Communities That Care: from social work, and with evidence of effect

Introduction: a child of social work

The most common misunderstanding about Communities That Care (CTC) is that the approach is too deficit-oriented: too far from everyday life, too technocratic, an import from public health that hands out questionnaires and manuals over the heads of practitioners. The premise is wrong. CTC does not come from a foreign professional culture but from social work itself. It was developed in the Social Development Research Group at the University of Washington’s School of Social Work, around J. David Hawkins and Richard F. Catalano, and its authors describe it explicitly as “a model of social work practice”, along four core principles of the profession: evidence-informed, ecologically grounded (person-in-environment), strengths-based and justice-promoting (Haggerty & Shapiro, 2013).

CTC thus embodies a professional ideal of social work, and it joins that ideal to something the profession has traditionally found difficult: systematic evidence of effect at the level of a whole system. More than that, the approach answers problems that social work with children and young people, in Europe as elsewhere, has long diagnosed in itself. The real question is therefore not whether CTC fits social work but what it adds to it.

The reservations of practitioners deserve to be taken seriously all the same: the worry about a focus on deficits, the neglect of lived experience and of the professional relationship, the risk of a “technocratisation” in which pedagogical tact gives way to fidelity to a manual. The objection has a distinguished core: the “technology deficit” described by Luhmann and Schorr (1982), the insight that systems which set out to change people, such as education and social work, structurally lack a reliable causal technology, because their counterpart is a participating, self-determining subject. This article tests the objections against the guiding principles of social work, sets out what CTC adds to services for children and young people, and reads the evidence, which has grown, with care.

The guiding principles of social work

Social work with children and young people is shaped by principles against which any prevention system must be measured. The vocabulary differs from country to country; the substance travels.

• Orientation to everyday life: the aim is to make a more successful everyday life possible within the medium of everyday life itself, respecting how people already cope in the dimensions of lived time, lived space and social relationships (Grunwald & Thiersch, 2018). The principle of proximity follows: measures that support the resources already present “in the field” take precedence over those that create their own arrangements and replace people’s own world.
• Orientation to resources and coping: strengths and the work of coping stand at the centre, not deficits. Böhnisch’s paradigm of life-coping captures the striving for agency in critical situations in which psychosocial balance is threatened, and ties it back to social-structural conditions (Böhnisch, 1997). It is a bridge to the logic of risk factors and protective factors.
• Orientation to the neighbourhood: area-based practice starts from what people want and are interested in, gives activating work precedence over care, orients itself to personal and local resources, works across target groups and departments, and rests on the networking and cooperation of services (Budde, Früchtel & Hinte, 2006).
• Participation and empowerment: Article 12 of the UN Convention on the Rights of the Child gives every child the right to be heard in all matters affecting them, in accordance with their age and maturity, and most European child-welfare laws restate the duty for public services. Professionally, it means taking those we serve seriously as the experts on their own situation. Empowerment operates at four levels – individual, group, institutional and community (Herriger, 2014) – and if it is narrowed to the individual level, structural problems are quietly depoliticised.

What CTC adds to services for children and young people

Social work names its own weaknesses. A national evaluation of outcome-oriented youth services in Germany recorded that systematic research on effects was virtually absent in social pedagogy and social work, and that much of what passed for it consisted of self-evaluations, formative evaluations and surveys (Albus et al., 2010). Readers in other European countries will recognise the pattern, and its companions: the siloing of services, which makes tailored, cross-departmental arrangements hard to build (Früchtel, Cyprian & Budde, 2013); planning for children’s services that is poor in data, with no obligation to integrated, small-area monitoring (Gehne & Schröpler, 2020); and the prevention dilemma, in which universal offers reach the groups that were never much at risk and reach the most burdened groups least (Bauer, 2005) – the inverse care law in a youth-work setting. All of this under a double pressure to justify itself, from tight budgets and from growing scepticism about effects (Albus et al., 2010).

These are exactly the sites where CTC goes to work, turning social work’s own guiding principles from programme statement into testable practice:

