Trauma Systems Therapy for Foster Care

Mental Health Does Not Currently Meet Criteria

Trauma Systems Therapy for Foster Care (TST-FC) is a trauma-focused parenting curriculum designed for caregivers of children and teens in foster care, including foster parents, kin, and other caregivers. TST-FC is an adaptation of Trauma Systems Therapy (TST) that aims to help foster parents support children and teens who have experienced traumatic events, improve children’s and teen’s well-being, and help agencies retain skilled foster parents. 


Organizations implementing TST-FC identify existing staff to serve as group facilitators. Staff typically include investigators, child welfare caseworkers, and mental health providers.


The TST-FC curriculum includes four modules that cover (1) the impact of trauma; (2) strategies to address trauma; (3) coping with difficult behavior; and (4) generating signals of safety, which are ways of communicating that convey warmth, concern, empathy, and positive regard. The modules, delivered in a group format, teach caregivers about traumatic stress, emotion regulation, and problem-solving. Each module includes didactic content, handouts, and activities. 

TST-FC does not currently meet criteria to receive a rating because no studies met eligibility criteria for review.

Date Research Evidence Last Reviewed: Apr 2023


The program or service description, target population, and program or service delivery and implementation information were informed by the following sources: the program or service manual and the program or service developer’s website.

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

TST-FC is designed for caregivers of children and teens in foster care, including foster parents, kin, and other caregivers.


TST-FC is delivered in four modules. The first two modules are 2.5 hours each and the second two modules are 2 hours each. Two facilitators deliver modules in-person to groups of approximately 12 parents. The frequency of implementation is flexible. For example, modules can be delivered once per week for 4 weeks, or two modules at a time.

Location/Delivery Setting
Recommended Locations/Delivery Settings

TST-FC is delivered in-person in locations convenient for participants. Delivery settings should have adequate audiovisual equipment for presenting module content.

Education, Certifications and Training

Organizations determine the educational requirements for TST-FC facilitators. Facilitators should have a background in trauma, experience with parenting, and be good storytellers.

Organizations must plan for implementation and train staff before delivering TST-FC to foster parents. This preparation period is recommended to last 3–6 months. During this period, the organization establishes a TST-FC agency workgroup that monitors TST-FC installation, updates organization policies and structures to increase the organization’s trauma competence, identifies measures to track the impact of TST-FC, develops training capacity and supports, and creates and implements a communication plan for communicating with stakeholders. 

TST-FC facilitators attend a 4–5-day training. Training includes learning the TST-FC curriculum, practicing delivering the curriculum, clarifying roles of co-facilitators, and establishing training time frames and logistics. The TST-FC program developers are available to provide technical assistance as needed throughout the planning and implementation process. 

Program or Service Documentation
Book/Manual/Available documentation used for review

The following six resources are used to implement TST-FC:

The Annie E. Casey Foundation. (2017). Implementing Trauma Systems Therapy for Foster Care (TST-FC): A guide for child welfare agencies.

The Annie E. Casey Foundation. (2017). Facilitator preparation and planning for TST-FC.

The Annie E. Casey Foundation. (2017). Facilitator’s guide for module one of TST-FC: The impact of trauma.

The Annie E. Casey Foundation. (2017). Facilitator’s guide to module two of TST-FC: Strategies to address trauma.

The Annie E. Casey Foundation. (2017). Facilitator’s guide to module three of TST-FC: Coping with difficult behavior.

The Annie E. Casey Foundation. (2017). Facilitator’s guide to module four of TST-FC: Generating signals of safety.

Available languages

TST-FC materials are available in English.

Other supporting materials

TST-FC Foster Parent Resource Guide

For More Information


Phone: (410) 547-6600


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 Trauma Systems Therapy for Foster Care
Identified in Search 1
Eligible for Review 0
Rated High 0
Rated Moderate 0
Rated Low 0
Reviewed Only for Risk of Harm 0
Sometimes study results are reported in more than one document, or a single document reports results from multiple studies. Studies are identified below by their Prevention Services Clearinghouse study identification numbers.

Studies Not Eligible for Review

Study 14683

Bartlett, J. D., Rushovich, B., Beltz, M., Gross, E., Schindler, A. (2017). Evaluation of the implementation of Trauma Systems Therapy-Foster Care in a public child welfare setting. Child Trends, 52(3),

Bartlett, J. D., & Rushovich, B. (2018). Implementation of Trauma Systems Therapy-Foster Care in child welfare. Children and Youth Services Review, 91, 30-38. 

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).