Safe Start in the Community: Philadelphia, Penn.

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Throughout the month we will feature the 10 Safe Start Promising Approaches grantees and the work they’re doing in their communities to help children exposed to violence and their families.

Carla is a 22-year-old African-American mother of Quinton age 2 and Sylvie age 1 month. Carla was sexually abused by her stepfather starting at age 8 and ending at age 15 when she ran away. She was placed in a foster home where her foster father sexually abused her from ages 15 to 17 when she again ran away. She lived with her boyfriend and was the victim of domestic partner violence. She has had several miscarriages as a result of the violence.

Carla is involved in the Health Federation of Philadelphia Early Head Start program, which referred her to the Enhanced Home Visitation Project (EHVP). She is exhibiting disturbing behaviors: cutting herself, physically attacking others in her home, having blackouts and seizures following flashbacks, non-nurturing with her children including withholding food, afraid to leave her house, and expressing feelings of hopelessness.

A family trauma specialist from EHVP visits Carla 24 times in her home to facilitate the Safety, Emotions, Loss and Future (S.E.L.F.) psycho-educational program. To work through the stages of trauma recovery, Carla learns how to create a safe environment. She uses candles, music, knitting, puzzles, and self-soothing techniques to ground herself.

Because Carla lives with relatives in an overcrowded household, it is difficult for the trauma specialist to create opportunities for Carla to engage with her children, but slowly Carla can hold her children, make eye contact, and share food with them. Gradually, Carla is becoming less angry and is able to maintain contact with two neighbors. For 6 weeks, Carla works on a transition project, develops a safety plan, and integrates self-soothing techniques into her daily activities. At one time, Carla did not believe she was a survivor, but now she writes in her journal: “Today I’m a survivor. I’m excited about a brighter future.”

Health Federation of Philadelphia
Enhanced Home Visitation Project

1211 Chestnut Street, Suite 801
Philadelphia, PA 19107


Embeds trauma specific services in a home visitation program. Prevents intergenerational trauma transmission by identifying and addressing unresolved caregiver trauma and its impact on parenting.

Target Population:

Parents/caregivers and children

Age Range:



  • Safety, Emotions, Loss and Future (S.E.L.F.) Psycho-Educational Program*
  • Integration
  • Capacity Building
  • Home Visitation

*Evidence-based or promising practice


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