Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care]

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
Medium
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. Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care] has been rated by the CEBC in the area of: Educational Interventions for Children and Adolescents in Child Welfare.

Target Population: Boys and girls, 12-18 years old, with severe delinquency and/or severe emotional and behavioral who were in need of out-of-home placement and could not be adequately served in lower levels of care

For children/adolescents ages: 12 – 18

For parents/caregivers of children ages: 12 – 18

Brief Description

TFCO-A (previously referred to as Multidimensional Treatment Foster Care - Adolescents) is a model of foster care treatment for children 12-18 years old with severe emotional and behavioral disorders and/or severe delinquency. TFCO-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 them with effective parenting. TFCO-A is also rated a “1 – Well-Supported Research Evidence” in the Disruptive Behavior Treatment (Child & Adolescent), Higher Level of Placement, Placement Stabilization, and Behavioral Management for Adolescents in Child Welfare topic areas for adolescents with severe delinquency and/or severe emotional and behavioral disorders. 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. TFCO also has versions for preschoolers and children. Treatment Foster Care Oregon for Preschoolers (TFCO-P) is rated separately on this website. Treatment Foster Care Oregon for Children (TFCO-C) has not been tested separately, but has the same elements as TFCO-A except it includes materials more developmentally appropriate for younger children.

Program Goals:

The goals of Treatment Foster Care Oregon - Adolescents (TFCO-A) are:

  • Eliminate or reduce youth problem behaviors
  • Increase developmentally appropriate normative and prosocial behavior in youth
  • Transition youth to a birth family or lower level aftercare resource
  • Improve youth peer associations
  • Improve parent-child interaction and communication
  • Improve youth coping and social skills
  • Improve behavior in school and provide academic support

Essential Components

The essential components of Treatment Foster Care Oregon - Adolescents (TFCO-A) include:

  • Four key components:
    • Provides a consistent, reinforcing environment where the youth is mentored and encouraged to develop academic and positive living skills
    • Provides a daily structure with clear expectations and limits, with well-specified consequences delivered in a teaching-oriented manner
    • Provides close supervision of youths' whereabouts
    • Helps youth avoid deviant peer associations while providing support and assistance needed for youth to establish pro-social peer relationships
  • Other components:
    • Allows only one treatment youth per home; may place sibling groups together depending on symptoms
    • Provides clinical team with stratified roles, led by the Program Supervisor
    • Has Program Supervisor with authority regarding the team & program
    • Includes foster parents as members of the team
    • Views the foster home as primary clinical environment
    • Treats youth symptoms as skill deficits
    • Uses daily contact with foster parent including collection of behavioral data on youth - Parent Daily Report
    • Trains foster parents in TFCO-A prior to placement of a child
    • Gives foster parents access to the Program Supervisor 24 hours a day/7 days a week
    • Uses a weekly group session with 10 or fewer foster parents

Child/Adolescent Services

Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care] directly provides services to children/adolescents and addresses the following:

  • Hyperactivity, delinquency, school failure, history of abuse, depressive symptoms, aggression, anxiety, defiance, stealing, social aggression, and general anti-social behavior
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: This program involves the family or other support systems in the individual's treatment: TFCO-A highly involves the parents or long-term care resource in the treatment throughout services to learn new parenting skills.

Parent/Caregiver Services

Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care] directly provides services to parents/caregivers and addresses the following:

  • Lack of parenting skills, conflict issues with children

Delivery Settings

This program is typically conducted in a(n):

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

Homework

Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care] 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 as well as with other children living in the home.

Languages

Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care] has materials available in languages other than English:

Dutch, Swedish

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

Resources Needed to Run Program

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 Caller, Family Therapist, Individual Therapist, and 2-3 Skills Trainers
  • Conference room with video recording
  • Internet access for Program Supervisor

Minimum Provider Qualifications

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.

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:

Conducted in Eugene, Oregon

Number of days/hours:

5 days for a total of 40 hours

Implementation Information

Since Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care] 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 Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care] as listed below:

The training protocol for TFCO includes a planning and readiness process that usually takes several months.

