Abstract
We examined Treatment Foster Care (TFC) in residential trajectories for youth with psychiatric disorders and aggressive behavior. We analyzed residential placements of a statewide sample of youth during the 12 months preceding and following admission to TFC. Prior to TFC, the majority of youth were residing in more restrictive settings (group homes or residential treatment). Two-thirds of youth remained in TFC throughout the follow-up year. Of those who left, nearly half returned home, and slightly fewer were discharged to group homes. By the end of the 12-month follow-up period, rates of group home use were similar to those seen in the pre-TFC period. Movement out of TFC during the year was associated with being older at placement and with increased problem behavior (particularly externalizing behaviors). TFC serves as a step-down placement for a substantial number of youth. However, this is not the only way it is used, and models based on short-term transitioning or reunification with families may not be widely implemented or relevant in practice. Additional research is needed to understand current functions of TFC in residential trajectories and to maximize its utility in systems of care.
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References
Achenbach, T.M. (1991). Manual for the Child Behavior Checklist 4–18 and 1991 Profile. Burlington, VT: University of Vermont Department of Psychiatry.
Behar, L. (in press). Using litigation to improve child mental health services: Promises and pitfalls. Journal of Mental Health Administration & Policy.
Behar, L. (1985). Changing patterns of state responsibility: A case study of North Carolina. Journal of Clinical Child Psychology, 14, 188-195.
Behar, L. (1986). A state model for child mental health services: The North Carolina experience. Children Today, 15, 16-21.
Chamberlain, P. (1994). Family connections: A treatment foster care model for adolescents with delinquency. Eugene, OR: Castalia Publishing Company.
Chamberlain, P. (2002). Treatment foster care. In B. J. Burns & K. Hoagwood (Eds.), Community treatment for youth: Evidence-based interventions for severe emotional and behavioral disorders (pp. 117-138). New York: Oxford University Press.
Chamberlain, P., & Moore, K. (1998). A clinical model for parenting juvenile offenders: A comparison of group care versus family care. Clinical Child Psychology & Psychiatry, 3, 375-386.
Clark, H.B. & Davis, M. (2000). Transition to adulthood: A resource for assisting young people with emotional or behavioral difficulties. Baltimore: Paul H. Brooks.
Clarke, G.N., Hawkins, W., Murphy, M., & Sheeber, L. (1993). School-based primary prevention of depressive symptomatology in adolescents: Findings from two studies. Journal of Adolescent Research, 8, 183-204.
Cox, D.R., & Oakes, D. (1984). Analysis of survival data. London: Chapman & Hall.
Duchnowski, A.J., Hall, K.S., Kutash, K., & Friedman, R.M. (1998). The alternatives to residential treatment study. In M.H. Epstein, K. Kutash, & A.J. Duchnowski (Eds.), Outcomes for children and youth with behavioral and emotional disorder and their families: Programs and evaluation best practices (pp. 55-80). Austin, TX: PRO-ED.
Epstein, M.H., & Sharma, J. (1998). Behavioral and emotional rating scale: A strength-based approach to assessment. Austin, TX: Pro-ED.
Farmer, E.M.Z., & Federman, E. (1996). Patterns of service use and outcomes among Willie M class members. Raleigh: Program Evaluation Branch, Willie M Section, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, State of North Carolina.
Farmer, E.M.Z., Burns, B.J., Dubs, M.S., & Thompson, S. (in press). Assessing conformity to standards for treatment foster care. Journal of Emotional & Behavioral Disorders.
Greenbaum, P., Dedrick, R., Friedman, R., Kutash, K., Brown, E., Lardieri, S., & Pugh, A. (1998). National Adolescent and Child Treatment Study (NACTS): Outcomes for Children with Serious Emotional and Behavioral Disturbance. In M.H. Epstein, K. Kutash, & A.J. Duchnowski (Eds.), Outcomes for children and youth with behavioral and emotional disorders and their families: Programs and evaluation best practices (pp. 21-54). Austin, TX: PRO-ED.
Hawkins, R.P., Almeida, M.C., Fabry, B., & Reitz, A.L. (1992). A scale to measure restrictiveness of living environments for troubled children and youths. Hospital and Community Psychiatry, 43, 54-58.
Hudson, J., Nutter, R.W., & Galaway, B. (1994). Treatment foster care programs: A review of evaluation research and suggested directions. Social Work Research, 18, 198-210.
James, S., Landsverk, J., & Slymen, D.J. (in press). Placement movement in out-of-home care: Patterns and predictors. Children & Youth Services Review.
Jensen, P.S., Hoagwood, K., & Petti, T. (1996). Outcomes of mental health care for children and adolescents: II. Literature review and application of a comprehensive model. Journal of the American Academy of Child & Adolescent Psychiatry, 35, 1064-1077.
Johnson, P.J., & Fried, B.J. (1984). Implementation dilemmas in North Carolina's Willie M. Program. Child Welfare, 63, 419-430.
Liao, Q., Manteuffel, B., Paulic, C., & Sondheimer, D. (2001). Describing the population of adolescents served in systems of care. Journal of Emotional and Behavioral Disorders, 9, 13-29.
Meadowcroft, P., Thomlison, B., & Chamberlain, P. (1994). Treatment foster care services: A research agenda for child welfare. Child Welfare, 73, 565-581.
Reddy, L.A., & Pfeiffer, S.I. (1997). Effectiveness of treatment foster care with children and adolescents: A review of outcome studies. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 581-588.
Rivera, V.R., & Kutash, K. (1994). Family support services and family support groups. In V. Rivera & K. Kutash (Eds.), Components of a system of care: What does the research say? (pp. 141-163). Tampa: Research and Training Center for Children's Mental Health, Florida Mental Health Institute, University of South Florida.
Smith, D.K., Stormshak, E., Chamberlain, P., Whaley, R.B. (2001). Placement disruption in treatment foster care. Journal of Emotional and Behavioral Disorders, 9, 200-205.
Stroul, B. (1993). Systems of care in children with severe emotional disturbance: What are the results. Washington, DC: Georgetown University Child Development Center, CASSP Technical Center.
Stroul, B.A. (1996). Children's mental health: Creating systems of care in a changing society. (Vol. II). Baltimore, MD: Paul H. Brookes Publishing.
Stroul, B.A., & Friedman, R.M. (1986). A system of care for severely emotionally disturbed children and youth. Washington, DC: Georgetown University Child Development Center, CASSP Technical Assistance Center.
Teare, J.F., Larzelere, R.E., Smith, G.L., Becker, C.Y., Castrianno, L.M., & Peterson, R.W. (1999). Placement stability following short-term residential care. Journal of Child and Family Studies, 8, 59-69.
Weisz, J.R., Martin, S.L., Walter, B.R., & Fernandez, G.A. (1991). Differential prediction of young adult arrests for property and personal crimes: Findings of a cohort follow-up study of violent boys from North Carolina's Willie M Program. Journal of Child Psychology and Psychiatry, 32, 783-792.
Weisz, J.R., Walter, B.R., & Weiss, B. (1990). Arrests among emotionally disturbed violent and assaultive individuals following minimal versus lengthy intervention through North Carolina's Willie M. Program. Journal of Consulting and Clinical Psychology, 58, 720-728.
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Farmer, E.M.Z., Wagner, H.R., Burns, B.J. et al. Treatment Foster Care in a System of Care: Sequences and Correlates of Residential Placements. Journal of Child and Family Studies 12, 11–25 (2003). https://doi.org/10.1023/A:1021349907744
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DOI: https://doi.org/10.1023/A:1021349907744