The Therapeutic Family Care Program: A 10-year community implementation of Treatment Foster Care in Ontario, Canada

The present study describes a community implementation of treatment foster care (TFC) for children and youth involved with child welfare in Ontario, Canada. There were two guiding research questions: (1) how are children and adolescents changing over the course of services and (2) how have the placements of children and adolescents changed over time? Clinical outcomes were tracked using the Assessment Checklist for Children (ACC) and Assessment Checklist for Adolescents (ACAs)—clinical tools that were specially designed to assess the functioning of young people in care. There were 1,068 ACCs on 518 children, and 559 ACAs on 222 adolescents. Each additional year of involvement with Therapeutic Family Care Program corresponded to additional improvement for both children, d = −.18; 95% confidence interval (CI) = −.25 to −.12, and adolescents, d = −.11; 95%CI = −.18 to −.03. Moderators and subdomains of clinical improvement were considered, though findings generally revealed significant improvement over time for most youngsters in most clinical areas. At the program level, there has been a significant increase in placement permanence across the last decade (i.e., greater prevalence of birth parent, adoption, and kinship care). In sum, this study illustrates an example of community implementation for TFC in a child welfare setting, which necessarily includes the systematic tracking of outcomes in the context of evidence-supported intervention.