Therapeutic Foster Care - Therapeutic Group Homes

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More of this Feature
One Parent's Story
Traditional vs Treatment Foster Care

Therapeutic foster care and therapeutic group homes are specialized care alternatives for children and youth, generally in the child welfare or juvenile justice system. Therapeutic Foster Care (TFC) is also a respite care resource for other families.

Therapeutic Foster Care

Therapeutic foster care is considered the least restrictive form of out-of-home therapeutic placement for children with severe emotional disorders. Care is delivered in private homes with specially trained foster parents.

While therapeutic foster care programs vary considerably, they have some features in common:
  • Children are placed with foster parents who are trained to work with children with special needs.
  • Usually, each foster home takes one child at a time, and caseloads of supervisors in agencies overseeing the program remain small.
  • Therapeutic foster parents are given a higher stipend than that given to traditional foster parents.
  • They receive extensive preservice training and in-service supervision and support. Frequent contact between case managers or care coordinators and the treatment family is expected, and additional resources and traditional mental health services may be provided as needed.
Therapeutic Group Homes

For adolescents with serious emotional disturbances, the therapeutic group home provides an environment conducive to learning social and psychological skills. These homes have been developed primarily for children under the care of juvenile justice or social welfare.

This intervention is provided by specially trained staff in homes located in the community, where local schools can be attended. Each home typically serves 5 to 10 clients and provides an array of therapeutic interventions. Although the types and combinations of treatment vary, individual psychotherapy, group therapy, and behavior modification are usually included.

There are two major models of therapeutic group homes. The first is the teaching family model, developed at the University of Kansas, then moved to Boys Town in Omaha, Nebraska. The second is the Charley model, developed at the Menninger Clinic. Both models use their staff as the key agents for change in the disturbed youth; selection and training of the staff are emphasized. Both models employ couples who live at the homes 24 hours a day. The teaching family model emphasizes structured behavioral interventions through teaching new skills and positively reinforcing improved behavior. Other group homes use individual psychotherapy and group interaction.

A Comparison

Therapeutic group homes were compared with therapeutic foster care in two studies. The first study found equivalent gains for youth in the two interventions, but group home placement was twice as costly as therapeutic foster care (Rubenstein et al., 1978). A second study, a randomized clinical trial, compared the outcomes for 79 males with histories of juvenile delinquency placed in either group homes or therapeutic foster homes (Chamberlain & Reid, 1998). The boys treated in therapeutic foster homes had significantly fewer criminal referrals and returned more often to live with relatives, suggesting this to be a more effective intervention. The implication of these studies is that if therapeutic foster care is available, and if the foster parents are willing to take youth with serious behavioral problems, therapeutic foster care may be a better treatment choice for youth who previously would have been placed in group homes.

Becoming a Therapeutic Foster Parent

If you are interested in exploring the challenges and rewards of therapeutic foster parenting, read One Parent's Story.

Source: Mental Health: A Report of the Surgeon General

Next page > One Parent's Story > Page 1, 2, 3

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