Is a Structured, Manualized, Evidence-Based Treatment Protocol Culturally Competent and Equivalently Effective Among American Indian Parents in Child Welfare?




Mark Chaffin, David Bard, Dolores Subia Bigfoot, and Erin J. Maher

Brief Type

Journal Publication


  • Other Models


In a statewide implementation, the manualized SafeCare home–based model was effective in reducing child welfare recidivism and producing high client satisfaction. Concerns about the effectiveness and acceptability of structured, manualized models with American Indians have been raised in the literature, but have rarely been directly tested. This study tests recidivism reduction equivalency and acceptability among American Indian parents. A subpopulation of 354 American Indian parents was drawn from a larger trial that compared services with versus without modules of the SafeCare model. Outcomes were 6-year recidivism, pre/post/follow-up measures of depression and child abuse potential, and post treatment consumer ratings of working alliance,service satisfaction, and cultural competency. Recidivism reduction among American Indian parents was found to be equivalent for cases falling within customary SafeCare inclusion criteria. When extended to cases outside customary inclusion boundaries,there was no apparent recidivism advantage or disadvantage. Contrary to concerns, SafeCare had higher consumer ratings of cultural competency, working alliance, service quality, and service benefit. Findings support using SafeCare with American Indian parents who meet customary SafeCare inclusion criteria. Findings do not support concerns in the literature that a manualized, structured, evidence-based model might be less effective or culturally unacceptable for American Indians. (author abstract)

Data Collection Methods

  • Program administrative record reviews
  • Standardized assessment tools



For More Information

Chaffin, M., Bard, D., Bigfoot, D. S., & Maher, E. J. (2012). Is a structured, manualized, evidence-based treatment protocol culturally competent and equivalently effective among American Indian parents in child welfare? Child Maltreatment17(3), 242-252.
doi: 10.1177/1077559512457239
Author Contact Information:
Mark Chaffin


  • Participant Characteristics
  • Participant, Family, and Program Outcomes