Treatment Foster Care for Improving Outcomes in Children and Young People: A Systematic Review

Abstract

Objective: To assess the impact of treatment foster care (TFC) on psychosocial and behavioral outcomes, delinquency, placement stability, and discharge status for children and adolescents who, for reasons of severe medical, social, psychological and behavioural problems, were placed in out-of-home care in restrictive settings or at risk of placement in such settings. Method: Electronic bibliographic databases, web searches, and article reference lists were used to identify randomized controlled trials (RCTs) investigating the effectiveness of TFC with children and young people. The Cochrane Collaboration's criteria were used to assess the methodological quality of studies that met the inclusion criteria. Wherever possible, extracted outcome data from similar studies were synthesized with random effects meta-analyses. Results: A total of 5 studies including 390 participants were included in this review. Data suggest that TFC may be a useful intervention for children and young people with complex emotional, psychological, and behavioural need, who are at risk of placements in nonfamily settings that restrict their liberty and opportunities for social inclusion. Conclusion: Although the inclusion criteria for this systematic review set a study design threshold higher than that of previous reviews, the findings mirror those of earlier reviews. While the results of individual studies generally indicate that TFC is a promising intervention for children and youth experiencing mental health problems, behavioral problems, or problems of delinquency, the evidence base is not robust and more research is needed due to the limited number of studies in this area.

Relationship Between Time in Residential Treatment and Youth Outcomes: Results from a Cross-Site 5-Year Analysis

“…Furthermore, increasing pressure to use evidence-based and empirically-supported interventions also contributes to the need for RTCs to demonstrate successful outcomes for youth (James et al 2012), especially when alternative treatments such as treatment foster care effectively serve youth with emotional and behavioral issues while maintaining them in a family environment at a reduced cost to funders (Chamberlain 1994;2002;Turner and Macdonald 2011). Due to effectiveness of lower cost services, RTCs not only need to demonstrate effectiveness in serving youth with behavioral problems, but also demonstrate cost effectiveness and overall cost savings to stakeholders.…”

Comparing the Experiences and Withdrawal Considerations of Treatment and Regular Foster Care Parents: The Canadian Perspective

“…Turner and MacDonald's (2012) meta-analysis of treatment foster care programs concluded that there was evidence for TFC to be a promising program however, "the evidence is not robust and more research is needed to add to the limited number of studies in this area." (p. 501).…”

Psychometric Evaluation of the Symptoms and Functioning Severity Scale (SFSS) Short Forms with Out-of-Home Care Youth

“…They frequently meet criteria for diagnoses of conduct disorder, mood and anxiety disorders, and adjustment disorders (Connor, Doerfler, Toscano, Volungis, & Steingard, 2004; Turner & Macdonald, 2011). Out-of-home care is typically characterized by facilities that provide well controlled and intensive treatment, which includes supervision, structured daily living, and psychoeducational interventions (Brown Hamilton, Natzke, Ireys, & Gillingham, 2011).…”