This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
Child Welfare Outcomes: Permanency and child/family well-being.
Type of Maltreatment: Emotional abuse, Exposure to domestic violence, Physical abuse, Physical neglect, and Sexual abuse
Target Population: Boys and girls, 12-18 years old with severe delinquency and/or severe emotional and behavioral disorders. These youth were in need of out-of-home placement and could not be adequately served in lower levels of care.
Brief Description:(The information in this program outline is provided by the program representative and edited by the CEBC staff.)
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) has been rated by the CEBC in the areas of Disruptive Behavior Treatment (Child & Adolescent), Higher Level of Placement, and Placement Stabilization. MTFC-A is a model of treatment foster care for children 12-18 years old with severe emotional and behavioral disorders and/or severe delinquency. MTFC-A aims to create opportunities for youths to successfully live in families rather than in group or institutional settings, and to simultaneously prepare their parents (or other long-term placement) to provide youth with effective parenting. Four key elements of treatment are (1) providing youths with a consistent reinforcing environment where he or she is mentored and encouraged to develop academic and positive living skills, (2) providing daily structure with clear expectations and limits, with well-specified consequences delivered in a teaching-oriented manner, (3) providing close supervision of youths' whereabouts, and (4) helping youth to avoid deviant peer associations while providing them with the support and assistance needed to establish pro-social peer relationships. MFTC-A also has versions for preschoolers and children. MFTC-P (for preschoolers) is rated separately on this website. MTFC-C (for children) has not been tested separately, but has the same elements as MFTC-A except it includes materials more developmentally appropriate for younger children. Since MTFC-A is highly rated on the Scientific Rating Scale, information on available pre-implementation assessments, implementation tools, and fidelity measures was requested from the program representative. Please see the program's separate Implementation Information page for details.
FOUR KEY COMPONENTS
OTHER COMPONENTS INCLUDE:
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) was designed to be conducted in a group.
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) has not been tested for use in a group setting.
The recommended group size is: One component of the foster parent support is designed to be delivered in a group format. The recommended group size is 10 or fewer foster parents.
Recommended intensity: For foster parent(s), there is typically a minimum of seven contacts per week which consist of five 10-minute contacts, one two-hour group and additional contacts based on the amount of support or consultation required. For the youth in treatment, two contacts per week which consist of a weekly individual therapy for one hour and weekly individual skills training in a two-hour session. For the biological family or other long-term placement resource, one contact per week in the form of a one-hour family therapy session.
Recommended duration: Designed with an overall treatment duration of 6-9 months.
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) includes a homework component.
Description: Biological (or other long-term placement resource) parents are guided in practicing parenting skills outside of the sessions during visits with the child in foster care and with other children living in the home.
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) is typically conducted in a(n): Birth Family Home, Community Agency, Foster Home, Outpatient Clinic, and School.
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) was designed with a Parent Component.
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) addresses the following presenting problems and symptoms: Has a child in the foster care system with severe delinquency and/or severe emotional and behavioral disorders
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) was designed with a Child Component.
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) addresses the following presenting problems and symptoms: Hyperactivity, delinquency, school failure, history of abuse, depressive symptoms, aggression, anxiety, defiance, stealing, social aggression, and general anti-social behavior.
Age range(s): 12-18
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) was not developed for children with developmental delays.
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) has not been tested for children with developmental delays.
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) has materials available in a language other than English.
Language(s) available:
Dutch and Swedish. For information on which materials are available in these languages, please check on the program's website or contact the program representative (all contact information is listed at the bottom of this page).
There is a manual that describes how to implement this program.
There is training available for Multidimensional Treatment Foster Care - Adolescents (MTFC-A).
Training contact: TFC Consultants, Inc., Gerard Bouwman, President, Phone: 541-343-2388
Number of days/hours: 5 days for a total of 40 hours
Training is obtained: It is conducted in Eugene, Oregon.
There currently are not additional qualified resources for training.
The typical resources for implementing Multidimensional Treatment Foster Care - Adolescents (MTFC-A) are: Office space for a team of approximately 6-8 people: Program Supervisor, Recruiter/Trainer/Parent Daily Report Caller, Family Therapist, Individual Therapist, and 2-3 Skills Trainers; Conference room with video recording; and Internet access for Program Supervisor.
