Is multidimensional treatment foster care (MTFC) more effective than treatment as usual in a three-year follow-up? Results from MTFC in a Swedish setting

Abstract

This study examines three-year post-baseline outcomes for a randomized controlled trial of Swedish antisocial youths who received either multidimensional treatment foster care (MTFC) or treatment as usual (TAU). Several studies in our literature review indicated that MTFC intervention is preferred to the alternative (TAU) in the USA during follow-up. Two studies (one conducted in the UK and one in Sweden) have shown indications of a washout effect between the intervention alternatives during follow-up. However, this study showed few but positive significant outcomes at follow-up for the MTFC programme in comparison to TAU. Juveniles who participated in MTFC spent fewer days in locked settings and had committed fewer violent crimes, according to the social case records. Two key features of the MTFC programme certainly merit use in general social service—namely, reducing exposure to deviant peers and increasing school participation.

Den här studien är en 3-års uppföljning av en grupp svenska ungdomar med antisocial problematik. Ungdomarna medverkade i en RCT-studie som jämförde effekten av multidimensional treatment foster care (MTFC) och socialtjänstens traditionella insatser (TAU — treatment as usual). Flera studier i den litteraturgenomgång vi gjort visar att MTFC är att föredra framför TAU i USA. Två studier (gjorda i England och Sverige) indikerar dock att skillnaden mellan de olika interventionerna inte kvarstår efter behandlingsinsatsens slut. Den här studien visar att det finns ett par signifikanta skillnader mellan MTFC och TAU som talar till MTFC:s fördel. Ungdomarna som genomgått MTFC hade enligt deras socialtjänstakter färre dagars placering i låsbar institutionsvård och hade begått färre våldsbrott under uppföljningsperioden än de ungdomar som fått TAU. Två viktiga områden i MTFC-behandlingen som man med fördel kan ta med sig till ungdomsvård i allmänhet är att minska ungdomarnas kontakt med andra anitsociala ungdomar samt att öka ungdomarnas delaktighet i sin skolgång.

Keywords:

• juveniles
• foster care
• MTFC
• interventions
• RCT

Nyckelord:

• Ungdomar
• familjehemsvård
• MTFC
• interventioner
• RCT

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Martin Bergström has a Ph.D. in Social Work and is currently working as a senior lecturer at Lund University. He has experience in clinical social work with children, juveniles and their families. The last 15 years he has done research on interventions for these children, juveniles and families

Lotta Höjman is a clinical psychologist, psychotherapist and supervisor in clinical family therapy. She has a long clinical experience working with children, juveniles and their families. She has during the last 13 years worked with the National Board of Institutional Care in Sweden (SiS).