• Binding cooperation. CTC brings the otherwise siloed departments – youth services, schools, health, police, civil society – to one table and gives them, in the risk and protective factors, a shared professional language. The expected effect grows with breadth: “the greater the number of sectors involved in CTC, the greater the expected community-level change” (Haggerty & Shapiro, 2013). A declaration of intent to cooperate becomes a standing working structure, the community board.
• Measured need. Where planning otherwise rests on intuition and on what happens to be on offer, CTC uses an anonymous pupil survey to produce a small-area profile of the risk factors that are actually elevated and the protective factors that are actually weak, and prioritises on that basis. The instrument has been validated in several European countries; the German version, for instance, is psychometrically sound and valid against violence, delinquency, substance use and depressive symptoms (Reder et al., 2024). Data-poor planning gains an empirical picture of its own neighbourhood.
• Tested programmes. The prioritised factors are coupled to programmes whose effect has been tested, through an evidence register: the European Xchange register, or a national one where it exists (Brender et al., 2024, describe the German register). Availability and habit no longer decide the choice; demonstrated effect does. That is the methodological answer to the effect gap the profession names in itself.
• Prevention in proportion to need. Because CTC works area by area and invests more where the burden is higher, it follows what the Marmot Review calls “proportionate universalism”: offers remain universal in principle, but their intensity rises with the deprivation of the area (Marmot Review, 2010). In Rose’s terms, CTC shifts the whole risk distribution of a community rather than picking out individual high-risk cases (Rose, 1992). That softens the prevention dilemma between neighbourhoods. It does not abolish it (see below).
• Structure instead of project. CTC invests in building municipal capacity, not in yet another time-limited project – the answer to the notorious project form of prevention and the lack of sustainability that goes with it (Wohlgemuth, 2009). First findings from Germany show that municipalities with higher capacity not only work from evidence more often; their adolescents also use less alcohol, tobacco and drugs, which is exactly what prevention is meant to achieve (demonstrated as an association, not yet as a causal effect; Birgel et al., 2024).
• Legitimacy through cost and benefit. CTC is one of the few prevention strategies with a robust economic balance: the long-term US study ended with a return of around 12.90 dollars per dollar invested (Kuklinski et al., 2021), an argument that takes municipal prevention out of the defensive.

That CTC is not pure risk management is a matter of its theory. The Social Development Model holds that opportunities for prosocial involvement, skills and recognition strengthen the bond to prosocial people and institutions, and that this bond works against antisocial behaviour (Catalano & Hawkins, 1996). CTC therefore measures and deliberately strengthens protective factors (Walter et al., 2023), which places it close to positive youth development – the fostering of competence, connection, self-efficacy and prosocial norms (Catalano et al., 2004) – and to the salutogenic view of the conditions of health, in the sense of salutogenesis (Raithel, 2011). And the fear of technocratisation? What matters is the distinction between the what (which programme) and the how (its pedagogical delivery), provided evidence is understood correctly: it gives the practitioner not “direct rules or guidelines” but “plausible hypotheses for intelligent problem solving” (Otto, Polutta & Ziegler, 2009). Precisely this question – what knowledge social work needs, and how far a claim to effectiveness reaches – has shaped the profession’s debate for a long time (Otto, Polutta & Ziegler, 2010); it is also a warning not to narrow “effect” to a linear notion that does not do justice to the complexity of social-pedagogical work (Oelerich & Otto, 2011). Evidence informs professional judgement; it does not replace it. That is what reflexive professionalism means.

CTC in the European landscape of social work

In disciplinary terms CTC belongs to the tradition of community organising – the activating, participatory, resource-oriented and cross-sector line of social work that Haggerty and Shapiro (2013) name explicitly as the approach’s home (for the German-speaking tradition see Stövesand, Stoik & Troxler, 2013), and that goes under many names in Europe: community work, community development, Gemeinwesenarbeit, travail social communautaire, opbouwwerk. Professionally it connects directly: most European child-welfare laws contain a preventive, promotional mandate alongside the protective one, and most oblige local authorities to plan services for children and young people on the basis of need. CTC’s data-based prioritisation is a way of honouring the second obligation. Decisions are taken in a steering group of key leaders and in an operational community board in which the most important local institutions should be represented (Walter et al., 2023). In Germany, where CTC was first piloted at three sites from 2009, the professionals involved largely accepted the programme logic (Schubert et al., 2013); the approach has since spread to municipalities in several federal states, and to a number of other European countries, as the Europe page records.

Participation is not a side issue here but the operating principle. CTC runs through five phases and builds a broad coalition of key leaders, practitioners, residents, parents and young people, which places priorities, programme selection and implementation in local hands and makes the community the owner of its action plan (Hawkins & Catalano, 1992; Haggerty & Shapiro, 2013). The perspective of young people is in fact the starting point of the whole process: their anonymous self-reports in the pupil survey – a full census of the neighbourhood – determine the diagnosis and with it the choice of measures. What remains to be calibrated is only the depth of direct co-decision. Who belongs to the coalition is decided locally (Haggerty & Shapiro, 2013), so the degree of formal youth participation varies from site to site – a matter of local design, not of the model.

Understood in this way, CTC is not a rival to area-based social work but its operating system: it makes the recognised but rarely realised principles – the resource view, cross-sector networking, activating rather than caretaking work – achievable as a process and open to verification. One tension remains at the core. Area-based social work starts from the articulated will of the people, not from a need defined from outside (Hinte & Treeß, 2014); CTC begins, conversely, with an epidemiologically measured risk profile. Reconciling data-based prioritisation with the will of those affected is not something the approach resolves by itself; it hands the task to local practice. The sore point is in any case less professional fit than continuity. Whatever the statutory framework in a given country provides for the structural side of prevention – the coordination, rather than the programmes – it tends in practice to be a subordinate option that depends on co-financing by the municipality. Local coordination of at least half a post has to be secured permanently, or the approach stays dependent on individuals (Schubert et al., 2013).

