CDC COMMUNITY GUIDE: Therapeutic Foster Care to Reduce Violence

Therapeutic foster care is used to describe two distinct forms of treatment.
• One form, that we refer to as "program-intensive therapeutic foster care" is an alternative to incarceration, hospitalization, or other forms of group and residential treatment for adolescents with a history of chronic antisocial behavior, or delinquency.
• Another form, that we refer to as "cluster therapeutic foster care" is provided to children with severe emotional disturbance (SED), most often by "clusters" of foster families that cooperatively care for a group of children.

The Task Force on Community Preventive Services recommends therapeutic foster care for adolescents ages 12-18 with a history of chronic delinquency based on sufficient evidence of effectiveness in preventing violence among this population.

Results from the Systematic Reviews:

"Program intensive" therapeutic foster care for reduction of violence by chronically delinquent adolescents:
Three studies qualified for the systematic review.
• Therapeutic foster care for chronically delinquent adolescents was found to reduce violent crime by approximately 71.9%, when compared with similar youth in standard group residential treatment facilities (3 studies).
• Participants were 12-18 years of age.
• Average duration of these programs was 6-7 months.
• Net benefits (i.e., benefits minus costs) of program intensive foster care for this population ranged from $20,351 to $81,664 per youth. It is estimated that, for every dollar invested in therapeutic foster care, approximately $14 are saved in justice system costs (one study).

"Cluster" therapeutic foster care for the reduction of violence by children with severe emotional disturbance:
Two studies qualified for the systematic review.
• Study 1 outcomes: Compared a cluster therapeutic foster care intervention (called a parent-therapist program) to group residence for the treatment of SED among youths aged 6-12 years.
-Change in conduct disorders: 31.3% increase for girls and a negligible effect (a 0.2% decrease) for boys
• Study 2 outcomes: Effects of New York State's version of cluster therapeutic foster care, Family-Based Treatment, on externalizing behavior among children aged 6-13 years with SED
-Change in externalizing behavior among children: increase of 2.5%