Multidimensional Multidimensional Treatment Foster CareTreatment Foster Care

Venango County Human ServicesVenango County Human Services

Multidimensional Treatment Foster Care and MTFC are registered service marks of OSLC Community Programs, Inc.

Background InformationBackground Information

OSLC started in the 1970’s by Gerald Patterson and John Reid in Eugene, Oregon

Focus is on understanding the development and treatment of child and adolescent conduct and emotional problems

Over 200 staff currently working on research and treatment projects

The MTFC ModelThe MTFC Model

Treatment is provided in a family setting

New skills are practiced & reinforced in-vivo

Treatment is facilitated by core program components for: Youth Families MTFC Parents

Multidimensional Treatment Multidimensional Treatment Foster Care Foster Care

Objective Change the trajectory of negative

behavior by improving social adjustment across settings

How is this achieved? Simultaneous & well-coordinated

treatments in multiple settings•Home•School•Community•Peer group

MTFC is evidenced basedMTFC is evidenced based

Eight randomized trials and numerous other studies have provided evidence of the feasibility and effectiveness of MTFC.

Areas studied: • Youth criminal behavior and incarceration rates    • Youth violent offending    • Youth behavioral and mental health problems    • Disruption of placements and running away    • Placement recidivism    • Attachment to caregivers    • Gender differences    • Foster parent retention and satisfaction

MTFC is evidenced basedMTFC is evidenced based

Results of the Study

MTFC was substantially lower resulting in savings for both systems and taxpayers

MTFC is evidenced basedMTFC is evidenced based

Both boys and girls referred from juvenile justice show greater benefits from participation in MTFC than in group care•½ of the number of arrests•Significant and meaningful differences

in violent criminal activity•Fewer run-aways•Significantly fewer days in locked

settings

MTFC is evidenced basedMTFC is evidenced based

90

57

72 75

22 20

10

20

30

40

50

60

70

80

90

100

Group Care MTFC

Baseline12-months24-months

Days in Locked Setting

s

Days in Psychiatric Hospitals or Incarcerated (locked settings)

2 year follow-upChamberlain, Leve, & DeGarmo Journal of Consulting and Clinical Psychology, 07

2.1 2.0 2.0

3.5

0

0.5

1

1.5

2

2.5

3

3.5

Group Care MTFC

Baseline12-months

Days/week spent 30 min on homework

Homework Completion at 12-Months

Logic Model for the InterventionLogic Model for the Intervention

Improvement in foster parent skills

(increase reinforcement

relative to discipline)

Decrease child

problems

Increase reunification &

decrease disruption

More stable and skilled

foster parents

Intervention

What does the MTFC model What does the MTFC model look like?look like?

Core Components for YouthCore Components for Youth

Daily structure and support via a point and level system

Daily school card Weekly individual

therapy Weekly skill building

and advocacy Close supervision of

whereabouts and associations

Recreational skill building

Psychiatric consultation

Daily mentoring by MTFC parents

Weekly contact with parents and frequent home visits

Level System for AdolescentsLevel System for Adolescents

Three levels Opportunities to earn points for compliance,

prosocial behavior Points are lost for rule violations,

misbehavior Provides a framework within which

interaction can occur without engagement in conflict

School Days Level II CardSchool Days Level II CardName Date

Points Things to Do to Earn Points

Earned Bonus Taken Total

10 UP ON TIME

10 READY IN MORNING

10 MORNING CLEANUP

2 GO TO SCHOOL

1/CLASS CARRY SCHOOL CARD

2/CLASS BEHAVIOR IN CLASS

10 SCHOOL CARD BONUS

20 READ AND STUDY

10 CHORE

15 A.M. ATTITUDE/MATURITY

15 P.M. ATTITUDE/MATURITY

2-10 VOLUNTEERING

10 BED ON TIME

DAILY TOTAL

COMMENTS

PRIVILEGE DESCRIPTION POINT COST

BASICS Use of telephone for 15 minutes daily, radio in your room. 9:30 P.M. Bedtime

350

TV Can watch TV after homework and/or chore(s) are completed

100

LATER BEDTIME 10:00 P.M. Bedtime Daily, 11:00 P.M. Bedtime on non-school days and holidays with permission.

100

ACTIVITY TIME With prior planning, permission and approval, you may plan to go skating, swimming, to a movie, school activity, etc. If you are late or not where you said you would be, you will lose 1 point per minute.

½ point per minute

BONDS 1 Bond costs 100 points. You need 12 bond to buy Level III.

100 each

EXTRA PHONE TIME

One 20 minute call (not long distance) 25

OTHER Foster Parents will choose if applicable 50

ALLOWANCE $5.00 per week. All purchases must have receipts and you must show your money to your foster parents. Money spent at school in pop/candy machines must have Case Manager approval.

200

Level II PrivilegesLevel II Privileges

ParentDailyReport(PDR)

Role of the Foster ParentRole of the Foster Parent

From recruitment through placement and for the duration of treatment, the program maintains a high level of contact with foster parents

Foster parents are “the eyes and ears of the program”

They are encouraged to call program staff at any hour to deal with problems

They help to identify target behaviors and formulate treatment plans

Role of the Program Role of the Program SupervisorSupervisor

Coordinates all aspects of youth’s treatment (e.g., individual and family therapy, school, community involvement)

Close (daily) attention to youth’s progress and problems in the foster home and at school – facilitated by Parent Daily Report (PDR) data

Conducts weekly foster parent support and training meetings

Maintains a small case load (10-12 cases) – typically one youth placed in each foster home (there is evidence this is cost effective for high risk youth)

School

FosterParents

JuvenileParole/

Probation

Child

ChildTherapist

NaturalFamily

NaturalFamily

Therapists

Program Supervisor

The Treatment Foster Care ModelThe Treatment Foster Care Model

CYS

Ongoing Consultation, Ongoing Consultation, Support and SupervisionSupport and Supervision

Weekly foster parent support meetings In-home behavior consultation and 24 hour

on-call crisis support Coordination with schools regarding

behavior and academic skills Facilitation of access to additional services,

service coordination and advocacy Respite care as needed

Role StratificationRole Stratification

Clearly defined roles of each treatment team member are specified and careful planning is taken to maintain the distinction of these roles

Minimal overlap in roles is allowed in order to: 1) increase the predictability of the treatment environment, 2) decrease emotionality

Clear expectations and roles help to create opportunities for teaching and reinforcing adaptive responses

Staff Role DescriptionsStaff Role Descriptions

Treatment Foster Parents Program Supervisor (1.0 FTE) Family Therapist (.50 FTE) Youth Therapist (.50 FTE) Skills Trainers (hourly) PDR Caller/Foster Parent Recruiter (1.0 FTE) Consulting Psychiatrist (hourly) Clinical Supervisor/Program Director