Teaching-Family Model (TFM)

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
High
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Teaching-Family Model (TFM) has been rated by the CEBC in the areas of: Higher Levels of Placement and Behavioral Management Programs for Adolescents in Child Welfare.

Target Population: Youth who are at-risk, juvenile delinquents, in foster care, mentally retarded/developmentally disabled, or severely emotionally disturbed; families at risk of having children removed

For children/adolescents ages: 0 – 17

For parents/caregivers of children ages: 0 – 17

Brief Description

TFM is a unique approach to human services characterized by clearly defined goals, integrated support systems, and a set of essential elements. TFM has been applied in residential group homes, home-based services, foster care and treatment foster care, schools, and psychiatric institutions. The model uses a married couple or other “teaching parents” to offer a family-like environment in the residence. The teaching parents help with learning living skills and positive interpersonal interaction skills. They are also involved with children’s parents, teachers, and other support network to help maintain progress.

Program Goals:

The goals of the Teaching-Family Model (TFM) are:

  • Improved outcomes related to mental health
  • Reduced restrictiveness of living
  • Reunification with family
  • Personalized goals identified by client and client's family

Essential Components

The essential components of Teaching-Family Model (TFM) include:

  • There are 4 critical delivery systems:
    • Staff selection & training
    • Competency-based management (consultation/supervision)
    • Quality assurance (evaluation)
    • Facilitative administration
  • There are 7 essential elements:
    • Teaching systems
    • Self-determination
    • Client advocacy
    • Relationships
    • Family-sensitive approach
    • Diversity
    • Professionalism
  • Each delivery system and element is supported by standards and competencies measuring attainment of those standards through the certification process supported by the Teaching-Family Association.

Child/Adolescent Services

Teaching-Family Model (TFM) directly provides services to children/adolescents and addresses the following:

  • Any behaviors resulting in problems

Parent/Caregiver Services

Teaching-Family Model (TFM) directly provides services to parents/caregivers and addresses the following:

  • All problems — it was designed to address behaviors with the client as well as the family

Delivery Settings

This program is typically conducted in a(n):

  • Birth Family Home
  • Community Agency
  • Foster/Kinship Care
  • Hospital
  • Outpatient Clinic
  • Residential Care Facility
  • School

Homework

This program does not include a homework component.

Languages

Teaching-Family Model (TFM) does not have materials available in a language other than English.

Resources Needed to Run Program

The typical resources for implementing the program are:

Meeting room and video equipment for implementation training

Minimum Provider Qualifications

The qualifications vary from agency to agency as their selection criteria are often based on state requirements in addition to the program's selection components. Minimum is a Bachelor's degree for practitioners, usually in social work or psychology.

Education and Training Resources

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

Training Contact:
Training is obtained:

Provided by regional sponsoring agency

Number of days/hours:

Pre-Service is roughly 1 week — 40 hours; ongoing consultation after placement with individual certification typically occurring after one year of practice

Implementation Information

Since Teaching-Family Model (TFM) is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Teaching-Family Model (TFM) as listed below:

There are materials that are customized appropriately to each agency, they include pre-assessment standards, reviewer checklists and other information designed to be reviewed with a representative of the association, or a representative from an accredited agency or an endorsed developer. These tools provide background and support necessary to prepare for the implementation which can last anywhere from 6 months to 24 months depending upon the agency’s readiness, cultural awareness of the model and strengths-based approach and behavior, and understanding of integrated systems. Contact the Teaching-Family Association for assistance (804.632.0155).

Formal Support for Implementation

There is formal support available for implementation of Teaching-Family Model (TFM) as listed below:

There is a development and implementation process. There is tremendous flexibility for an agency interested in implementation. They may choose to work with an individual consultant developer or with an accredited agency (or any other variation that m ay suit the agency interested in development). Fees and supports are based upon the agency implementing's requirements and restrictions. Contact the Teaching Family Association at (804) 632-0155 for further information.

Fidelity Measures

There are fidelity measures for Teaching-Family Model (TFM) as listed below:

Fidelity is assessed through onsite review observation checklists as part of the accreditation process through the Teaching-Family Association. Contact Peggy McElgunn at (804) 632-0155 or peggymcelgunn@comcast.net for more information.

Implementation Guides or Manuals

There are no implementation guides or manuals for Teaching-Family Model (TFM).

