Improving Treatment Foster Care in "real world" practice: Findings from a randomized trial

In recent years, there has been tremendous interest in improving treatment and outcomes for youth with serious mental health problems. Considerable effort has been placed on developing, manualizing, and disseminating evidence-based treatments. However, the vast majority of “real world” providers are not using these evidence-based interventions. For a variety of philosophical and practical reasons, it appears unlikely that straight dissemination of evidence-based treatments will be adopted by many of the relevant providers. Therefore, our approach has attempted to bring together findings from the evidence-based version with “practice-based” evidence from existing practice to develop a broadly applicable “enhanced” model to increase quality of treatment and outcomes in a wide range of agencies.

This work focuses on Treatment Foster Care (TFC). TFC is one of the few community-based interventions for youth that has an established evidence base. This session reports on recent findings from an NIMH-funded randomized trial of TFC to examine the effectiveness of an enhanced training and consultation approach to improving practice and outcomes in “usual care” TFC agencies. The approach draws elements both from Chamberlain's evidence-based model as well as practice-based evidence from existing programs. The intervention, “Together Facing the Challenge,” shows significant improvement (compared to youth in control agencies) on a range of youth-level outcomes (e.g., symptoms, behavior, strengths).