?
Step 1. Step 2.
Rectal
Dip the tip of the thermometer
in K-Y Jelly or Vaseline
Turn the thermometer on. Label
this thermometer with the word
RECTAL.
Step 3.
Lay your baby on your lap, with
one hand on his back. Put the
thermometer a half inch into the
baby’s bottom. Wait for the beep.

Translations – cont.
?

.
?
.
!38.

Buy-in at all levels
O Director of social services in Ashdod is
committed to SafeCare implementation
O Agency directors less enthusiastic and
hesitant to provide necessary level of
support to providers
O Providers were formally promised one day
a week to see families. In reality, their
previous workload was not lessened

Inhibiting factors in
implementation: “because life happens”
O Families dropped out
 Both parents went to prison
 a mother wasn’t working, then started
working, then stopped working
O War in Israel

Promoting factors in
implementation
O Government funding in Israel for projects
targeted for projects addressing child
neglect
O SafeCare is easily learned and not
dependent upon experienced clinicians
O Ashdod stands to gain in status as an
early adopter, and champion of the
intervention

Promoting factors in implementation
(cont.) : potential cost effectiveness
O Cost of SafeCare: 408 GBP per family
O Cost of out-of-home placement for one
child: between 1070-2035 GBP, per month

How do we keep the
momentum?
O Keeping an eye on the goals
O Joint Ashdod Municipality-Haruv
conference in Ashdod, highlighting
innovations in EBP to prevent child
neglect, and SafeCare in particular
O Bringing key SafeCare developers to
Ashdod (Prof. Lutzker, Prof. Chaffin)
O Bringing ambivalent stakeholders to
Atlanta

The biggest implementation
challenges
O Funding for home visitors
O allocating sufficient time for effective
implementation (e.g., provider, coach, and
trainer time needed to conduct their
various roles efficiently and effectively)

What we have learned
O Implementation takes more time than
expected
O An organization’s original willingness to
adopt a new EBP does not preclude the
existence of fundamental obstacles to its
implementation
O It is difficult to imagine, in advance, all of
the resources needed to implement a new
EBP

SafeCare in Israel

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SafeCare in Israel