Treatment Foster Care Oregon for Preschoolers
Treatment Foster Care Oregon for Preschoolers (TFCO-P) is designed for children ages 3–6 with severe emotional and behavioral problems. TFCO-P aims to support children to live in a family setting during treatment, rather than in group or institutional settings, and to support parents and caregivers to provide effective parenting. TFCO-P adapts Treatment Foster Care Oregon for Adolescents (TFCO-A) for young children. TFCO-P focuses on five key areas: (1) increasing prosocial behaviors and decreasing negative behaviors; (2) providing close supervision and structure; (3) providing a consistent and reinforcing environment with clear expectations and limit-setting; (4) developing skills for forming positive relationships; and (5) enhancing parenting skills to create a therapeutic environment.
TFCO-P places children in a therapeutic foster family. A treatment team supports each child. The team includes a program case manager who is also the team lead; the foster parents; a family therapist; a skills coach who also leads play groups; a foster parent consultant; and a person that calls the foster parents for a daily report. Treatment team members provide daily and weekly monitoring and support to the child, foster family, and the child’s parents or caregivers.
TFCO-P uses a structured daily behavior management system, tailored to the child’s developmental needs. The foster family uses behavior enhancing techniques including clear and explicit instructions, daily routines, praise, and incentives to reinforce appropriate behavior, foster prosocial and coping skills, and manage negative behavior. Children also receive weekly individual skills training and participate in a weekly therapeutic playgroup to develop age-appropriate social-emotional skills and prepare for school.
The family therapist meets weekly with the parents or caregivers to whom the child is expected to return after the placement. Family therapy teaches parents and caregivers positive parenting practices, including how to monitor and manage the child’s behavior, problem solve, communicate effectively, and provide encouragement to the child. In the 6–8 weeks before a child returns home, the treatment team initiates weekly home visits to provide the opportunity to practice skills and to help transition the child. After the child returns to their parents or caregivers, the family therapist provides aftercare support, in which they maintain contact with the family for at least three months.
TFCO-P does not currently meet criteria to receive a rating because no studies of the program achieved a rating of moderate or high on design and execution.
Date Research Evidence Last Reviewed: Jul 2023
Sources
The following sources informed the program or service description, target population, and program or service delivery and implementation information: the program or service manual, the program or service developer’s website, and the California Evidence-Based Clearinghouse for Child Welfare.
This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the Review Process page or download the Handbook.
Target Population
TFCO-P is designed for children ages 3–6 with severe behavioral and emotional problems.
Dosage
A treatment team delivers TFCO-P for 6–12 months with at least 3 months of aftercare support. Skills coaches meet individually with the child for approximately 2 hours per week and facilitate a 2-hour weekly therapeutic play group. Family therapists meet with parents or caregivers weekly. Members of the treatment team conduct weekly home visits for 6–8 weeks. Parent daily report callers place daily calls to the foster parents.
Location/Delivery Setting
Recommended Locations/Delivery Settings
The treatment team delivers TFCO-P in-person in the foster home, in the community, and in the home of the parents or caregivers.
Education, Certifications and Training
A treatment team delivers TFCO-P. The TFCO-P team consists of a team lead, who also serves as the program case manager; trained foster parents; a family therapist; a skills coach; play group leaders; a foster parent consultant, who acts as a supportive advocate for the foster parent; and a parent daily report caller. In addition to the treatment professionals, the team includes a foster parent recruiter and a foster parent trainer who finds and trains foster parents to implement TFCO-P. The parent daily report caller, recruiter, and trainer roles are often combined.
Foster parents must be certified by their state and must complete a written application and a 1-hour home visit to be considered for TFCO-P. TFCO-P foster parents must complete 20 hours of pre-service training on the daily behavior management system and how to support the youth. Prior to a placement, foster parents must sign a written agreement to provide TFCO-P services.