Program supervisor: In addition to a Master’s degree in a clinical field and considerable relevant experience in behavior management approaches, this person should possess supervisory skills, considerable organizational abilities, and a thorough understanding of and enthusiastic attitude toward the treatment model.
Family therapist: Master’s degree in a clinical field.
Individual Therapist: Master’s degree in a clinical field.
Skills trainer(s): Bachelor’s degree in a relevant field.
Foster parent Recruiter/Trainer/PDR Caller: This important position should be filled by someone with a thorough understanding of the treatment model and experience in foster parent activities. The specific education level for this position is less important. This position can be filled an experienced (ex-) foster parent.
Foster family: No formal education is required for foster parents. However, foster parents trained in the program should have a basic understanding of child development with reasonable expectations for this population of foster children. It is especially helpful when foster parents have a good sense of humor and do not take behaviors personally.
Consulting psychiatrist: Adequately serve children in the program who need medication prescribed and managed.
Multidimensional Treatment Foster Care - Adolescents (MTFC-A) is rated a "1 - Well-Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least two rigorous randomized controlled trials with one showing a sustained effect of at least 1 year. For more information on the rating of a "1 - Well-Supported by Research Evidence," please see the Scientific Rating Scale.
Chamberlain, P., & Reid, J. B. (1991). Using a specialized foster care treatment model for children and adolescents leaving the state mental hospital. Journal of Community Psychology, 19, 266-276.
Type of Study: Randomized controlled trial.
Number of participants: 20
Population:
Location/Institution: Oregon
Summary: (To include comparison groups, outcomes, measures, notable limitations) Hospitalized youth preparing for community placement were randomly assigned to receive either Specialized Foster Care (SFC) or care as usual (e.g., residential treatment centers, groups homes or relatives home). Emotional disturbance, social competency, self-reported symptoms and problem behaviors were measured using the Child Global Assessment Scale, the Parent Daily Report Checklist (PDR), the Behavior Symptom Inventory (BSI) and a social interaction task. Results showed that the SFC group was placed in the community more quickly and for more days. In addition, the SFC group had fewer behavioral problems at 3 months than those in the control condition. However, SFC group participants reported more emotional distress during the course of the study. Conclusions are limited by the small sample size.
Length of post-intervention follow-up: 1 year after initial placement.
Chamberlain, P., & Reid, J. B. (1998). Comparison of two community alternatives to incarceration for chronic juvenile offenders. Journal of Consulting and Clinical Psychology, 66(4), 624-633.
Type of Study: Randomized controlled trial.
Number of participants: 79
Population:
Location/Institution: Oregon
Summary: (To include comparison groups, outcomes, measures, notable limitations) Boys were randomly assigned to receive either MTFC or to community-based group care (GC). Data collected for the study included criminal court referrals and self-reported delinquency measured by the Elliott Behavior Checklist. Results of the study indicated that participation in MTFC produced more favorable outcomes than participation in GC. Boys ran away less frequently, completed their programs more often and were referred to detention or training schools less frequently. They had fewer criminal referrals and had fewer self-reported delinquent acts, and violent or serious crimes. Finally they spent more days living with their families in follow up. These differences held even among older youths and those who began exhibiting delinquent behaviors at a younger age. One study limitation includes exclusion of girls from the sample.
Length of post-intervention follow-up: 1 year.
Eddy, J. M., & Chamberlain, P. (2000). Family management and deviant peer association as mediators of the impact of treatment condition on youth antisocial behavior. Journal of Consulting and Clinical Psychology, 5(68), 857-863
Type of Study: Randomized controlled trial.
Number of participants: 53
Population:
Location/Institution: Oregon
Summary: (To include comparison groups, outcomes, measures, notable limitations) Note: This study uses the same sample as Chamberlain & Reid, 1998. This is an explanatory study to explore mediators of the effectiveness of MTFC over group care (GC) programs. Data included responses from an interview protocol developed for the study adapted from the Parent Daily Report, criminal referrals and self-reported delinquent acts. Analyses showed that parenting practices (supervision, discipline, positive reinforcement and positive interactions with parents) and limiting association with delinquent peers mediated the effects of program type on outcomes. The strength of the analysis is limited by the small sample size.
Length of post-intervention follow-up: 3 months following placement.