  • No decision is made regarding actual implementation until this process has been successfully completed.
  • During the process, all aspects relevant to a successful implementation are discussed and reviewed. Necessary accommodations and adjustments in procedures and practices are then made.
  • Also, during this process the client is assisted with foster parent recruitment. A sufficient number of foster homes to start operations (4 or 5) must be recruited, licensed, and available for placements before the readiness process is concluded.

Topics reviewed during the readiness process include:

  • Determining program costs and funding
  • Foster parent recruitment
  • Staffing: Team composition, qualifications, FTE and hiring sequence/timing
  • Referrals: Referral criteria, referral mechanisms and procedures
  • Geography: Catchment area and location of foster homes
  • Placement and matching procedures
  • Interface between the program and probation/case workers
  • Integration of psychiatry
  • Logistical issues (daily behavior information gathering and video recording of weekly meetings)
  • Additionally, any site-specific issues are considered

No written materials that further detail this process are available.

Formal Support for Implementation

The program representative did not provide information about formal support for implementation of Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care].

Fidelity Measures

There are fidelity measures for Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care] as listed below:

  • In the course of executing the model, daily behavior information is gathered for each of the youth. This information (Parent Daily Report (PDR)) is used to track behavior change over time. The collection and use of this information is also used to assess model adherence and outcomes.
  • During the first year of implementation, three structured program reviews are provided so that progress and fidelity can be easily tracked from one review to the next. Once program standards are met, the program applies for program certification with an independent evaluator, the Center for Research to Practice in Eugene, OR.
  • Initial certification is valid for a period of two years and subsequent renewal certifications are valid for three-year periods, provided that a contractual arrangement is in place with TFC Consultants or one of its implementation partners to monitor program fidelity and address model adherence issues. In the absence of such an arrangement, certification is valid for a period of one year.

Implementation Guides or Manuals

There are implementation guides or manuals for Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care] as listed below:

There are operational manuals for program supervision, foster parent recruitment, family therapy, child therapy, foster parent training, and skills training. These are not publicly available.

Research on How to Implement the Program

The program representative did not provide information about research conducted on how to implement Treatment Foster Care Oregon - Adolescents (TFCO-A) [Educational Interventions for Children and Adolescents in Foster Care].

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

Leve, L. D., & Chamberlain, P. (2007). A randomized evaluation of Multidimensional Treatment Foster Care: Effects on school attendance and homework completion in juvenile justice girls. Research on Social Work Practice, 17, 657–663.

Type of Study: Randomized controlled trial
Number of Participants: 81

Population:

  • Age — 13-17 years
  • Race/Ethnicity — 74% Caucasian, 12% Native American, 9% Hispanic, 2% African-American, 1% Asian American, and 2% other or biracial
  • Gender — 100% Female
  • Status — Participants were girls who were referred from juvenile court judges.

Location/Institution: Oregon

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined the efficacy of Multidimensional Treatment Foster Care - Adolescents (MTFC-A) [now called Treatment Foster Care Oregon - Adolescents (TFCO-A)] on school attendance and homework completion in juvenile justice girls who were referred to out-of-home care. Girls were randomly assigned to MTFC-A or out-of-home care services as usual. Results suggest that MTFC-A was more effective than group care in increasing girls’ school attendance and homework completion while in treatment and at 12 months post-baseline. Limitations included the small number of minority youth and the lack of male subjects in the sample.

Length of postintervention follow-up: Unclear – data was collected 12 months after the baseline data collection, and the mean length of treatment was 174 days (Std Dev = 144).

References

Chamberlain, P. (1994). Family connections. Eugene, OR: Northwest Media, Inc.

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.

Kirton, D. & Thomas, C. (2011).  A Suitable Case? Implementing multidimensional treatment foster care in an English local Authority. Adoption and Fostering, 35(2).

Contact Information

Name: John Aarons
Agency/Affiliation: TFC Consultants, Inc.
Website: www.tfcoregon.com
Email:
Phone: (541) 343-2388 x204

Date Research Evidence Last Reviewed by CEBC: January 2017

Date Program Content Last Reviewed by Program Staff: April 2016

Date Program Originally Loaded onto CEBC: July 2012