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Purpose: Treatment adherence is a central component of implementation fidelity and key to our understanding of client outcomes. This study examines treatment adherence in the Neurosequential Model of Therapeutics (NMT) and four functional outcomes among a sample of adopted youth: sensory integration, self-regulation, and relational and cognitive functioning. Methods: The sample includes 178 youth receiving supportive services from a U.S. adoption service provider. Regression analysis was used to examine clinician adherence to NMT recommendations and child outcomes. Results: Most (61.24%) of the essential or therapeutic treatment recommendations were carried out with majority adherence. A key finding is the predictive relationship between adherence to treatment recommendations and improvement in child outcomes at T2, controlling for all other variables in the model. Conclusions: Findings illustrate the importance of treatment adherence in promoting positive outcomes for children engaged in NMT. Implications are discussed regarding clinician training and reducing barriers to treatment adherence.

While the sexual health risks among young people of color in foster care have been well-documented, healthy sexual development in this population has been less examined. The current study explored the experiences of Black youth in foster care and the factors that influenced their safer sex practices. Qualitative interviews were conducted with 18 sexually active Black participants (18–22 years old) in foster care from a large, Midwestern city in the United States. Grounded theory methods were used to (a) construct a conceptual framework illustrating the conditions the youth experienced that influenced their safer sex efforts, and (b) describe different types of intimate relationships that reflected their sexual health practices. Using specific strategies, the majority of the youth overcame obstacles and participated in positive sexual health practices. More than half (59%) reported they were in an intimate relationship for at least 6 months and either abstained from sex, used condoms 100% of the time, or employed safer sex methods. The findings suggest Black youth in state care can engage in positive sexual health practices and form healthy intimate relationships.