Research on How to Implement the Program

Research has been conducted on how to implement Teaching-Family Model (TFM) as listed below:

Fixsen, D., Blase, K., Timbers, G., & Wolf, M. (2007). In search of program implementation: 792 replications of the Teaching-Family Model. The Behavior Analyst Today, 8(1), 96-110.

Relevant Published, Peer-Reviewed Research

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

Kirigin, K. A., Braukman, C. J., Atwater, J. D., & Wolf, M. M. (1982). An evaluation of Teaching-Family (Achievement Place) group homes for juvenile offenders. Journal of Applied Behavior Analysis, 15, 1-16.

Type of Study: Nonmatched comparison group
Number of Participants: Treatment: 140 Comparison: 52

Population:

  • Age — 14-15 years
  • Race/Ethnicity — Girls/Treatment: 82% White, 18% Non-white. Girls/Comparison: 83% White, 17% Non-white. Boys/Treatment: 76% White, 24% Non-white. Boys/Comparison: 77% White, 23% Non-white
  • Gender — 124 Boys and 68 Girls
  • Status — Participants were youths assigned to residential programs by the court.

Location/Institution: Kansas

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Youths in group homes using the Teaching-Family Model were compared to youths in group homes chosen by state agencies to be representative residential programs. Comparison group homes were similar to treatment homes in terms of youths served, size, and staffing by a live-in married couple. Data was collected prior to treatment entry, during treatment, and at 1 year following treatment. Court and police records provided information on offenses, alleged offenses, and institutional confinements. For girls, a higher percentage of Teaching-Family participants had offenses pretreatment, but a significantly lower percentage had offenses during treatment. During the posttreatment year, a lower percentage of both boys and girls in the program had offenses, but this was not statistically significant. Looking at rate of offenses, Teaching-Family boys significantly decreased their number of offences during treatment, while the rate for non-Teaching-Family boys increased. For girls, the number of offenses was significantly reduced during treatment, but they did not differ significantly from the comparison group during that time. For both boys and girls, groups did not differ in rate of offenses during the follow-up period. Limitations include lack of randomization of participants and generalizability to youth in residential programs.

Length of postintervention follow-up: 1 year.

Bedlington, M. M., Braukman, C. J., Ramp, K. A., & Wolfe, M. M. (1988). A comparison of treatment environments in community-based group homes for adolescent offenders. Criminal Justice and Behavior, 15(3), 349-363.

Type of Study: Nonequivalent comparison group
Number of Participants: 82 Teaching-Family, 103 Comparison

Population:

  • Age — 11-17 years
  • Race/Ethnicity — Teaching Family: 77% Caucasian; Comparison: 71% Caucasian
  • Gender — Not Specified
  • Status — Participants were court-adjudicated youth assigned to group homes.

Location/Institution: Kansas

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Teaching-Family group homes were compared to non-Teaching-Family homes. Researchers created observer protocols to measure adult/youth interactions, teaching, intolerance of deviance, youth social behavior, pleasantness of the environment, and family-likeness. Youth in the homes also self-rated likelihood of detection of delinquent acts, staff approval/disapproval of those acts, and importance of staff reaction. They also filled out the Self-Reported Delinquency (SRD) questionnaire. Teaching-Family homes were rated as having significantly higher levels of adult/youth communication and instances of adults teaching youth. Limitations include nonrandomization of participants, reliance on self-reported measures and lack of follow-up.

Length of postintervention follow-up: None.

Slot, N. W., Jagers, H. D., & Dangel, R. F. (1992). Cross-cultural replication and evaluation of the Teaching Family Model of community-based residential treatment. Behavioral Residential Treatment, 7(5), 341-354.

Type of Study: Three samples: one pretest/posttest, and two nonmatched, nonrandomized comparison groups
Number of Participants: Study 1: 58; Study 2: 50 treatment, 470 comparison; Study 3: 57 treatment, 57 comparison matched by age only

Population:

  • Age — Study 1: 14.2-19.1 years; Study 2: Not Specified; Study 3:14-18.3 years
  • Race/Ethnicity — Not specified
  • Gender — 100% Males
  • Status — Participants were youth in a Dutch residential facility.

