Treatment Foster Care Oregon

Evidence Rating  
Evidence rating: Scientifically Supported

Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.

Health Factors  
Retired Strategy

Retired strategies are no longer updated.

Date last updated

In the Treatment Foster Care Oregon (TFCO) model, severely and chronically delinquent youth join foster families who have received training in behavior management and are connected to TFCO-trained program supervisors through daily phone calls, weekly group meetings, family therapy, and case management1. Foster parents provide daily structure, set expectations, monitor youths’ behavior, and deliver rewards and consequences while helping youth avoid socially deviant peers2. There are TFCO program versions for adolescents (TFCO-A), young children (TFCO-C), and preschoolers (TFCO-P)3. TFCO was formerly called Multidimensional Treatment Foster Care.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Reduced recidivism

  • Reduced delinquent behavior

  • Reduced violence

  • Reduced drug use

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Reduced teen pregnancy

  • Increased academic achievement

  • Improved mental health

  • Increased foster care placement stability

What does the research say about effectiveness?

There is strong evidence that Treatment Foster Care Oregon (TFCO) reduces participating youths’ recidivism1, 4 and delinquency2, 5, 6 compared to peers in group homes. TFCO has also been shown to reduce violent crime2, 5, 7, days of incarceration1, 4, and drug use2, 8.

For girls, TFCO has been shown to reduce teen pregnancy and increase school attendance and homework completion1, 9. Juvenile female offenders in TFCO experience greater decreases in psychological problems, depression, and suicidal ideation than girls in group care homes10, 11, 12. TFCO for preschoolers (TFCO-P) can increase the likelihood of successful, permanent placement for participants and decrease their problem behaviors13.

A Washington-based analysis estimates that TFCO cost about $8,300 per juvenile offender in 2016, with a benefit to cost ratio of $1.7014.

How could this strategy impact health disparities? This strategy is rated no impact on disparities likely.
Implementation Examples

TFCO is used in more than 50 U.S. locations and internationally15.

Implementation Resources

TFCO - TFC Consultants, Inc. Treatment Foster Care Oregon (TFCO).


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1 SPTW - Social Programs That Work (SPTW). Full list of programs.

2 Blueprints - Center for the Study and Prevention of Violence (CSPV). Blueprints for healthy youth development.

3 TFCO - TFC Consultants, Inc. Treatment Foster Care Oregon (TFCO).

4 Osei 2016 - Osei GK, Gorey KM, Hernandez Jozefowicz DM. Delinquency and crime prevention: Overview of research comparing treatment foster care and group care. Child & Youth Care Forum. 2016;45(1):33–46.

5 OJJDP Model Programs - Office of Juvenile Justice and Delinquency Prevention (OJJDP). OJJDP model programs guide.

6 Turner 2011 - Turner W, Macdonald G. Treatment foster care for improving outcomes in children and young people: A systematic review. Research on Social Work Practice. 2011;21(5):501–527.

7 CG-Violence - The Guide to Community Preventive Services (The Community Guide). Violence.

8 Leve 2013 - Leve LD, Kerr DCR, Harold GT. Young adult outcomes associated with teen pregnancy among high-risk girls in a randomized controlled trial of multidimensional treatment foster care. Journal of Child & Adolescent Substance Abuse. 2013;22(5):421–434.

9 Rhoades 2013 - Rhoades KA, Chamberlain P, Roberts R, Leve LD. MTFC for high risk adolescent girls: A comparison of outcomes in England and the United States. Journal of Child & Adolescent Substance Abuse. 2013;22(5):435–449.

10 Poulton 2014 - Poulton R, Van Ryzin MJ, Harold GT, et al. Effects of Multidimensional Treatment Foster Care on psychotic symptoms in girls. Journal of the American Academy of Child & Adolescent Psychiatry. 2014;53(12):1279–1287.

11 Harold 2013 - Harold GT, Kerr DCR, Van Ryzin M, et al. Depressive symptom trajectories among girls in the juvenile justice system: 24-month outcomes of an RCT of Multidimensional Treatment Foster Care. Prevention Science. 2013;14(5):437–446.

12 Kerr 2014 - Kerr DCR, DeGarmo DS, Leve LD, Chamberlain P. Juvenile justice girls’ depressive symptoms and suicidal ideation 9 years after Multidimensional Treatment Foster Care. Journal of Consulting and Clinical Psychology. 2014;82(4):684–693.

13 CEBC - California Evidence-Based Clearinghouse for Child Welfare (CEBC). Information and resources for child welfare professionals: List of programs.

14 WSIPP-Benefit cost - Washington State Institute for Public Policy (WSIPP). Benefit-cost results.

15 Henggeler 2012 - Henggeler SW, Sheidow AJ. Empirically supported family-based treatments for conduct disorder and delinquency in adolescents. Journal of Marital & Family Therapy. 2012;38(1):30–58.