Topic: Alternatives to Long-Term Residential Care Programs

Scientific Ratings in this topic:

1 - Well-Supported by Research Evidence

2 - Supported by Research Evidence

3 - Promising Research Evidence

4 - Evidence Fails to Demonstrate Effect

5 - Concerning Practice

NR - Not able to be Rated

Learn more about the scale

Definition for Alternatives to Long-Term Residential Care Programs:

Alternatives to Long-Term Residential Care Programs are defined by the CEBC as family-home-based or short-term residential programs that meet the clinical or therapeutic needs of children and youth in out-of-home care who were traditionally served in congregate care settings. Congregate care settings, in this context, would include group, residential, and community treatment facilities with a California rating classification level of 12 and above. (Note: There are 14 rating classification levels of care for children in California, each of which represents more therapeutic and more restrictive care. For information on the different levels, please click here:

This topic area was created in response to California’s Continuum of Care Reform efforts and an understanding that children who must live apart from their biological parents do best when they are cared for in committed and nurturing family homes. California’s statutory and policy framework ensures that services and supports provided to the child, youth, and family are tailored toward the ultimate goal of maintaining a stable permanent family. Reliance on congregate or residential care should be limited to short-term, therapeutic interventions that are just one part of a continuum of care available for children, youth, and young adults.

  • Target population: Children and youth with need for a higher level of care who would typically have been placed in residential or congregate care settings; could also include the caregivers of these youth
  • Services/types that fit: Home- or community-based clinical interventions, school-based services, short-term/time-limited residential interventions, parent training programs
  • Delivered by: Resource parents, licensed clinical professionals, paraprofessionals, social workers, educators, and other child welfare related staff
  • In order to be included: Program must deliver either short-term higher level of placement services or services designed to be an alternative to placement in higher levels of care, or must train staff and/or caregivers to deliver these services
  • In order to be rated: There must be research evidence (as specified by the Scientific Rating Scale) that examines child welfare outcomes such as reductions in the use of higher levels of placement or occurrence of placement disruptions, and/or behavior-related outcomes for youth/children such as changes in behavior, symptom levels, and/or functioning.

Programs in this Topic Area

The programs listed below have been reviewed by the CEBC and, if appropriate, been rated using the Scientific Rating Scale.

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

  • Multidimensional Family Therapy (MDFT)
    Adolescents 11 to 18 with the following symptoms or problems: substance use or at risk, delinquent/conduct disorder, school and other behavioral ...
  • Multisystemic Therapy (MST)
    Youth, 12 to 17 years old, with possible substance abuse issues who are at risk of out-of-home placement due to antisocial or ...
  • Treatment Foster Care Oregon - Adolescents (TFCO-A)
    [Multidimensional Treatment Foster Care - Adolescents]
    Boys and girls, 12-18 years old, with severe delinquency and/or severe emotional and behavioral disorders who were in need ...

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

  • Functional Family Therapy (FFT)
    11-18 year olds with very serious problems such as conduct disorder, violent acting-out, and substance abuse
  • Treatment Foster Care Oregon for Preschoolers (TFCO-P)
    [Multidimensional Treatment Foster Care for Preschoolers]
    Preschool foster children aged 3-6 years old who exhibit a high level of disruptive and anti-social behavior which cannot be ...

Seven Programs with a Scientific Rating of 3 - Promising Research Evidence:

  • Children and Residential Experiences (CARE)
    Child care staff, clinical staff, and agency administrators working with 6- to 20-year-old children and youth living in residential care ...
  • Dialectical Behavior Therapy (DBT) – non-responder
    Chronically suicidal youth with behaviors found in borderline personality disorder (BPD)
  • Multifunctional Treatment in Residential and Community Settings (MultifunC) – non-responder
    High-risk juvenile criminals
  • Risk Reduction through Family Therapy (RRFT)
    Trauma-exposed adolescents aged 13-18 years who experience co-occurring trauma-related mental health problems (e.g., posttraumatic stress disorder [PTSD], depression), substance ...
  • Sanctuary Model
    This program is not a client-specific intervention, but a full-system approach that targets the entire organization with the intention of ...
  • Stop-Gap
    Children and/or adolescents with disruptive behavior disorders (Conduct disorder [CD], Oppositional Defiant Disorder [ODD], attention-deficit hyperactivity disorder [ADHD]) living ...
  • Teaching-Family Model (TFM)
    Youth who are at-risk, juvenile delinquents, in foster care, mentally retarded/developmentally disabled, or severely emotionally disturbed; families at risk ...

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

Topic Expert

Sigrid James, PhD, LCSW, Associate Professor
Department of Social Work and Social Ecology, Loma Linda University
Loma Linda, CA