This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cachildwelfareclearinghouse.org/
This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cachildwelfareclearinghouse.org/
Child Welfare Outcomes: Permanency and child/family well-being.
Type of Maltreatment: Not specified
Target Population: Preschool foster children aged 3-6 years old who exhibit a high level of disruptive and anti-social behavior which cannot be maintained in regular foster care or who may be considered for residential treatment.
Brief Description:
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) has been rated by the CEBC in the area of Placement Stabilization. MTFC-P is a treatment foster care model specifically tailored to the needs of 3 to 6-year-old foster children. MTFC-P is effective at promoting secure attachments in foster care and facilitating successful permanent placements. MTFC-P is delivered through a treatment team approach in which foster parents receive training and ongoing consultation and support; children receive individual skills training and participate in a therapeutic playgroup; and birth parents (or other permanent placement caregivers) receive family therapy. MTFC-P emphasizes the use of concrete encouragement for pro-social behavior; consistent, non-abusive limit-setting to address disruptive behavior; and close supervision of the child. In addition, the MTFC-P intervention employs a developmental framework in which the challenges of foster preschoolers are viewed from the perspective of delayed maturation.
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THREE KEY MECHANISMS
OTHER COMPONENTS
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) was designed to be conducted in a group.
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) has not been tested for use in a group setting.
The recommended group size is: There are two main components that are conducted in group environment: Therapeutic Playgroup and Foster Parent Support Meeting. The Therapeutic Playgroup is conducted with approximately 10 children. The Foster Parent Support Meeting occurs with 10 caregivers from foster homes.
Recommended intensity: For Foster parent(s), there is typically a minimum of seven contacts per week which consist of five 10-minute contacts, one two-hour group and additional contacts based on the amount of support or consultation required. For the child in treatment, two contacts per week which consist of a two-hour therapeutic playgroup and a two-hour skills training session. For the biological family or other long-term placement resource, one contact per week in the form of a one-hour skill-building session.
Recommended duration: Designed with an overall treatment duration of 6-9 months.
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) includes a homework component.
Description: Biological (or other long-term placement resource) parents are guided in practicing parenting skills outside of the sessions during visits with the child in foster care and with other children living in the home.
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) is typically conducted in a(n): Birth Family Home, Community Agency, Foster Home, and School.
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) was designed with a Parent Component.
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) addresses the following presenting problems and symptoms: Consistent encouragement of positive behavior; non-abusive and consistent limit setting for problem behavior; facilitating reunification and permanency.
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) was designed with a Child Component.
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) addresses the following presenting problems and symptoms: Children in the program are treated for disruptive, maladaptive behaviors. These include a wide range of diagnoses and include developmental delays. Behaviors of aggression, anxiety, depression, hyperactivity, autism spectrum, attachment, enuresis, encopresis, defiance, tantrums and general anti-social behavior.
Age range(s): 3-6
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) was developed for children with developmental delays.
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) has been tested for children with developmental delays.
Relevant research studies:
Fisher, P. A., Burraston, B., & Pears, K. (2005). The Early Intervention Foster Care Program: Permanent placement outcomes from a randomized trial. Child Maltreatment, 10, 61-71.
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) was not designed for specific racial/ethnic/cultural groups.
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) was not tested in specific racial/ethnic/cultural groups.
There is a manual that describes how to implement this program.
There is training available for Multidimensional Treatment Foster Care for Preschoolers (MTFC-P).
Training contact: TFC Consultants, Inc., Gerard Bouwman, President, 1163 Olive Street, Eugene, OR 97401, 541-343-2388
Number of days/hours: 5 days for a total of 40 hours
Training is obtained: It is conducted in Eugene, Oregon.
There currently are not additional qualified resources for training.
The typical resources for implementing Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) are: Office space for a team of approximately 6-8 people, room for therapeutic playgroup with video recording, conference room with video recording, Internet access for Program Supervisor, FP Consultant, and PDR caller.
Program supervisor: In addition to a Master's level education in a clinical field and considerable relevant experience in behavior management approaches, this person should possess supervisory skills, considerable organizational abilities, and a thorough understanding of and enthusiastic attitude toward the treatment model. The program supervisor must be available to the foster parents and treatment team members 24 hours a day, 7 days a week.
Foster parent consultant/recruiter/trainer: While a formal post-secondary education is not necessary for this position, this person must have knowledge of foster parents and a clear understanding of the model. Prior experience as a foster parent or as an adoptive parent of older children is strongly desirable.
Family therapist: Master’s level education in a clinical field. Knowledge of Parent Management Training or related behaviorally based parenting techniques is highly desirable. Playgroup leader: Bachelor’s level education in a relevant field. The playgroup leader is responsible for organizing, preparing, and executing the playgroup curriculum. This person is also responsible for leading the assistants for playgroup. The playgroup leader is also an individual skills trainer for children in the program.
