MTFCE stands for Multidimensional Treatment Foster Care in England. It was intially a pilot project funded by the then "Department for Children School and Families (DCSF)" - since 2002. The DfE has continued its committment to this model and has now embarked on a roll out of this and other evidence based programmes i.e. KEEP, MST and FFT.
The project is managed overall by a National Implementation Team and receives funding from the DfE. The National Team is staffed by personnel from the Institute of Psychiatry and two NHS Hospital Trusts – Central Manchester University Hospitals NHS Foundation Trust (CMFT) and South London & Maudsley NHS Foundation Trust (SLAM). The National Team consults regularly with the developers of the approach at the Oregon Social Learning Center (OSLC).
The DfE has awarded start up grants to local authorities who have successfully tendered for grants to set up teams to work with children and young people who have experienced several placement disruptions and who have high levels of need. MTFCE follows an evidence-based model developed by researchers at Oregon Social Learning Center (OSLC) in the United States over the course of 30 years and which has been shown to work in the US for children with a variety of difficulties. The local teams are supported by the National Implementation Team.
How Does MTFCE Work?
MTFCE works by having highly trained foster carers who are supported by a specially trained clinical team. Together they deliver individualised treatment programmes to children and young people.
Each foster family works with one child at a time for between six and twelve months. Foster carers and clinical staff are trained in behaviour management systems for the age group with which they will work. (There are MTFC Programmes to cover all of the age ranges i.e. MTFC-P for 3-6 years; MTFC-C for 7-11 years; MTFC-A for 11-16 years). These systems involve giving lots of encouragement and celebrating children and young people’s achievements. They are helped to learn and practise new skills in a supportive environment.
The foster carer is seen as a key agent of change and is supported by a clinical team who help to make changes in other aspects of the child/young person's life i.e. school, community, birth family. This co-ordinated approach over weeks and months helps to make a real difference.
When the children and young people move on to a permanent placement, the team helps their permanent carers to continue this work.
MTFCE Evaluation
The MTFC-Adolescents pilot project has been evaluated independently by the Universities of Manchester and York. They conducted a randomised controlled trial (RCT) which ended in 2009. The study was set up to compare MTFCE with other placements for children and young people. It was run by the Care Placements Evaluation team (CaPE) who have submitted their final report for a peer review. There may be some news on this towards the latter part of 2011.
MTFC in Europe
A number of other European countries, including Sweden, Denmark, Norway, Ireland and the Netherlands, are similarly developing MTFC programmes for adolescents and for the younger 3-6 age group; however the English programme is the largest programme outside the USA and the only national initiative in Europe. A randomised controlled trial on MTFC-A has been completed in Sweden and was written up and published in the Journal of Family Therapy 2010.
There was an excellent European conference in Copenhagen (May 2011) which brought together colleagues from the USA and from throughout Europe. Ideas and examples of good practice continue to be shared and developed within the MTFC community.