Among clinical program staff, the team lead must have at least a bachelor’s degree in social work, behavioral science, or a related field and one year of experience treating children or young adults. A master’s degree is preferred. Youth and family therapists must meet any required state certification or licensing criteria and have relevant clinical experience with youth and families. Skills coaches must meet any required state certification or licensing criteria and be familiar with behavior management principles. TFCO-P skills coaches who are also playgroup leaders ideally have previous classroom experience. Staff in the parent daily report caller or foster parent recruiter roles must have experience with the foster system and at least 1–2 years of office or administrative experience.
All staff complete an initial clinical training, though duration varies by role. Team leads must complete 5 days of training, therapists complete 4 days of training, and recruiter/trainer/parent daily report callers complete 3 days of training. Initial training is typically in-person, though virtual trainings may be available under limited circumstances. Team leads conduct weekly supervision meetings and provide ongoing training for the treatment team.
Programs must be certified or receive clinical supervision from TFC Consultants, Inc. The certification application process involves a thorough evaluation and a fee. As part of this process, team leads have weekly consultation calls with a TFCO consultant.
Program or Service Documentation
Book/Manual/Available documentation used for review
The following nine resources are used to implement TFCO-P:
Treatment Foster Care Oregon for Preschoolers. (2015). Team lead manual. TFC Consultants, Inc.
Treatment Foster Care Oregon for Preschoolers. (2015). Behavior management manual. TFC Consultants, Inc.
Treatment Foster Care Oregon for Preschoolers. (2015). Foster parent consultant manual. TFC Consultants, Inc.
Treatment Foster Care Oregon for Preschoolers. (2015). Playgroup manual. TFC Consultants, Inc.
Treatment Foster Care Oregon for Preschoolers. (2015). Skills coach manual. TFC Consultants, Inc.
Treatment Foster Care Oregon for Preschoolers. (2015). Family therapy manual. TFC Consultants, Inc.
Treatment Foster Care Oregon for Preschoolers. (2015). Foster parent recruitment manual. TFC Consultants, Inc.
Treatment Foster Care Oregon for Preschoolers. (2015). Playgroup training manual. TFC Consultants, Inc.
Treatment Foster Care Oregon for Preschoolers. (2015). Skills coach training manual. TFC Consultants, Inc.
Available languages
TFCO-P materials are available in English.
Other supporting materials
For More Information
Website: https://www.tfcoregon.com/
Phone: (541) 343-2388
Contact form: https://www.tfcoregon.com/contact-us
Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.
| Results of Search and Review | Number of Studies Identified and Reviewed for Treatment Foster Care Oregon for Preschoolers |
|---|---|
| Identified in Search | 4 |
| Eligible for Review | 3 |
| Rated High | 0 |
| Rated Moderate | 0 |
| Rated Low | 3 |
| Reviewed Only for Risk of Harm | 0 |
Studies Rated Low
Study 13125Fisher, P. A., Gunnar, M. R., Chamberlain, P., & Reid, J. B. (2000). Preventive intervention for maltreated preschool children: Impact on children's behavior, neuroendocrine activity, and foster parent functioning. Journal of the American Academy of Child & Adolescent Psychiatry, 39(11), 1356-1364. https://doi.org/10.1097/00004583-200011000-00009
This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.Study 13134
Jonkman, C., Schuengel, C., Oosterman, M., Lindeboom, R., Boer, F., & Lindauer, R. (2017). Effects of Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) for young foster children with severe behavioral disturbances. Journal of Child & Family Studies, 26(5), 1491-1503. https://doi.org/10.1007/s10826-017-0661-4
