The information in this program outline is provided by the program representative and edited by the CEBC staff. The Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) program has been rated by the CEBC in the areas of: Disruptive Behavior Treatment (Child & Adolescent), Higher Level of Placement, Infant and Toddler Mental Health (0-3) and Placement Stabilization.

• Types of Maltreatment: Does not target any specific kind of maltreatment
• Target Population: Preschool foster children aged 3-6 years old who exhibit a high level of disruptive and anti-social behavior which cannot be maintained in regular foster care or who may be considered for residential treatment.

MTFC-P is a foster care treatment model specifically tailored to the needs of 3 to 6-year-old foster children. MTFC-P is effective at promoting secure attachments in foster care and facilitating successful permanent placements. MTFC-P is delivered through a treatment team approach in which foster parents receive training and ongoing consultation and support. Children receive individual skills training and participate in a therapeutic playgroup, and birth parents (or other permanent placement caregivers) receive family therapy. MTFC-P emphasizes the use of concrete encouragement for pro-social behavior; consistent, non-abusive limit-setting to address disruptive behavior; and close supervision of the child. In addition, the MTFC-P intervention employs a developmental framework in which the challenges of foster preschoolers are viewed from the perspective of delayed maturation.

The goals of MTFC-P are to:

• Eliminate or reduce child problem behaviors.
  
• Increase developmentally appropriate normative and prosocial behavior in children.
  
• Transition children to a birth family, adoptive family, or lower level aftercare resource.
  
• Improve children's peer associations.
  
• Improve parent-child interaction and communication.
  
• Improve children's coping and social skills.
  

Three Key Mechanisms:

• A proactive approach to reducing problem behavior.
• The creation and maintenance of a consistent and reinforcing environment for participating children.
• The separation and stratification of program staff roles. Using a team approach, specific staff are assigned to supporting foster parents, working with children, facilitating the transition to long term placement resources and interagency consultation.

Other Components:

• Foster parents are trained in MTFC-P prior to placement of a child.
• Program Supervisor has authority regarding the team & program.
• One child allowed per home; may place sibling groups together depending on symptoms.
• Foster parents are members of the team.
• The foster home is viewed as primary clinical environment.
• Children's symptoms are treated as skill deficits.
• A high level of encouragement is balanced with fair & consistent limits.
• Children are closely supervised.
• Adults are taught to be responsive to child cues.
• The Parent Daily Report is administered Monday-Friday in a 10-minute daily phone call with foster parents to collect behavioral data and program contact.
• Foster parents have access to FP (Foster Parent) Consultant and Program Supervisor 24 hours a day/7 days a week.

Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) was designed with a child component that addresses the following presenting problems and symptoms:

• Disruptive, maladaptive behaviors such as aggression, anxiety, depression, hyperactivity, autism spectrum, attachment, enuresis, encopresis, defiance, tantrums and general anti-social behavior. They include a wide range of diagnoses and also include developmental delays.

Age range: 3 – 6

Developmental Delays:

This program was developed for children with developmental delays, and has been tested for children with developmental delays.

Relevant research studies:

Treatment Involves Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: The MTFC-P model highly involves the parents or long-term care resource in learning new parenting skills throughout treatment.

Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) was not designed with a parent/caregiver component.

Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) was designed to be conducted in a group setting; but has not been tested for use in a group setting.

Recommended group size:

There are two main components that are conducted in group environment: Therapeutic Playgroup and Foster Parent Support Meeting. The Therapeutic Playgroup is conducted with approximately 10 children. The Foster Parent Support Meeting occurs with 10 caregiv

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 child in treatment, two contacts per week which consist of a two-hour therapeutic playgroup and a two-hour skills training session. For the biological family or other long-term placement resource, one contact per week in the form of a one-hour skill-building session.

Recommended Duration:

Designed with an overall treatment duration of 6-9 months.

This program is typically conducted in a(n):

• Birth Family Home
• Community Agency
• Foster Home
• School

Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) includes a homework component:

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 for Preschoolers (MTFC-P) has materials available in a language other than English:

Dutch

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

The typical resources for implementing the program are:

Office space for a team of approximately 6-8 people: Program Supervisor, Recruiter/Trainer/Parent Daily Report Checklist Caller, Family Therapist, 2-3 Skills Trainers/Playgroup Assistants/Playgroup Leader and FP (Foster Parent) Consultant; 1-2 treatment rooms with video recording; Conference room with video recording; and Internet access for Program Supervisor.

Program supervisor – In addition to a Master's level education 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. The program supervisor must be available to the foster parents and treatment team members 24 hours a day, 7 days a week.

Foster parent consultant/recruiter/trainer – While a formal post-secondary education is not necessary for this position, this person must have knowledge of foster parents and a clear understanding of the model. Prior experience as a foster parent or as an adoptive parent of older children is strongly desirable.

Family therapist – Master's level education in a clinical field. Knowledge of Parent Management Training or related behaviorally based parenting techniques is highly desirable.

Playgroup leader – Bachelor's level education in a relevant field. The playgroup leader is responsible for organizing, preparing, and executing the playgroup curriculum. This person is also responsible for leading the assistants for playgroup. The playgroup leader is also an individual skills trainer for children in the program.

Skills trainer – Bachelor's level education in a relevant field. Since skills training activities take place outside of the office, mileage reimbursements and reimbursements for modest entertainment, food, and beverage expenses are typically associated with these activities. Two skills trainers will also hold the position of playgroup assistants.

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. It may be filled by 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.

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:

• Gerard Bouwman, President
  TFC Consultants, Inc.
  phone: (541) 343-2388
  1163 Olive Street
  Eugene, OR 97401

Training is obtained:

It is conducted in Eugene, Oregon.

Number of days/hours:

5 days for a total of 40 hours.

Since Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) is highly rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

This program is rated a "2 - Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one rigorous randomized controlled trial with a sustained effect of at least 6 months. Please see the Scientific Rating Scale for more information.

Child Welfare Outcomes: Permanency and Child/Family Well-Being