Multidimensional Treatment Foster Care Print

For Juvenile Justice Females Mandated to Out-of-Home Care

Program Components

  • Juvenile justice referral to community-based out-of-home care
  • Highly trained, supervised homes with state-certified foster parents
  • Program coordinators with small caseload (up to 10 MTFC families)
  • Coordinators maintaining daily contact with foster parents and providing ongoing consultation, support, crisis intervention, and treatment monitoring
  • Weekly support meetings for foster parents
  • Individualized, in-home, daily program for each teenage foster female
  • Individual therapy for each teenage foster female
  • Family therapy for the after-care placement family, focused on parenting management
  • Close monitoring of school attendance, performance and homework completion
  • Case management to coordinate interventions in foster family, peer, and school settings
  • 24-hour, on-call staff support for foster and biological parents
  • Psychiatric consultations, as needed

For Use With

  • Adolescent females, referred to the out-of-home care by the juvenile justice system
  • Delinquent females, ages 13-17

Evaluation Methodology

  • Two consecutive, experimental, randomized, controlled trials, conducted in Oregon among adolescent females referred by the juvenile justice system for out-of-home care
  • Participants (n=166) in either of two consecutive interventions (n=81 in Trial One; n=85 in Trial Two) randomly assigned to treatment (n=81; n=37 in Trial One; n=44 in Trial Two) or control condition (n=85; n=44 in Trial One; n=41 in Trial Two)
  • Interview at baseline with follow-up at 12 and 24 months after baseline for Trial One; interview at baseline with follow-up at 6, 12, 18, and 24 months after baseline for Trial Two
  • Interviews with caregivers at 12- and 24-months after baseline

Evaluation Findings

  • Reduced incidence of pregnancy

Evaluators' Comments: Relative to usual community services (group care), MTFC has been shown to have positive and enduring effects on delinquency rates among girls mandated to out-of-home care [and] also decreases pregnancy rates among these girls relative to group care. Both general care and MTFC girls were removed from their families, schools and peer groups and both groups of girls showed significant reductions in delinquency over time. Thus, the significant effects of MTFC on delinquency and pregnancy are even more impressive, given that MTFC was compared against another active treatment.
Source: Kerr, Leve, Chamberlain, 2009


Program Description


Multidimensional Treatment Foster Care is an intervention aimed at preventing delinquency and pregnancy among teenage females who are already in trouble with the juvenile justice system. Young women are referred by the justice system for out-of-home care and placed in highly trained and supervised foster homes. Program supervisors coordinate all aspects of youth's placement, supervise clinical staff, and maintain daily contact with the foster parents in order to provide ongoing support and crisis intervention as well as to monitor treatment fidelity. Although each case is individualized, all receive the following MTFC components: daily telephone contact with foster parents; weekly group supervision and support meetings for foster parents; individualized, daily program for each adolescent female; individual therapy for each adolescent female; close monitoring of school attendance, school performance and homework completion; case management; 24-hour on-call staff support for foster and biological families; and psychiatric consultation, as needed.

Evaluation Methodology

At referral by the juvenile justice system in Oregon, 251 teenage females, ages 13 through 17, were assessed for eligibility, either for Trial One or, later, for Trial Two. Eighty-five were excluded: 60 did not meet inclusion criteria; 21 refused to participate; and four could not be located. The remaining 166 teenage females were randomized to treatment (MTFC; n=81) or control (general foster care; n=85) conditions. Of those who received the intervention, either in treatment or control conditions, 78 MTFC participants and 81 controls participated in follow-up interviews. Three were lost to follow-up from MTFC condition; four were lost to follow-up from the control condition.

Of the 78 analyzed from MTFC condition, 34 participated in Trial One and 44 in Trial Two. Of the 81 analyzed from the control condition, 42 participated in Trial One and 39 in Trial Two. For analysis, the data from the two trials were combined, providing data from 159 young women at 24-month follow-up.

At baseline, the average age in years was 15.4 and 15.3 for MTFC participants in Trials One and Two, respectively, and 15.1 and 15.4, respectively, for controls. Among participants, those referred for criminal activity amounted to 10 and seven percent, respectively, of MTFC participants in Trials One and Two and eight percent for controls in both trials. Sexual activity in the 12 months prior to referral was reported by 89 and 71 percent, respectively, of MTFC participants in Trials One and Two and by 91 and 83 percent, respectively, of controls. History of a previous pregnancy was reported by 27 and 23 percent, respectively, of MTFC participants in Trials One and Two and by 30 and 22 percent, respectively of controls. Within each trial, MTFC and control conditions did not differ significantly on any baseline measure. They did not differ between trials except for sexual activity (Trial 1, 90.1 percent; Trial 2, 77.4 percent). Final analysis controlled for significant covariates.

At 12- and 24-months after baseline, the adolescent female participants and the current caregivers were interviewed separately regarding pregnancies that had occurred during the study. For both trials, the presence or absence of a post-baseline pregnancy was coded in yes/no format based on all available information. Pregnancies reported by the participants were counted as positive (yes). Caregiver reports were used when participants' reports were missing. Although other published articles on these trials have evidently reported on long-term findings related to delinquency, this article did not discuss these or outcomes related to knowledge, attitudes, or behaviors.

Long-Term Impact

  • Reduced incidence of pregnancy – Fewer MTFC females reported a pregnancy (26.9 percent) during follow-up than did controls (46.9 percent; P=.004). After controlling for covariates, final analysis showed that the odds of becoming pregnant during the follow-up period were 2.44 times larger for controls than for MTFC participants.

Note: Final evaluation indicated that baseline history of pregnancy and criminal referral was independently associated with increased likelihood of pregnancy. Controlling for these covariates indicated that baseline criminal referral predicted follow-up pregnancy among controls but not among MTFC participants.

For More Information on the Program, Contact

  • Patricia Chamberlain, Ph.D, Oregon Social Learning Center, 10 Shelton McMurphey Blvd, Eugene OR 97401; This e-mail address is being protected from spambots. You need JavaScript enabled to view it