This competing continuation builds upon findings from our current study of treatment foster care (MH57448) to propose a randomized trial of enhanced long-term treatment foster care. Treatment foster care (TFC) is one of the only evidence-based residential treatment options for youth with mental health disorders and severe aggression. Previous randomized trials of TFC in model programs show that it can promote a range of positive outcomes (e.g., decreased problems and arrests, increased prosocial behavior and community tenure). Our current study, Therapeutic Foster Care in a System of Care, is built upon this research base to examine use, implementation, and outcomes of TFC in 'real-world' practice. Findings from this naturalistic study provide the impetus for the proposed competing continuation. Among other results, we found that TFC, as widely practiced, is often a relatively long-term treatment placement (mean length of stay was 22 months, and 46% of youth remained in TFC for longer than 24 months). This is in contrast to the short-term model (6-9 months) that has been the basis of existing research. Factors that drive outcomes in longer-term care appear to differ from those in short-term placement. Also, data suggest that several issues emerge during longer-term placements that require additional treatment foci to maximize the relevance and effectiveness of this approach. Building from the current evidence-based short-term model, our findings from 'real-world' practice, and additional promising practices, the proposed randomized trial will examine effectiveness of an enhanced model of long-term TFC for improving treatment and outcomes. A subset of agencies from the current study will be involved in implementing and evaluating this enhanced model. We will follow a sample of 300 youth and treatment parents (150 intervention, 150 control) for two years to assess implementation and outcomes. At present, TFC is widely regarded as an evidence-based treatment. The proposed study brings together the strengths of evidence-based treatment with the realities of practice to examine an improved approach to meeting the needs of youth in long-term TFC. Such information is crucial for maximizing the utility and effectiveness of TFC for some of the nation's most difficult to treat youth. ? ?
| Farmer, Elizabeth M Z; Lippold, Melissa A (2016) The need to do it all: Exploring the ways in which Treatment Foster Parents enact their complex role. Child Youth Serv Rev 64:91-99 |
| Southerland, Dannia G; Burns, Barbara J; Farmer, Elizabeth M Z et al. (2014) Family Involvement in Treatment Foster Care. Resid Treat Child Youth 31:2-16 |
| Brenner, Sharon L; Southerland, Dannia G; Burns, Barbara J et al. (2014) Use of Psychotropic Medications among Youth in Treatment Foster Care. J Child Fam Stud 23:666-674 |
| Murray, Maureen; Culver, Tom; Farmer, Betsy et al. (2014) From Theory to Practice: One Agency's Experience with Implementing an Evidence-Based Model. J Child Fam Stud 23:844-853 |
| Dorsey, Shannon; Burns, Barbara J; Southerland, Dannia G et al. (2012) Prior Trauma Exposure for Youth in Treatment Foster Care. J Child Fam Stud 21:816-824 |
| Farmer, Elizabeth M Z; Burns, Barbara J; Wagner, H Ryan et al. (2010) Enhancing ""usual practice"" treatment foster care: findings from a randomized trial on improving youths' outcomes. Psychiatr Serv 61:555-61 |
| Murray, Maureen M; Southerland, Dannia; Farmer, Elizabeth M et al. (2010) Enhancing and Adapting Treatment Foster Care: Lessons Learned in Trying to Change Practice. J Child Fam Stud 19:393-403 |
| Farmer, Elizabeth M (2009) What's the Relationship Got to do with It? Understanding the Therapeutic Relationship in Therapeutic Foster Care. Child Adolesc Social Work J 26:49-63 |
| Farmer, Elizabeth M Z; Dorsey, Shannon; Mustillo, Sarah A (2004) Intensive home and community interventions. Child Adolesc Psychiatr Clin N Am 13:857-84, vi |
| Burns, Barbara J (2003) Children and evidence-based practice. Psychiatr Clin North Am 26:955-70 |
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