Are we reinforcing the anti-medical model?

Abstract

Harold & DeGarmo also question whether there was indeed a difference in the standard control condition (usual care) for participants in the US and UK studies. There are certainly likely to be differences in the nature and uses of group care between the two countries, given the differences in their child-welfare and juvenile-justice systems. However, the point we were making is that, in the USA, the MTFC programme for adolescents has been principally found to be successful when targeted at young offenders, in studies that have used a variety of measures of recorded reoffending to assess its effectiveness. 1-3 This emphasis on the effectiveness of MTFC-A with young offenders is also clear from the programme developers' own website (www.mtfc.com). By contrast, the participants in our study were young people with complex emotional and behavioural difficulties, 93% of whom were in care because of abuse or neglect and less than a third of whom had a recent criminal conviction. The differences between the populations served by MTFC-A are clearly evident in an article comparing outcomes for high-risk adolescent girls written by the programme developers in the USA and their English colleagues 4 and may perhaps partly explain why the results of the English evaluation were less positive than those in the USA. 1 Chamberlain P. Comparative evaluation of foster care for seriously delinquent youth: a first step. Community Altern 1990; 2: 21-36. 2 Chamberlain P, Reid JB. Comparison of two community alternatives to incarceration for chronic juvenile offenders.