Eddy, J. M., Whaley, R. B., & Chamberlain, P. (2004). The prevention of violent behavior by chronic and serious male juvenile offenders: A 2-year follow-up of a randomized clinical trial. Journal of Emotional and Behavioral Disorders, 12(1), 2-8.
Type of Study: Randomized controlled trial.
Number of participants: 79
Population:
Location/Institution: Oregon
Summary: (To include comparison groups, outcomes, measures, notable limitations) Note: This study used the same sample as Chamberlain & Reid, 1998. Results showed that 24% of the youth in the group care condition had two or more criminal referrals for violent offenses in the 2 years following study entry, versus 5% of youth in the MTFC condition. Those in the MTFC group also self-reported violent behavior levels that were within normal range. Those in the GC condition reported levels 4 to 9 times higher.
Length of post-intervention follow-up: 2 years after study entry.
Leve, L. D., Chamberlain, P., & Reid, J. B. (2005). Intervention outcomes for girls referred from juvenile justice: Effects on delinquency. Journal of Consulting and Clinical Psychology, 73(6), 1181-1185.
Type of Study: Randomized controlled trial.
Number of participants: 81
Population:
Location/Institution: Oregon
Summary: (To include comparison groups, outcomes, measures, notable limitations)Girls were randomly assigned to and MTFC condition or to a group care (GC) control condition. Outcome measures included number of days in locked settings, criminal referrals, care-giver reported delinquency, using the Child Behavior Checklist (CBCL), and self-reported delinquency, using the Elliott Self-Report of Delinquency Scale. The MTFC group had significantly fewer days in locked settings and less care-give reported delinquency than the GC group. They also had fewer criminal referrals than GC youth at follow-up, although this did not reach statistical significance. There were no effects of condition on self-reported delinquency although rates were down for both groups at follow-up. Conclusions are limited by a small sample size.
Length of post-intervention follow-up: 12 months.
Leve, L. D., & Chamberlain, P. (2005). Association with delinquent peers: Intervention effects for youth in the juvenile justice system. Journal of Abnormal Child Psychology, 33(3), 339-347.
Type of Study: Randomized controlled trial.
Number of participants: 72 boys and 81 girls
Population:
Location/Institution: Oregon
Summary: (To include comparison groups, outcomes, measures, notable limitations) Youth were randomly assigned to the MTFC condition or to a group care (GC) condition. Measures included the Describing Friends Questionnaire which assesses association with friends who engage in delinquent behaviors and caregiver reports using the Child Behavior Checklist (CBCL). Analyses suggested the MTFC youth had fewer associations with delinquent peers than did those in the GC condition and that this was carried through to follow-up.
Length of post-intervention follow-up: 12 months.
Chamberlain, P., Leve, L. D., & DeGarmo, D. S. (2007). Multidimesional treatment foster care for girls in the juvenile justice system: 2-year follow-up of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 75(1).
Type of Study: Randomized controlled trial.
Number of participants: 81
Population:
Location/Institution: Oregon
Summary: (To include comparison groups, outcomes, measures, notable limitations) Note: This study used the same sample as Leve, Chamberlain and Reid, 2005. Girls were randomly assigned to and MTFC condition or to a group care (GC) control condition. Delinquency as-of follow-up was assessed using a combination of number of criminal referrals, number of days in locked settings, and self-reported delinquency, as measured by the Elliott General Delinquency Scale. Findings show that the one-year effects for MTFC were maintained at 2 years on all measures. The study also showed that older girls showed less delinquency over time for both the MTFC and GC conditions.
Length of post-intervention follow-up: 2 years.
Chamberlain, P. (1994). Family connections. Eugene, OR: Northwest Media, Inc.
Chamberlain, P. (2003). Treating chronic juvenile offenders: Advances made through the Oregon multidimensional treatment foster care model. Washington, DC: American Psychological Association.
Chamberlain, P., & Mihalic, S. F. (1998). Multidimensional treatment foster care: Blueprints for Violence Prevention, Book Eight. Blueprints for Violence Prevention Series (D. S. Elliott, Series Editor). Boulder, CO: Center for the Study and Prevention of Violence, Institute of Behavioral Science, University of Colorado.
Contact name: Patricia Chamberlain
Affiliation/Agency: Center for Research to Practice/ Oregon Social Learning Center
Email: pattic@oslc.org
Phone: 541-485-2711
Fax: 541-485-7087
Website: http://www.mtfc.com