Treatment Foster Care Oregon for Delinquent Adolescents: A Systematic Review and Meta-Analysis

Abstract

Purpose: To examine the effects of Treatment Foster Care on youth with serious behavior problems. Method: Included studies are controlled trials with high or medium quality, published between 1990 and September 2017. The control group consists of youth with serious behavior problems in group care, and the follow-up time was at least 12 months. The review also examines ethical and economic aspects. Results: A total of eight controlled studies were included, consisting of 633 young people and 55 effect sizes. All studies examined the same model, Treatment Foster Care Oregon (TFCO). There is moderate certainty of evidence that TFCO reduces the risk of future criminal behavior and the number of days in locked settings. Furthermore, there is low certainty of evidence that TFCO reduces the risk of delinquent peer associations, drug use, and depression. Discussion: TFCO is to be preferred to group care for youth with serious behavior problems. Ethical and economic implications are discussed.

What changes during specialized foster care? A study on adaptive functioning and emotional and social problems

“…The results of the present study show that the model is also associated with improvements in emotional and social problems. It is possible that specialized foster care that is focused on attachment and mentalizing can improve mental health more than foster care in general and also more than specialized foster care with a different focus (Åström et al, 2020; Goemans et al, 2015). Most notably, feelings of anger and disruptive behaviour decreased.…”

“…TFCO is intended for young people with antisocial and/or criminal behaviour. Evaluations of TFCO have shown some evidence of reducing risk of future criminal behaviour but low evidence of reducing mental health problems like depression (Åström et al, 2020). Another model, also developed from MTFC, is KEEP (Keeping Foster Parents Trained and Supported) (Price et al, 2009).…”

Comparing Medicaid Expenditures for Standard and Enhanced Therapeutic Foster Care

“…As rates of mental health concerns in children and adolescents have increased dramatically in recent years, identifying cost-effective evidence-based treatments is imperative to minimize the increasing financial burden on the health care system (Curtin, 2019 ; Cutler et al, 2022 ; Tkacz & Brady, 2021 ; Twenge et al, 2019 ). One such potential treatment is therapeutic foster care (TFC, also called treatment foster care), a mental health service for children and adolescents with severe emotional and behavioral symptoms (Åström et al, 2020 ; Farmer et al, 2010 ; McMillen et al, 2015 ; Reddy & Pfeiffer, 1997 ). TFC services are provided outside of the child’s home of origin in a structured in-home environment with a trained professional therapeutic treatment parent.…”

“…In contrast with traditional foster care, children placed in TFC homes may or may not be involved with the child welfare system. Several manualized TFC programs have been rigorously evaluated and, overall, TFC has garnered sufficient evidence to support its dissemination across the U.S. (Åström et al, 2020 ; Hahn et al, 2005 ; Turner & Macdonald, 2011 ). In most cases, TFC services are reimbursable through public and private insurance.…”

Effectiveness of Intensive Alternative Family Treatment on Reducing Re-Admissions to Psychiatric Residential Treatment Facilities

“…Interventions that build on and intensify the services provided under the TFC model of care have the potential to reduce the risk that a child with intensive service needs will be removed from the family and community setting and treated in a PRTF. In recent years, researchers have developed and rigorously evaluated several evidence-based TFC models, creating manualized interventions that can be implemented in communities and quality-controlled through intentional fidelity monitoring (Åström et al, 2020; Hahn et al, 2005). The purpose of this study is to describe Intensive Alternative Family Treatment (IAFT), an innovative model of intensive TFC.…”