The CARE Curriculum represents an important period in the development and implementation history of the Triple-A Model of Therapeutic Care and Secure Start’s work with children, caregivers and organisations.
CARE organised therapeutic caregiving around four qualities: Consistency, Accessibility, Responsiveness and Emotional Connectedness.
It was developed as a practical framework for helping caregivers think about the everyday experiences they create for children affected by adversity and was applied across a range of child, family and community service settings.
CARE also provided an important vehicle for implementing principles associated with the Triple-A Model of Therapeutic Care at scale.
Secure Start now uses AAA and AURA as the two complementary frameworks within the contemporary Triple-A Model of Therapeutic Care. CARE is therefore retained here as part of the developmental and implementation history of Triple-A and related Secure Start work, rather than as a separate contemporary Secure Start Model of Care.
CARE and the development of Triple-A
The relationship between CARE and Triple-A developed over time.
The foundational Triple-A approach was first published in Educational and Child Psychology in 2010. Triple-A focused attention on three domains relevant to understanding children affected by adversity:
Attachment
Arousal
Accessibility to needs provision
CARE subsequently provided a framework for considering the qualities of caregiving and relating that might positively influence these areas.
The CARE framework emphasised:
Consistency — providing sufficiently predictable and dependable caregiving experiences.
Accessibility — being emotionally and physically available to the child.
Responsiveness — recognising and responding appropriately to the child’s needs.
Emotional Connectedness — maintaining warmth, connection and emotional engagement within the caregiving relationship.
In this way, CARE contributed to the development of the therapeutic-responding side of Triple-A.
The contemporary Triple-A Model has subsequently consolidated this work into two complementary frameworks:
AAA — understanding what may be happening for the child
and
AURA — considering how we can respond therapeutically.
AURA emphasises caregiving that is Accessible, Understanding, Responsive and Attuned.
CARE should therefore be understood as an important part of the developmental lineage of contemporary Triple-A rather than as a third framework sitting alongside AAA and AURA.
The Kinship CARE Project
One of the most substantial implementations of CARE occurred through the South Australian Kinship CARE Project.
Between 2018 and 2020, Secure Start delivered a two-year initiative with the support of the South Australian Department for Child Protection.
The project applied a contextualised CARE framework that explicitly drew upon Triple-A to help kinship carers understand children’s behaviour and provide therapeutic caregiving.
By completion, the project had reached 250 kinship carers across 24 metropolitan and regional locations in South Australia.
Among carers completing the training and three-month follow-up survey:
- 84% reported improved relationships with children in their care.
- 89% reported greater confidence in their role as a kinship carer.
- 98% reported learning helpful strategies.
- 100% reported receiving helpful information.
Session evaluations also demonstrated very high levels of participant satisfaction, perceived usefulness and willingness to recommend the program.
Pre- and post-training findings suggested a change in the way carers understood children’s behaviour. Following training, carers were more than twice as likely to describe behaviour in terms of children’s needs rather than simply in terms such as “naughtiness”.
These findings provide useful practice-based evidence concerning the CARE implementation. They should not be interpreted as demonstrating the effectiveness of the contemporary Triple-A Model itself.
Implementation across the service system
An important feature of the Kinship CARE Project was that implementation extended beyond training individual carers.
Department for Child Protection staff and psychologists also received preparation and support so that carers could encounter a consistent therapeutic framework through their interactions with the wider service.
The implementation sought to establish shared language and practice across different levels of the Kinship Care Program and included attention to workforce development, implementation support and fidelity.
This experience contributed to the subsequent development of Triple-A’s contemporary distinction between:
Foundation Training
Practice Integration
Organisational Embedding
and
Fidelity and Continuous Development.
The Kinship CARE Project therefore forms an important part not only of the practice history of Triple-A, but also of the development of its approach to implementation.
Martinthi Aboriginal Kinship CARE Program
The Kinship CARE approach continued between 2021 and 2024 through the Martinthi Aboriginal Kinship CARE Program in South Australia.
Martinthi involved collaboration between InComPro, Bookyana, UCWB and Secure Start and provided a further context in which CARE and Triple-A-informed principles were applied within kinship care.
This period is retained as part of the implementation and developmental history of CARE and Triple-A.
It is not presented here as evidence of particular outcomes, as Secure Start does not currently hold evaluation material suitable for public reporting.
From CARE to AURA
The development of AURA represents an evolution rather than a rejection of the therapeutic principles that informed CARE.
CARE emphasised:
Consistency
Accessibility
Responsiveness
Emotional Connectedness
AURA now asks caregivers to reflect on whether their caregiving is:
Accessible
Understanding
Responsive
Attuned
The change reflects the continuing development of Triple-A as an integrated Model of Therapeutic Care.
AAA provides a framework for understanding the child’s experience.
AURA provides a framework for therapeutic responding.
Together they provide the contemporary architecture of Triple-A.
CARE remains significant because it contributed to the development of this architecture and provided a framework through which Triple-A principles were implemented with substantial numbers of caregivers and across service systems.
The contemporary Triple-A Model of Therapeutic Care
Secure Start no longer presents CARE as a separate contemporary Model of Care or as a framework alongside AAA and AURA.
The current Triple-A Model of Therapeutic Care is organised around:
AAA
Attachment
Arousal
Accessibility to needs provision
and
AURA
Accessible
Understanding
Responsive
Attuned
Triple-A is supported by Foundation Training, Practice Integration, Organisational Embedding and Fidelity and Continuous Development.
Learn about the contemporary Triple-A Model of Therapeutic Care
Read the Triple-A Evidence & Practice Foundation
Some Stats:
A two-year joint-initiative of Secure Start® and the Department for Child Protection (DCP) in South Australia, the CARE Curriculum was delivered to 250 kinship carers across 7 regional and 17 metropolitan locations. Twelve percent (12%) of participants identified as being of Australian Aboriginal descent. Eighty-four percent (84%) of participant kinship carers who completed the training and a three-month follow up survey reported that they were experiencing improved relationships with the children in their care, eighty-nine percent (89%) reported that they felt more confident in the role, ninety-eight percent (98%) reported that they had learnt strategies that had helped them in the kinship role, and one-hundred percent (100%) reported that they had received helpful information. Session by session evaluations showed that more than 98% of participant kinship carers indicated that the training was informative, practical and useful, that they were satisfied with the training, and that they would recommend it to other kinship carers. Analysis of pre-post questionnaires for the first twelve implementation groups identified that kinship carers were more than twice as likely to refer to behaviour being an expression of needs, as opposed to naughtiness, after four training sessions.
References:
Pearce, C.M. (2016) A Short Introduction to Attachment and Attachment Disorder (Second Edition).London, Jessica Kingsley Publishers
Pearce, C & Gibson, J (2016), A Preliminary Evaluation of the Triple-A Model of Therapeutic Care, Foster, 2, 95-104
Pearce, C.M. (2011). A Short Introduction to Promoting Resilience in Children. London, Jessica Kingsley Publishers
Pearce, C.M. (2010). An Integration of Theory, Science and Reflective Clinical Practice in the Care and Management of Attachment-Disordered Children – A Triple A Approach. Educational and Child Psychology (Special Issue on Attachment), 27 (3): 73-86