ABSTRACT

Treatment Foster Care (TFC) fills a unique niche in a system and continuum of care for youth with behavioral and emotional disorders. It is generally viewed positively within the fields of both child welfare and children’s mental health for its ability to provide intensive individualized out-of-home treatment to a wide range of youth. TFC has a relatively strong evidence base, fits well with contemporary paradigmatic underpinnings of systems of care, and is substantially less expensive than other out-of-home treatment options. Data show that it can serve as a step-down for youth after discharge from more restrictive placements, a step-up to prevent more restrictive placements, and a short- or long-term placement that provides flexibility and systematic intervention to address complex youth and family issues. The current evidence base provides guidance on potential models and foci for improving practice and outcomes. However, there is a great deal that still needs to be examined to fully understand, disseminate, and implement empirically supported TFC across the wide range of agencies, settings, and communities where it is practiced. This chapter highlights the key features and history of TFC, examines the current state of the evidence base, and concludes with a discussion of existing dilemmas and future directions.