Skills trainer: Bachelor’s level education in a relevant field. Since skills training activities take place outside of the office, mileage reimbursements and reimbursements for modest entertainment, food, and beverage expenses are typically associated with these activities. Two skills trainers will also hold the position of playgroup assistants.
PDR-caller: This important position should be filled by someone with a thorough understanding of the treatment model and experience in foster parent activities. The specific education level for this position is less important. It may be filled by an experienced (ex-) foster parent.
Foster family: No formal education is required for foster parents. However, foster parents trained in the program should have a basic understanding of child development with reasonable expectations for this population of foster children. It is especially helpful when foster parents have a good sense of humor and do not take behaviors personally.
Consulting psychiatrist: Adequately serve children in the program who need medication prescribed and managed.
Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) is rated a "2 - Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one rigorous randomized controlled trial with a sustained effect of at least 6 months. For more information on the rating of a "2 - Supported by Research Evidence," please see the Scientific Rating Scale.
Fisher, P. A., Burraston, B., & Pears, K. (2005). The Early Intervention Foster Care Program: Permanent placement outcomes from a randomized trial. Child Maltreatment, 10, 61-71.
Participants were 90 children in the foster care program with an average age of approximately 4 years. Those in Early Intervention Foster Care (EIFC) received parent training, supervision and support and children received behavioral therapy as needed. Children in EIFC had significantly fewer failed permanent placements than children in the regular foster care comparison condition. The number of prior placements was positively associated with the risk of failed permanent placements for children in the comparison condition but not for children in EIFC. Type of prior maltreatment did not predict permanent placement outcomes.
Fisher, P. A., Gunnar, M. R., Chamberlain, P., & Reid, J. B. (2000). Preventive intervention for maltreated preschoolers: Impact on children's behavior, neuroendocrine activity, and foster parent functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1356-1364.
This article describes the results of a pilot study that evaluated the effectiveness of the Early Intervention Foster Care (EIFC) program in the period immediately following a preschool child's placement in a new foster home. Data were collected from an EIFC group (mean age 5.35 yrs), a regular foster care group, and a community comparison group--each with 10 participants--via questionnaires for children and their caretakers and salivary cortisol sampling. EIFC foster parents adopted and maintained positive parenting strategies, EIFC children's behavioral adjustment improved, and changes occurred in several salivary cortisol measures. Moreover, regular foster care children exhibited decrements in functioning in several areas over the same time period. Results are discussed with regard to how such research fits into a larger program of prevention research for high-risk preschool children.
Fisher, P.A. & Kim, H.K. (in press). Intervention effects on foster preschoolers attachment-related behaviors from a randomized trial. Prevention Science.
Describes same sample as Fisher, P. A., Burraston, B., & Pears, K. (2005). This study examines change in attachment-related behaviors among foster preschoolers participating in a randomized trial of the Multidimensional Treatment Foster Care Program for Preschoolers. Measures of secure, resistant, and avoidant behaviors were collected using a caregiver-report diary at 3-month intervals during the 12 months following a new foster placement. Children randomly assigned to the intervention condition (n = 57) showed significant increases in secure behavior and significant decreases in avoidant behavior relative to children assigned to a regular foster care condition (n = 60). Both groups showed significant decreases in resistant behavior over time. Analyses also revealed a significant interaction between treatment condition and age at first foster placement on change in secure behavior.
Fisher, P. A., Gunnar, M., Dozier, M., Bruce, J., & Pears, K. C. (in press). Effects of a therapeutic intervention for foster children on behavior problems, caregiver attachment, and stress regulatory neural systems. Annals of the New York Academy of Sciences.
Describes same sample as Fisher, P. A., Burraston, B., & Pears, K. (2005) and provides evidence that caregiver-based interventions can help normalize HPA axis function, and that such changes co-occur with improved behavioral functioning.
Fisher, P. A., Ellis, B. H., & Chamberlain, P. (1999). Early intervention foster care: A model for preventing risk in young children who have been maltreated. Children's Services: Social Policy, Research, and Practice, 2, 159-182.
Chamberlain, P., & Fisher, P. A. (2003). An application of MTFC for early intervention. In P. Chamberlain (Ed.), Treating chronic juvenile offenders: Advances made through the Oregon MTFC model (pp. 129-140). Washington, DC: American Psychological Association.
Contact name: Rena Gold, MS
Affiliation/Agency: TFC Consultants, Inc.
Email: renag@mtfc.com
Phone: 541-343-2388
Fax: 541-343-2764
Website: http://www.mtfc.com