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Evidence summaries

Treatment Foster Care (Tfc) for Improving Outcomes in Young People with Behaviour Problems

Treatment Foster Care (TFC) care may be a useful intervention to help place delinquent children and young people with a range of behaviour problems in family settings. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 5 studies with a total of 390 subjects. Four studies focussed on young delinquents or children with a range of behaviour problems. The fifth examined the effectiveness of TFC for young people in a state mental hospital. Both boys and girls were included. All studies originated from the U.S.. In three cases the TFC intervention included 1) pre-service training of specially selected foster carers; 2) the implementation of a behaviour management programme for the child in both the home and the community; 3) an individualised treatment plan for the children and young people; 4) supervision and support of foster carers via daily telephone calls and weekly groups, and 5) services were coordinated by case managers were on call 24/7 and available to biological parents as well as foster carers, where appropriate. Interventions in the remaining two studies were less intensive in nature. Follow-up times were up to 2 years. No cost-benefit analyses were undertaken

Findings indicate that TFC care may be a useful intervention to help place these children and young people in family settings. Results indicate some clinically meaningful decreases in: antisocial behaviour, the number of days children and young people abscond from placement; the number of criminal referrals and the time spent in locked settings. There is some evidence that young people in Treatment Foster Care spent more time in treatment over the long-term and more time at home. Examination of educational and employment outcomes showed improvements in school attendance, homework completion and engagement with employment.

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by potential reporting bias (all included studies were conducted by research teams that developed the intervention).

    References

    • Macdonald GM, Turner W. Treatment foster care for improving outcomes in children and young people. Cochrane Database Syst Rev 2008 Jan 23;(1):CD005649. [PubMed]

Primary/Secondary Keywords