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Treatment Foster Care

Health Factors: Community Safety
Decision Makers: Community Members Local Government State Government Federal Government Nonprofit Leaders
Evidence Rating: Some Evidence
Population Reach: <1% of WI's population
Impact on Disparities: No impact on disparities likely

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Description

Treatment or Therapeutic Foster Care (TFC) provides a foster family-based intervention that is structured, nurturing, individualized, and therapeutic to youth with mental, social, emotional, and behavioral challenges. TFC offers a less restrictive environment than residential care or juvenile justice settings. Core components of TFC include specialized training and routine support for foster parents, treatment services and supervision for youth by foster parents, and agency caseworkers who serve as consultants and service coordinators (SAMHSA-TFC 2013Bishop-Fitzpatrick 2015, CINAHL-Teska 2015). TFC models and services vary by agency.

Expected Beneficial Outcomes

Reduced delinquent behavior
Improved youth behavior
Reduced incarceration
Increased foster care placement stability
Reduced arrests
Improved social emotional skills

Evidence of Effectiveness

There is some evidence that Treatment Foster Care (TFC) reduces problem behaviors, general delinquency, and days incarcerated for participating youth while increasing placement permanency (Campbell-MacDonald 2008). However, additional evidence is needed to confirm effects.

TFC can also reduce the likelihood of arrest among youth with emotional or behavioral problems compared to peers in group home care (Robst 2013). Boys who have participated in TFC have fewer felony charges than peers in group home care (Robst 2011). TFC may improve daily life functioning for youth with emotional or behavioral problems (Bishop-Fitzpatrick 2015).

Enhanced TFC, which includes intense behavioral modification training for foster parents and staff, can improve outcomes more than traditional TFC (Farmer 2010a). Researchers also recommend enhancing TFC with routine check-ins to address problems before they worsen, and training staff regularly and foster parents over several weeks so that trainees can practice their skills (Murray 2010).

Implementation

United States

Treatment or Therapeutic Foster Care is practiced in at least 2000 locations through various models including Treatment Foster Care Oregon (TFCO), Specialized Therapeutic Foster Care (STFC), Pressley Ridge Treatment Foster Care (PR-TFC), and Together Facing the Challenge (TFTC) (Bishop-Fitzpatrick 2015).

Wisconsin

Many organizations offer TFC in Wisconsin. The Children’s Hospital of Wisconsin, for example, offers TFC through regional offices in Baraboo, Eau Claire, Fox Valley, Green Bay, Madison, and Milwaukee (CHW-TFC).

Implementation Resources

US DHHS-TFC - US Department of Health and Human Services (US DHHS). Child Welfare Information Gateway. Treatment foster care (TFC). Accessed on March 13, 2017

Citations - Description

Bishop-Fitzpatrick 2015* - Bishop-Fitzpatrick L, Jung N, Nam I, Trunzo AC, Rauktis ME. Outcomes of an agency-developed treatment foster care model for adolescents. Journal of Emotional and Behavioral Disorders. 2015;23(3):156–166. Accessed on August 23, 2016
CINAHL-Teska 2015 - Teska J. A quick lesson about therapeutic foster care: Child welfare. Glendale, CA: CINAHL Information Systems; 2015. Accessed on August 23, 2016
SAMHSA-TFC 2013 - Substance Abuse and Mental Health Services Administration (SAMHSA). What does the research tell us about services for children in therapeutic/treatment foster care (TFC) with behavioral health issues?: Report of the SAMHSA, CMS and ACYF Technical Expert Panel, September 27–28, 2012. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration; 2013. Accessed on August 24, 2016

Citations - Evidence

Bishop-Fitzpatrick 2015* - Bishop-Fitzpatrick L, Jung N, Nam I, Trunzo AC, Rauktis ME. Outcomes of an agency-developed treatment foster care model for adolescents. Journal of Emotional and Behavioral Disorders. 2015;23(3):156–166. Accessed on August 23, 2016
Campbell-MacDonald 2008 - MacDonald GM, Turner W. Treatment foster care for improving outcomes in children and young people. Campbell Systematic Reviews. 2008:9. Accessed on September 2, 2016
Farmer 2010a - Farmer EMZ, Burns BJ, Wagner HR, Murray M, Southerland DG. Enhancing “usual practice” treatment foster care: Findings from a randomized trial on improving youths’ outcomes. Psychiatric Services. 2010;61(6):555–61. Accessed on September 2, 2016
Murray 2010* - Murray MM, Southerland D, Farmer EM, Ballentine K. Enhancing and adapting treatment foster care: Lessons learned in trying to change practice. Journal of Child and Family Studies. 2010;19(4):393–403. Accessed on September 2, 2016
Robst 2011* - Robst J, Armstrong M, Dollard N. Comparing outcomes for youth served in treatment foster care and treatment group care. Journal of Child and Family Studies. 2011;20(5):696–705. Accessed on September 2, 2016
Robst 2013* - Robst J, Armstrong M, Dollard N, Rohrer L. Arrests among youth after out-of-home mental health treatment: Comparisons across community and residential treatment settings. Criminal Behaviour and Mental Health. 2013;23(3):162–176. Accessed on August 23, 2016

Citations - Implementation

Bishop-Fitzpatrick 2015* - Bishop-Fitzpatrick L, Jung N, Nam I, Trunzo AC, Rauktis ME. Outcomes of an agency-developed treatment foster care model for adolescents. Journal of Emotional and Behavioral Disorders. 2015;23(3):156–166. Accessed on August 23, 2016
CHW-TFC - Children’s Hospital of Wisconsin (CHW). Treatment foster care. Accessed on September 2, 2016
PR-TFC - Pressley Ridge. Pressley Ridge Treatment Foster Care (PR-TFC). Accessed on August 23, 2016
STFC - Daniel: Improving the odds for kids. Specialized Therapeutic Foster Care (STFC). Accessed on August 23, 2016
TFCO - TFC Consultants, Inc. Treatment Foster Care Oregon (TFCO). Accessed on September 2, 2016
TFTC - Duke University School of Medicine, Services effectiveness research program. Together Facing the Challenge (TFTC). Accessed on August 23, 2016

Page Last Updated

September 2, 2016

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