Location/Institution: The Netherlands. Note: Comparison group in Study 2 was Canadian youth.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study evaluated the effectiveness of a cross-cultural replication of the Teaching-Family Model in residential care called Kursushuis in three studies. Study 1 compared the pretreatment and posttreatment scores of 58 Kursushuis youth on several measures of antisocial behavior and social competence. Study 2 compared the offending patterns of Kursushuis youth with those of a nontreatment group of Canadian youth. Study 3 compared the effects and cost of placement in the Kursushuis programs with those of placement in a Dutch State Correctional Institute. Measures utilized include the Youth Evaluation List (YEL). Results indicate for Study 1 significant improvements were shown in overall adjustment, family adjustment, relationship with parents, number of offenses, social competence, and number of problems at home. Results also indicated that there was also a significant increase in drinking posttreatment, but not to levels considered problematic in the Netherlands. Results for Study 2 in youth experiencing the Teaching Family Program (TFP) [now called the Teaching-Family Model] indicated that the number of youth staying at the same offending level was lower for the TFP group than the comparison group (24% vs. 48%). Results for Study 3 indicate there were no differences between groups on scores for overall problems and abilities for relationships outside the family: both groups improved. Limitations include nonrandomization of participants in all 3 studies, lack of comparison group in Study 1, and length of follow-up.

Length of postintervention follow-up: 6 months (Studies 1 & 2 only).

Thompson, R. W., Smith, G. L., Osgood, D. W., Dowd, T. P., Friman, P. C., & Daly, D. L. (1996). Residential care: A study of short- and long-term educational effects. Children and Youth Services Review, 18(3), 221-242.

Type of Study: Nonrandomized comparison group
Number of Participants: 497 Treatment, 84 Comparison

Population:

  • Age — Treatment: Mean=14.7 years, Comparison: Mean=14.4 years
  • Race/Ethnicity — Treatment: 68% Caucasian, 21% Black, 7% Hispanic, and 4% Other; Comparison: 71% Caucasian, 20% Black, 6% Hispanic, and 3% Other
  • Gender — 92% Male and 8% Female
  • Status — Treatment: Participants were youth admitted to the residential treatment program on referral by social services. Comparison: Participants were youth who applied but were not admitted to the residential treatment program.

Location/Institution: Boy’s Town home campus, Nebraska

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study evaluated the effectiveness of the Teaching Family Model on school performance and attitudes for children who applied for admission to the Boy’s Town residential program. Participants who were admitted to the program formed the treatment group and those who were admitted, but did not ultimately enter the program, and those denied admission for space limitations comprised the control group. Measures utilized included self-reported grade point average (GPA), highest level of school completed, and completion of diploma or GED. Results showed an increase in GPA for the treatment group while they were in residence. It decreased after leaving the program, but remained significantly higher than the comparison group’s GPA. The treatment youth completed years of school at a faster rate than comparison students, but this rate decreased significantly after leaving treatment. Results also revealed higher rates of graduation and GED completion for treatment youth, although this was not statistically significant. Ratings on importance of education increased for the treatment group, but decreased for the comparison group. This difference remained after departure. Treatment youth had more help with homework both during and after the program than did comparison youth. Limitations include nonrandomization of participants and results do not pinpoint what treatment experiences were responsible for the effects.

Length of postintervention follow-up: Approximately 4 years.

Friman, P. C., Osgood, D. W., Smith, G. L., Shanahan, D. L., Thompson, R. W., Larzelere, R. E., & Daly, D. L. (1996). A longitudinal evaluation of prevalent negative beliefs about residential placement for troubled adolescents. Journal of Abnormal Child Psychology, 24, 299-324.

Type of Study: Pretest-posttest control group design
Number of Participants: 581

Population:

  • Age — 10-17 years
  • Race/Ethnicity — 70% Caucasian, 20% African American, 7% Hispanic, and 3% Other
  • Gender — 92% Male and 8% Female
  • Status — Treatment: Participants were youth admitted to the residential treatment program on referral by social services. Comparison: Participants were youth who applied but were not admitted to the residential treatment program.

