Written by Zoe Bezeckzy

Intensive family preservation services are designed to keep families together where safe and possible to do so, and the evidence is promising. 

What are intensive family preservation services? 

Intensive family preservation services support families with children at imminent risk of entering care. They seek to avoid the need for children to enter care by overcoming the current crisis and providing families with the opportunity to develop their skills. 

The service is based on the ‘Homebuilders’ model which was established in the US. The model has several core characteristics. For example:  

  • Families are contacted within 24 hours of a referral.
  • Caseworkers are available to families 24 hours a day, 7 days a week.
  • Support is provided in the family’s home over a short period of 4-6 weeks.

Are they effective? 

To understand whether intensive family preservation services are effective at reducing the need for children to enter care, we conducted a systematic review. The review included 33 studies. All the studies included a group of families who received the service and a comparison group who did not.  

There were two key findings. First, intensive family preservation services tended to reduce the likelihood of out-of-home care. In studies that tracked the outcomes of individual children, the risk of being placed in care was reduced at 3, 6, 12 and 24 months after the intervention. In studies that tracked the outcomes of families, the risk of one or more child entering care was reduced overall but not at the individual time points. 

Second, it was clear that the effectiveness of the service varied. This suggests that the quality of implementation is likely to be crucial. We know from the literature that the services differed in terms of length, intensity, and the availability of the family’s caseworker. But there are likely to be other important differences. For example, personal and contextual factors are harder to capture and report in the literature, but they may play an important role. Further qualitative research is needed to identify the key elements that enable intensive family preservation services to be effective. 

Are they cost-effective? 

Seven studies in our review included a partial economic evaluation. They provided some evidence to suggest that the service could be cost saving. For instance, one study found that the local authority saved £1,178 in placement costs for each child referred to the service. However, the data was limited, and full economic evaluations are needed. 

What does this mean for practice?

Overall, intensive family preservation services appear to be a promising way of reducing the number of children who enter care. The service does not appear to be widely used in the UK and there is potential value in offering it to families. The studies in our review were predominately from the US so further evaluations of the service in the UK would be beneficial. 


Written by

Zoe Bezeckzy