Abstract
BackgroundAmong children placed out of home, behavioral and relationship functioning is often problematic. When placed in foster care, problems tend to persist or even worsen and increase the risk of placement breakdown. Multidimensional Treatment Foster Care for Preschoolers is an intensive behavior-focused program for young foster children (3 to 7 years) aiming to provide children with a positive and stimulating foster family setting and individually tailored behavioral interventions. This study will be the first to examine the effectiveness of Multidimensional Treatment Foster Care for Preschoolers outside the US and to examine the effectiveness across a broader range of problems related to foster care.MethodsThis is a randomized controlled trial, wherein we expect to include 80 child-foster carer dyads. Forty dyads will be assigned to Multidimensional Treatment Foster Care for Preschoolers and 40 to treatment as usual, following pre-randomization. Data to be gathered concern problem behavior, symptoms of attachment disorder, post-traumatic stress symptoms, quality of life, hypothalamic-adrenal-pituitary axis functioning, parental stress and autonomic reactivity, to be collected via questionnaires, observations, interviews, saliva and recording at six time-points over 24 months. To compare treatment outcomes, Fisher’s exact tests and repeated measures (mixed models) and independent t-tests will be used. All analyses will be performed following the intention-to-treat principle.DiscussionExamining the generalizability of previous findings in the US and extending these previous findings is a step towards improving knowledge about treatment of young foster children with severe behavioral, emotional and attachment problems.Trial registrationNTR1747
Highlights
Among children placed out of home, behavioral and relationship functioning is often problematic
The experimental condition, Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) is compared with treatment as usual using randomized allocation
Relevance for this study derives from a shortage in evidencebased programs combining foster care placements with effective treatment of behavioral, emotional and attachment disorders, while the population of young foster children is still growing and problems become more taxing [56]
Summary
When children’s legal authorities provide no informed consent or when foster parents disagree with the treatment they are assigned to, the children are excluded from the randomized trial. To maintain a beneficial treatment setting for children, therapeutic foster carers are encouraged to stay consistent and responsive toward the child They receive parental strategies to promote positive behavior and effective non-abusive limit setting for problem behavior [28]. Researchers are unable to ensure that the child’s legal authority has retrieved, understood and signed informed consent before the child must be allocated to a treatment [53] This results in a preliminary loss of participants. Policy makers and service providers in the Dutch mental health care are informed about the study findings through national conferences
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