What the effectiveness research shows

The evidence has become broader and more robust in recent years. Its foundation is the Community Youth Development Study, a community-randomised controlled trial in 24 US communities with 4,407 adolescents. The most reliable findings come from it. In the United States, CTC reduced the cumulative risk of carrying a handgun in adolescence by around a quarter (OR 0.76; 95 % CI 0.70–0.84; Rowhani-Rahbar et al., 2023) – a central indicator of violence in the US context and not directly transferable to Europe. And at 23, twelve years after the programme began, young adults who had grown up in CTC communities still showed higher rates of sustained abstinence from alcohol and drugs; the benefit-cost analysis, resting on individual significant results despite behavioural effects that were on the whole modest, found a net benefit of around 7,150 US dollars per person (Kuklinski et al., 2021). Outside trial conditions too, in routine practice across 388 school districts and just under 471,000 pupil surveys in Pennsylvania, CTC districts showed lower levels of substance use, delinquency and depression (small to moderate; Chilenski et al., 2019). An Australian benefit-cost finding (around 2.6 Australian dollars per dollar; Abimanyi-Ochom et al., 2024) and a recent violence finding from disadvantaged Denver neighbourhoods (Kingston et al., 2026) support the picture – the latter with a qualification: the fall in youth arrests for violence appeared in only one of the two communities, a sign that context and quality of implementation decide success (more on the Denver study).

Equally important is what the evidence does not support. The long-term effects of the US study concern above all a prevented onset of risky behaviour, not current behaviour at 21; the global test across all primary endpoints narrowly missed significance, and the effects were concentrated among young men (Oesterle et al., 2018). Favourable effects on protective factors in grade 8 (Kim, Gloppen et al., 2015) were no longer consistently detectable by grade 10 (Kim, Oesterle et al., 2015). There is also a proximity effect in the research itself: a considerable share of the most robust findings comes from the group that developed the approach; independent replications in Pennsylvania, Australia and Denver point in the same direction, but the closeness of programme and evaluation has to be kept in mind when weighing them. In November 2025 the UK Youth Endowment Fund pooled 41 effect sizes from 13 publications and found a pooled relative risk of 0.93 across violence and offending outcomes, with a 95 % confidence interval of 0.84 to 1.02 that includes no effect; it rated the approach as low impact and very low confidence, on a set of studies none of which came from the United Kingdom (our reading of the verdict).

For Europe, robust evidence of behavioural effects is still outstanding. The German research so far has secured the study design (Röding et al., 2022) and the instrument (Reder et al., 2024). At the level of the municipal prevention system, the CTC-EFF study found no significant effects over the observation period to 2023; the authors attribute this to implementation progress slowed by the pandemic (Röding et al., 2026). What did demonstrably increase was the number of evidence-based programmes implemented (Decker et al., 2025) – not, so far, adolescent behaviour. A meta-analysis of the twelve pairs of sites finds, at the same time, a positive overall effect on adoption (g = 0.57) and attributes 40.5 % of the variation between sites to implementation quality (von Holt et al., 2025; a conference paper for now). The two are not in contradiction: where CTC was implemented well, something moved; on average across all sites, most of which barely progressed during the pandemic, it did not.

Prevention in proportion to need has a limit too. It doses at the level of the area and reduces the gradient between neighbourhoods; within the burdened neighbourhood, the most burdened families remain the hardest to reach, because self-selection into services follows the same social gradient. Without low-threshold, outreach work, CTC relocates the prevention dilemma rather than dissolving it (cf. Marmot Review, 2010). Finally, the fundamental critique of the risk-factor paradigm still deserves to be taken seriously – that a view centred on risk and programmes can individualise structural causes and label young people (Haines & Case, 2008). The double focus on risk and protective factors does not dispose of it; it remains a matter for professional reflection.

Conclusion: making the principles operational

CTC is not a foreign body that social work lets itself be forced into, but an approach from its own ranks that joins its principles to a rare good: systematic, area-based, data-driven and outcome-oriented steering. It takes seriously weaknesses that social work with children and young people has long named in itself – the effect gap, the siloing of services, data-poor planning, the prevention dilemma – and translates the profession’s own guiding principles from programme statement into verifiable practice.

The responsible way to do this is not mechanically “evidence-based” but evidence-informed: evidence supports professional judgement without replacing it. Whether CTC is “more socially just” in its effect is decided not by the measurability of effects but by whether it widens young people’s real opportunities, the yardstick of the capability approach (Otto & Ziegler, 2010). European evidence of behavioural effect and of continuity is still to come; until then, the demonstrated strength of CTC lies in delivering, methodically and reliably, the right things that the profession has mostly only postulated.