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Overview of MTFC Maintenance, Fidelity, and Clinical Trials Outcomes

This document explores the efficacy and fidelity of Multi-Dimensional Treatment Foster Care (MTFC), highlighting early data, measurement strategies, and efficacy trials from various European and UK studies. It reviews intervention effectiveness through statistical correlations and graduation statistics, illustrating youth placements and outcomes over time. The findings detail program adaptations, team successes, and challenges faced in urban settings. Key qualitative insights reveal how fidelity manifests throughout the intervention, alongside essential accreditation evaluations for service improvement.

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Overview of MTFC Maintenance, Fidelity, and Clinical Trials Outcomes

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  1. MTFC: Maintenance and Fidelity

  2. Overview • Fidelity generally • Fidelity and MTFC – early data • Measurement • Special issues from UK/Europe

  3. MST Delinquency Clinical Trials Effect Sizes* LARGE Efficacy Trials Effectiveness Trials Transportability Trials MEDIUM SMALL Aos, 2004 (1.5 yr. follow-up) Borduin et al., 1990 (3 yr. follow-up) Cunningham, 2006 (3 yr. follow-up) Henggeler et al., 1997 (1.7 yr. follow-up) Henggeler et al., 1993 (2.4 yr. follow-up) Henggeler et al., 2006 (1 yr. follow-up) Henggeler et al., 2002 (4 yr. follow-up) Schaeffer & Borduin, 2005 (14 yr. follow-up) Timmons-Mitchell et al., 2006 (1.5 yr. follow-up) Borduin & Schaeffer, 2003 (8 yr. follow-up) Ogden & Halliday-Boykins, 2004 (1.5 yr. follow-up)

  4. MST Transportability Study (N = 1,979 Families) 0 .28 .55 .83 1 MST Therapist Adherence Measure

  5. Bronx – NIJ study • Included qualitative and quantitative data collection • Looking at relationships among beliefs about empirically validated treatment, model adherence, and youth outcomes • State juvenile justice referrals

  6. Time one initerviews • Program started March 2004 • Through 21 July 2005 • 45 youth placed in MTFC • 17 currently in placement • 28 left the program • 9 Graduated to a lower level of care • 17 Return to OCFS facility • 2 currently AWOL

  7. Not evenly distributed • Team “A” – 28.5% successful • Team “B” – 42% successful • Team “C” – 18% successful • Benchmark is 70% ‘successful’ • Successful is youth placed at discharge to a lower level of care

  8. Contributing factors Program changed agencies Working out relationship with juvenile justice (all of the ‘return to facility recommendations’ were contested) New foster parents, staff, program Getting particularly difficult initial referrals Developing matching protocols Working with schools Figuring out the solutions to urban situations (e.g., public transportation, distant schools)

  9. CR2P Fidelity ratings by PS

  10. Correlational Data r = .94 Fidelity of the Implementation Foster Parent Stress (PDR) Percentage of placements to lower levels of care r = .99

  11. The program matures by Time Two Interviews • Through 01 April 2007 • 107 youth placed in MTFC • 25 in placement • 62 graduated to lower level of care • Graduating youth at 76% • All three teams certified • Includes point sheets, school cards, tape reviews, graduation rates…

  12. Qualitative Analyses • Many entered this implementation with the expectation that practices would have to be modified • NYC is seen as fundamentally different • Interesting themes around race/ethnicity • Fidelity seems to manifest all of the way through the intervention

  13. Accreditation Independent evaluation Youth outcomes Program has been in place for a year and Graduated at least 7 youth 70% to lower levels of care Youth are expected to receive at least 3 therapy contacts/month Behavioral components Staff are collecting PDR, P&L, and school cards daily Ratings of Foster carer and Clinical team meetings Program has adequate staff Staff training and staff replacement plans in place

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