About the program

The Promoting First Relationships^® (PFR) program is a 10-week home visiting service that aims to support families to build positive connections, strengthen parent/carer confidence and increase parent/carer caregiving through use of strengths-based, reflective video feedback and curriculum.

Program structure

The PFR program is delivered weekly, for 1 hour, over a 10-week period with parents/carers and their children.  

Facilitators follow a program manual and observe interactions between parents/carers and their children via video recordings. Video recordings are used to help parents/carers reflect on their child’s social and emotional needs and how they respond to those needs. Facilitators then support parents/carers to better respond to their child’s needs; in the process building parenting confidence and competence. 

Facilitator training

Three levels of training are offered:

1. Knowledge building: Designed for service providers or practitioners, this foundations course is a 14-hour workshop which is delivered online over 4 half days. The course covers PFR skills and knowledge and how to apply them in practice.  
2. Skill building: A 15-week online, mentored professional development training course which leads to certification in the PFR evidence-based home visiting model. After completing this training, practitioners can deliver the 10-week PFR intervention in their own setting with a parent/ carer and child dyad.  
3. Agency trainer: An additional 15-week online training program is by invitation only to certified PFR providers who have shown high fidelity to the program are eligible to participate. The participant is mentored by a PFR Master trainer to grow their PFR expertise with a 2nd dad and learn how to train others in PFR level 2.

Learn more about the training program.

Cost

Level 1: $640 per person. The cost covers the training course and reproducible parent/caregiver handouts

Level 2: $2,750 per person. The cost includes 15 contact hours with a PFR master trainer, and a fidelity certification fee.

Level 3: $2,750 per person 

Evaluation and effectiveness

PFR has been extensively tested using randomised control trials with diverse populations of caregivers with toddlers (Oxford, Spieker et al., 2016; Spieker et al., 2012). The results of these and other studies (Pasalich et al, 2016, Spieker et al, 2014, Oxford et al, 2023) show that families, including families with the greatest need, positively benefit from the program.

For example, results from Oxford, Spieker and colleagues’ (2016) study of families who were under investigation by Child Protective Services for maltreatment (n=247), demonstrated statistically significant effects on parent understanding of toddlers, parent sensitivity, and child atypical affective communication. The study demonstrated non-significant effects on parent stress, child social-emotional competence and child emotion-regulation.  

An older study examined the outcomes of 210 families who were randomised into intervention and control groups (Spieker et al., 2012). In similar findings to the Oxford et al., paper (2016), parents/carers who attended PFR demonstrated improved levels of parental sensitivity compared to those in the control group. However, there were no major differences between the two groups on child security outcomes.

Visit the PFR website for further research.

References

Oxford, M. L., Spieker, S. J., Lohr, M. J., & Fleming, C. B. (2016). Promoting first relationships®: Randomized trial of a 10-week home visiting program with families referred to child protective services. Child Maltreatment, 21(4), 267–277. https://doi.org/10.1177/1077559516668274  

Oxford, M. L., Hash, J. B., Lohr, M. J., Fleming, C. B., Dow-Smith, C., & Spieker, S. J. (2023). What works for whom? Mother’s psychological distress as a moderator of the effectiveness of a home visiting intervention. Infant Mental Health Journal, 44(3), 301–318. https://doi.org/10.1002/imhj.22050

Pasalich DS, Fleming CB, Oxford ML, Zheng Y, Spieker SJ. (2016). Can parenting intervention prevent cascading effects from placement instability to insecure attachment to externalizing problems in maltreated toddlers? Child Maltreatment, 21(3):175-185. doi:10.1177/1077559516656398

Spieker, S. J., Oxford, M. L., Kelly, J. F., Nelson, E. M., & Fleming, C. B. (2012). Promoting first relationships: Randomized trial of a relationship-based intervention for toddlers in child welfare. Child Maltreatment, 17(4), 271–286. https://doi.org/10.1177/1077559512458176

Oxford, M.L., Spieker, S.J., Lohr, M.J., & Fleming, C.B. (2016). Promoting first relationships®: Randomized trial of a 10-week home visiting program with families referred to child protective services. Child Maltreatment, 21(4):267-277. doi:10.1177/1077559516668274