mtfc overview
DESCRIPTION
Overview of the MTFC programTRANSCRIPT
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