A necessary but not sufficient intervention: Implementing safe and together across Scottish and English sites – Psychiatry AI: Real-Time AI Scoping Review

AI Summary

Safe & Together increased acceptability and shifted practice from mother-blaming to perpetrator-pattern focused assessments, improving assessment quality.
Assessment gains were undermined by scarce perpetrator programmes and children's therapeutic services, leaving identified needs unmet.
No evidence of adult or child survivor involvement; co-production and infrastructure investment are required for genuine, comprehensive transformation.

Child Abuse Negl. 2026 Jul 16;179:108223. doi: 10.1016/j.chiabu.2026.108223. Online ahead of print.

ABSTRACT

BACKGROUND: Child welfare responses to domestic violence and abuse often blame mothers for “failing to protect” while ignoring perpetrators. The Safe & Together model promises transformation through perpetrator pattern-focused assessment.

OBJECTIVE: To examine how S&T implementation translates into practice across diverse UK child welfare contexts.

METHODS: Focus groups with 55 professionals across five Scottish and English sites were analyzed using Two-Stage Reflexive Implementation Analysis, integrating reflexive thematic analysis with Proctor’s implementation framework.

RESULTS: Safe & Together achieved high practitioner acceptability, with professionals reporting it resolved conflicts between their values and bureaucratic demands. Implementation successfully transformed professional language from mother-blaming to perpetrator pattern analysis and improved assessment quality. However, critical gaps were identified between assessment capabilities and intervention availability. Insufficient perpetrator programmes or children’s therapeutic services existed to address identified needs. There was also no evidence of involvement of adult or child survivors in implementation of the intervention, despite “partnering” rhetoric.

CONCLUSIONS: Safe & Together is necessary but insufficient for comprehensive transformation. While successfully shifting professional consciousness away from victim-blaming, the model cannot improve family outcomes without parallel investments in intervention infrastructure. The absence of family voices in both model development and implementation perpetuates professional-centric approaches even within anti-oppressive innovations. This “necessary but not sufficient” framework advances implementation science beyond binary success/failure assessments. Findings indicate that genuine transformation requires not only assessment innovation but also service infrastructure development and authentic co-production with families experiencing domestic violence and abuse.

PMID:42462417 | DOI:10.1016/j.chiabu.2026.108223

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