Location/Institution: Boys Town, Nebraska

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study used the same sample as the Thompson et al. (1996) study. This study evaluated the effectiveness of the Teaching-Family Model (TFM) for improving adolescent attitudes about residential treatment. The majority of participants (n=497) were assigned to a treatment group for duration of 18 to 21 months, and the remainder to a treatment-as-usual comparison group. Participants were assessed at intake, at various points throughout the intervention, and at 1-year post-intervention follow-up using the Delivery of Helpful Treatment and Satisfaction with Supervising Adults questionnaires, National Youth Survey, and the Locus of Control scale. Results indicated that the TFM group’s ratings were significantly more positive than the comparison group on four of the five scales. Major study limitations include lack of randomization and the comparison group experienced high attrition.

Length of postintervention follow-up: Varied.

Jones, R. J., & Timbers, G. D. (2003). Minimizing the need for physical restraint and seclusion in residential youth care through skill-based treatment programming. Families in Society, 84(1), 21-29.

Type of Study: Pretest/Postest with archival data
Number of Participants: Average of 26.5 per month at Barium Springs, average of 8.8 per month at Bridgehouse.

Population:

  • Age — 8-18 years
  • Race/Ethnicity — Not specified
  • Gender — Not specified
  • Status — Participants were youth in two residential programs for behavioral and emotional problems.

Location/Institution: Barium Springs Home for Children, NC; Bridgehouse Program, IA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article details an analysis of data kept by two residential programs for youth on the use of physical restraint or other coercive measures such as seclusion per client prior to and following the implementation of the Teaching-Family Program (TFP) [now called the Teaching-Family Model]. For the Barium Springs program, restraints were reduced by 40% and significant negative incident reports were reduced by 80% after the introduction of the TFP. At the Bridgehouse program, there was a 75% reduction in restraints, a similar decline in secluding clients in a locked, quiet room, and close to elimination of the use of the time out room after the introduction of TFP. With the exception of the Barium Springs restraint level, all of these reductions reached statistical significance. Limitations include reliability of archival data and lack of follow-up.

Length of postintervention follow-up: None.

Lewis, R. E. (2005). The effectiveness of Families First services: An experimental study. Children and Youth Services Review, 27, 499-509.

Type of Study: Randomized controlled trial
Number of Participants: 150 families

Population:

  • Age — 3.9-17.3 years
  • Race/Ethnicity — Not specified
  • Gender — 75% Male
  • Status — Participants were families referred by school or juvenile court due to a child with serious problems in functioning.

Location/Institution: Utah Youth Village

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study assessed a version of the Teaching-Family Model which had been adapted for use in the family’s home, and so will not be included in the Scientific Rating for Higher Level of Placement. Families were randomly assigned to treatment or control groups. Control groups families had access to services normally available to schools, courts, and the community. Parents were interviewed at baseline, at completion of treatment (about 5 months), and 3 months after completion. The questionnaire assessed concrete services/physical care and resources, parent effectiveness/parent-child relationships, and child behavior problems. A composite score of the 63 questionnaire items showed a significant positive overall effect of the intervention and both posttests. For the subscales, concrete services/physical care and resources showed improvements, as did child behavior problems. There was no significant difference across groups for parent effectiveness/parent-child relationships due to improvement in the control group’s score over time. The authors note that all group differences narrowed over time largely due to the control group having received some traditional services. Limitations include reliance on parental perceptions of outcomes and length of follow-up.

Length of postintervention follow-up: 3 months.

Lee, B. R., & Thompson, R. (2008). Comparing outcomes for youth in treatment foster care and family-style group care. Children and Youth Services Review, 30, 746-757.

Type of Study: Retrospective study using propensity matching
Number of Participants: 828

Population:

  • Age — Mean=13 years
  • Race/Ethnicity — 56% Caucasian, remainder not specified
  • Gender — 50% Male and 50% Female
  • Status — Participants were youth with presenting problem behaviors in residential care for at least 30 days at Girls and Boys Town locations.

Location/Institution: Omaha, Nebraska; North Florida, Louisiana, Washington, DC, Philadelphia, Western Iowa/Nebraska, and New England

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Using propensity matching on 18 background variables, this study evaluated the effectiveness of Teaching-Family Model-based group home services with treatment foster care services in a sample of youth with problem behaviors in residential care. Administrative data was evaluated for youth outcomes, such as favorable discharge, returning home, legal involvement, formal placements, and homelike setting. Results indicated that group care youth were more likely to be favorably discharged, more likely to return home, and less likely to experience subsequent placement in the first 6 months after discharge. Legal involvement and residing in a home-like environment at follow-up did not differ. Limitations included the lack of randomization and the lack of standardized measures of youth behavior problems and mental health need.