Jonkman, C. S., Schuengel, C., Lindeboom, R., Oosterman, M., Boer, F., & Lindauer, R. J. L. (2013). The effectiveness of Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) for young children with severe behavioral disturbances: Study protocol for a randomized controlled trial. Trials, 14, Article 197. https://doi.org/10.1186/1745-6215-14-197
This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.Study 13126
Fisher, P. A., Burraston, B., & Pears, K. (2005). The early intervention foster care program: Permanent placement outcomes from a randomized trial. Child Maltreatment, 10(1), 61-71. https://doi.org/10.1177/1077559504271561
Fisher, P. A., Stoolmiller, M., Gunnar, M. R., & Burraston, B. O. (2007). Effects of a therapeutic intervention for foster preschoolers on diurnal cortisol activity. Psychoneuroendocrinology, 32(8-10), 892-905. https://doi.org/10.1016/j.psyneuen.2007.06.008
Fisher, P. A., & Kim, H. K. (2007). Intervention effects on foster preschoolers' attachment-related behaviors from a randomized trial. Prevention Science, 8(2), 161-170. https://doi.org/10.1007/s11121-007-0066-5
Fisher, P. A., & Stoolmiller, M. (2008). Intervention effects on foster parent stress: Associations with child cortisol levels. Development and Psychopathology, 20(3), 1003-1021. https://doi.org/10.1017/S0954579408000473
Fisher, P. A., Kim, H. K., & Pears, K. C. (2009). Effects of Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) on reducing permanent placement failures among children with placement instability. Children and Youth Services Review, 31(5), 541-546. https://doi.org/10.1016/j.childyouth.2008.10.012
Bruce, J., McDermott, J. M., Fisher, P. A., & Fox, N. A. (2009). Using behavioral and electrophysiological measures to assess the effects of a preventive intervention: A preliminary study with preschool-aged foster children. Prevention Science, 10(2), 129-140. https://doi.org/10.1007/s11121-008-0115-8
Pears, K. C., Fisher, P. A., Bruce, J., Kim, H. K., & Yoerger, K. (2010). Early elementary school adjustment of maltreated children in foster care: The roles of inhibitory control and caregiver involvement. Child Development, 81(5), 1550-1564. https://doi.org/10.1111/j.1467-8624.2010.01491.x
Fisher, P. A., Van Ryzin, M. J., & Gunnar, M. R. (2011). Mitigating HPA axis dysregulation associated with placement changes in foster care. Psychoneuroendocrinology, 36(4), 531-539. https://doi.org/10.1016/j.psyneuen.2010.08.007
Fisher, P., Tininenko, J., Bruce, J., & Pears, K. (2010). Sleep disruption in young foster children. Child Psychiatry and Human Development, 41(4), 409-424. https://doi.org/10.1007/s10578-010-0177-2
Graham, A. M., Yockelson, M., Kim, H. K., Bruce, J., Pears, K. C., & Fisher, P. A. (2012). Effects of maltreatment and early intervention on diurnal cortisol slope across the start of school: A pilot study. Child Abuse & Neglect, 36(9), 666-670. https://doi.org/10.1016/j.chiabu.2012.07.006
Lynch, F. L., Dickerson, J. F., Saldana, L., & Fisher, P. A. (2014). Incremental net benefit of early intervention for preschool-aged children with emotional and behavioral problems in foster care. Children and Youth Services Review, 36, 213-219. https://doi.org/10.1016/j.childyouth.2013.11.025
Jankowski, K. F., Bruce, J., Beauchamp, K. G., Roos, L. E., Moore, W. E., III, & Fisher, P. A. (2017). Preliminary evidence of the impact of early childhood maltreatment and a preventive intervention on neural patterns of response inhibition in early adolescence. Developmental Science, 20(4), Article e12413. https://doi.org/10.1111/desc.12413
This study received a low rating because it did not meet design confound standards.Studies Not Eligible for Review
Study 13127
Fisher, P., Gunnar, M., Dozier, M., Bruce, J., & Pears, K. (2006). Effects of therapeutic interventions for foster children on behavioral problems, caregiver attachment, and stress regulatory neural systems. Annals of the New York Academy of Sciences,1094(1), 215-225. https://doi.org/10.1196/annals.1376.023
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).