The California Evidence-Based Clearinghouse for Child Welfare
The California Evidence-Based Clearinghouse for Child Welfare

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/

Higher Level of Placement

1. Well-Supported by Research Evidence
2. Supported by Research Evidence
3. Promising Research Evidence
4. Fails to Demonstrate Effect
5. Concerning Practice
NR. Not able to be Rated
See Scientific Rating Scale

Here are your search results for programs in the Topic Area - Higher Level of Placement:

The programs listed below have a full program description. They have been reviewed by the CEBC and, if appropriate, been rated using the Scientific Rating Scale. You can see the full rating scale on the right.

Occasionally program representatives who are invited to submit information on their program decline or do not respond, click here to see if there are any declining or non-responding programs for Higher Level of Placement

You can also read why the Advisory Committee chose Higher Level of Placement as a topic area at the bottom of this page.


Programs with a Scientific Rating of 1 - Well-Supported by Research Evidence

  1. Multidimensional Treatment Foster Care - Adolescents (MTFC-A)

Programs with a Scientific Rating of 2 - Supported by Research Evidence

  1. Multidimensional Treatment Foster Care for Preschoolers (MTFC-P)
  2. Positive Peer Culture (PPC)

Programs with a Scientific Rating of 3 - Promising Research Evidence

  1. Sanctuary Model
  2. Stop-Gap
  3. Teaching-Family Model

Programs with a Scientific Rating of NR - Not able to be Rated

  1. Re-ED

See why Higher Level of Placement was selected by the Advisory Committee.

What is Higher Level of Placement as it relates to Child Welfare?

Child Welfare uses foster placement as a service to ensure the protection of children and youth who must be removed from the home of their parents or guardians because of the occurrence of abuse and neglect.  Law and practice dictate that children be placed in the "least restrictive setting."  The least restrictive placement for a child is in the home of their parent or guardian;   the range of foster placements outside of the parents' or guardians' homes, from least to most, are the following:  relative or non-related extended family member, foster family home, foster family agency home, group home, residential treatment center, and community treatment facility.  Within the last two categories, there are approximately 15 rating classification levels, each of which represents more therapeutic and more restrictive care.  When Child Welfare staff refers to "higher level of placement," they are usually discussing about residential treatment and community treatment facility placements, in the rating classification levels of 12 and above.

Why Higher Level of Placement was chosen by the Advisory Committee?

For over twenty years, Child Welfare has been concerned about the effects of higher level placements.  It has been observed and documented that children and youth who are placed in higher levels of care can become "institutionalized" and therefore unable to return to normal family home environments.  While therapeutic treatment is provided in higher levels of care, it does not always prepare children and youth to become accustomed to the intimacy of family life. Therefore, it is often a self-perpetuating intervention that results in children and youth become habituated to living in institutional environments and unable to return to either their own families or to be placed successfully in other family environments.  Child Welfare invests tremendous financial resources in these placements and then cannot find alternative placements once the mental health treatment has been successfully completed-children and youth become unable to leave the institutional environment despite having addressed the mental health issues that brought them there.  Children and youth who have become institutionalized by this intervention often then move from one institutional placement to another until they leave the foster care system, thereby resulting in the Child Welfare agency's performing very poorly in the measure of placement stability.  It is believed that alternative placement milieus such as Therapeutic Foster Care and Wraparound programs, which bring therapeutic interventions to a family environment, can be as successful as higher level placements in addressing the mental health needs of children and youth while avoiding the problem of institutionalization and the concomitant placement instability.

Stuart Oppenheim
Executive Director
Child & Family Policy Institute of California
Sacramento Office
Sacramento, CA