Multidimensional Treatment Foster Care for Adolescents in English care: Randomised trial and observational cohort evaluation

TY - JOUR

T1 - Multidimensional Treatment Foster Care for Adolescents in English care

T2 - Randomised trial and observational cohort evaluation

AU - Green, J.

AU - Biehal, Nina

AU - Roberts, C.

AU - Dixon, Jo

AU - Kay, C

AU - Parry, E

AU - Rothwell, J.

AU - Roby, A.

AU - Kapadia, D.

AU - Scott, S.

AU - Sinclair, Ian Alexander Charles

PY - 2014/3/1

Y1 - 2014/3/1

N2 - BackgroundChildren in care often have poor outcomes. There is a lack of evaluative research into intervention options.AimsTo examine the efficacy of Multidimensional Treatment Foster Care for Adolescents (MTFC-A) compared with usual care for young people at risk in foster care in England.MethodA two-arm single (assessor) blinded randomised controlled trial (RCT) embedded within an observational quasi-experimental case–control study involving 219 young people aged 11–16 years (trial registration: ISRCTN 68038570). The primary outcome was the Child Global Assessment Scale (CGAS). Secondary outcomes were ratings of educational attendance, achievement and rate of offending.ResultsThe MTFC-A group showed a non-significant improvement in CGAS outcome in both the randomised cohort (n = 34, adjusted mean difference 1.3, 95% CI −7.1 to 9.7, P = 0.75) and in the trimmed observational cohort (n = 185, adjusted mean difference 0.95, 95% CI −2.38 to 4.29, P = 0.57). No significant effects were seen in secondary outcomes. There was a possible differential effect of the intervention according to antisocial behaviour.ConclusionsThere was no evidence that the use of MTFC-A resulted in better outcomes than usual care. The intervention may be more beneficial for young people with antisocial behaviour but less beneficial than usual treatment for those without.

AB - BackgroundChildren in care often have poor outcomes. There is a lack of evaluative research into intervention options.AimsTo examine the efficacy of Multidimensional Treatment Foster Care for Adolescents (MTFC-A) compared with usual care for young people at risk in foster care in England.MethodA two-arm single (assessor) blinded randomised controlled trial (RCT) embedded within an observational quasi-experimental case–control study involving 219 young people aged 11–16 years (trial registration: ISRCTN 68038570). The primary outcome was the Child Global Assessment Scale (CGAS). Secondary outcomes were ratings of educational attendance, achievement and rate of offending.ResultsThe MTFC-A group showed a non-significant improvement in CGAS outcome in both the randomised cohort (n = 34, adjusted mean difference 1.3, 95% CI −7.1 to 9.7, P = 0.75) and in the trimmed observational cohort (n = 185, adjusted mean difference 0.95, 95% CI −2.38 to 4.29, P = 0.57). No significant effects were seen in secondary outcomes. There was a possible differential effect of the intervention according to antisocial behaviour.ConclusionsThere was no evidence that the use of MTFC-A resulted in better outcomes than usual care. The intervention may be more beneficial for young people with antisocial behaviour but less beneficial than usual treatment for those without.

KW - looked after children

KW - foster care

KW - treatment foster care

KW - RCT

UR - https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/197809/DFE-RB194.pdf

U2 - 10.1192/bjp.bp.113.131466

DO - 10.1192/bjp.bp.113.131466

M3 - Article

SN - 0007-1250

VL - 204

SP - 214

EP - 221

JO - British Journal of Psychiatry

JF - British Journal of Psychiatry

IS - 3

ER -