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

J. Green, Nina Biehal, C. Roberts, Jo Dixon, C Kay, E Parry, J. Rothwell, A. Roby, D. Kapadia, S. Scott, Ian Alexander Charles Sinclair

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Children in care often have poor outcomes. There is a lack of evaluative research into intervention options.

To 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.

A 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.

The 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.

There 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.
Original languageEnglish
Pages (from-to)214-221
Number of pages8
JournalBritish Journal of Psychiatry
Issue number3
Publication statusPublished - 1 Mar 2014


  • looked after children
  • foster care
  • treatment foster care
  • RCT

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