Enhancing and Adapting Treatment Foster Care: Lessons Learned in Trying to Change Practice

J Child Fam Stud (2010) 19:393403 DOI 10.1007/s10826-009-9310-x

ORIGINAL PAPER

Enhancing and Adapting Treatment Foster Care: Lessons Learned in Trying to Change Practice

Maureen M. Murray Dannia Southerland Elizabeth M. Farmer Kess Ballentine

Published online: 16 September 2009 Springer Science+Business Media, LLC 2009

Abstract Evidence-based practices to improve outcomes for children with severe behavioral and emotional problems have received a great deal of attention in childrens mental health. Therapeutic foster care (TFC), a residential intervention for youth with emotional or behavioral problems, is one of the few community-based programs that is considered to be evidence-based. However, as for most treatment approaches, the vast majority of existing programs do not deliver the evidence-based version. In an attempt to ll this gap and improve practice across a wide range of TFC agencies, we developed an enhanced model of TFC based on input from both practice and research. It includes elements associated with improved outcomes for youth in usual care TFC agencies as well as key elements from Chamberlains evidence-based model. The current manuscript describes this hybrid intervention Together Facing the Challengeand discusses key issues in implementation. We describe the sample and settings, highlight key implementation strategies, and provide lessons learned to help guide others who may wish to change practice in existing agencies.

Keywords Therapeutic foster care

Evidence based practice Changing practice

Implementation of evidence based practices

Train the trainer

Introduction

There has been a great deal of attention in recent years to improving outcomes for children with severe behavioral and emotional problems by implementing evidence-based practices in childrens mental health services (Brestan and Eyberg 1998; Burns and Hoagwood 2002; Chamberlain et al. 2008a, b; Chambless and Ollendick 2001). Although the eld has made signicant gains toward developing and implementing evidence-based interventions, there is still a great deal to learn about the process (Fixsen et al. 2005). The dissemination of evidence based practices into real world settings, which is the goal of translational science in mental health, depends on developing and rening processes that can move these practices into usual care (Brekke et al. 2007). Central to the challenge of translational science in childrens mental health services is the larger task of improving practice in usual care. The discussion of implementation of evidence based practices generally focuses...