Length of postintervention follow-up: 6 months.

Farmer , E. M., Wagner, H. R., Burns, B. J., & Murray, M. (2015). Who goes where? Exploring factors related to placement among group homes. Journal of Emotional and Behavioral Disorders. Advance online publication. doi:1063426615585082

Type of Study: Randomized controlled trial (randomized at the agency level)
Number of Participants: 554

Population:

  • Age — 4-20 years (Mean=15 years)
  • Race/Ethnicity — 70% African American, 46.3% Non-white, 14% multi-racial, 8% American Indian, and 6% Hispanic
  • Gender — 51.7% Male
  • Status — Participants were adolescents in a residential care facility.

Location/Institution: 7 TFM agencies and 7 non-TFM agencies in a southeastern state

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article explores potential variations among group homes to examine whether different programs are systematically serving different types of youth. The study evaluated the effectiveness of placement in homes using the Teaching-Family Model (TFM), versus homes that do not. Measures utilized include the Restrictiveness of Living Environment Scale (ROLES) and the Strengths and Difficulties Questionnaire (SDQ). Results indicate demographics are not significantly associated with TFM placement. However, custody status, types of mental health problems, and use of psychotropic medications are. Homes appear to be serving distinct niches within a geographic area. Limitations include the study only being conducted in a single state, missing data, all included agencies that operated at least two group homes. Hence, the full range of homes, particularly the small single-home operation, is not included in these results, and lack of follow-up.

Length of postintervention follow-up: None.

Farmer, E. M., Seifert, H., Wagner, H. R., Burns, B. J., & Murray, M. (2016). Does model matter? Examining change across time for youth in group homes. Journal of Emotional and Behavioral Disorders. Advance online publication. doi:10.1177/1063426616630520

Type of Study: Quasi-experimental (secondary data analysis)
Number of Participants: 554

Population:

  • Age — 4-20 years (Mean=15 years)
  • Race/Ethnicity — 70% African American, 46.3% Non-white, 14% multi-racial, 8% American Indian, and 6% Hispanic
  • Gender — 51.7% Male
  • Status — Participants were adolescents in a residential care facility.

Location/Institution: 7 TFM agencies and 7 non-TFM agencies in a southeastern state

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article utilizes information from Farmer et al. (2015). This article examines differences across time for youth served in group homes utilizing the Teaching Family Model (TFM) and geographically proximate homes using more eclectic approaches. Measures utilized include the Strengths and Difficulties Questionnaire (SDQ). Results indicate youth showed, on average, significant and rapid improvement during initial months in a group home. Improvement did not differ for TFM and non-TFM homes during this initial period. Postdischarge results, though, show that TFM was associated with continued improvement after discharge and significantly better outcomes by 8 months postdischarge. Limitations include the study only being conducted in a single state, missing data, and all included agencies that operated at least two group homes; hence, the full range of homes, particularly the small single-home operation, is not included in these results.

Length of postintervention follow-up: 8 months.

References

Blase, K. A., Fixsen, D. L., Freeborn, K., & Jaeger, D. (1989). The Behavioral Model. In R.D. Lyman, S. Prentice-Dunn, & S. Gabel (Eds.), Residential and inpatient treatment of children and adolescents (pp. 43-59). New York: Plenum Publishing Corp.

Kirigin, K. A. (1996). Teaching-Family Model of group home treatment of children with severe behavior problems. In M. C. Roberts (Ed.), Model programs in child and family mental health (pp. 231-247). Mahwah, NJ: Erlbaum.

Wolf, M. M., Kirigin, K. A., Fixsen, D. L., Blase, K. A., & Braukmann, C. J. (1995). The Teaching-Family Model: A case study in data-based program development and refinement (and dragon wrestling). Journal of Organizational Management and Behavior, 15, 11-68.

Contact Information

Name: Peggy McElgunn
Title: Esq. (Juris Doctorate)
Agency/Affiliation: Teaching-Family Association
Website: www.teaching-family.org
Email:
Phone: (804) 639-9213
Fax: (804) 639-9212

Date Research Evidence Last Reviewed by CEBC: August 2016

Date Program Content Last Reviewed by Program Staff: March 2016

Date Program Originally Loaded onto CEBC: June 2008