The British Journal of Psychiatry
Multidimensional Treatment Foster Care for Adolescents in English care: randomised trial and observational cohort evaluation
J. M. Green, N. Biehal, C. Roberts, J. Dixon, C. Kay, E. Parry, J. Rothwell, A. Roby, D. Kapadia, S. Scott, I. Sinclair
  • Declaration of interest




Children in care often have poor outcomes. There is a lack of evaluative research into intervention options.


To examine the efficacy of Multidimensional Treatment Foster Care for Adolescents (MTFC-A) compared with usual care for young people at risk in foster care in England.


A two-arm single (assessor) blinded randomised controlled trial (RCT) embedded within an observational quasi-experimental case-control study involving 219 young people aged 11-16 years (trial registration: ISRCTN 68038570). The primary outcome was the Child Global Assessment Scale (CGAS). Secondary outcomes were ratings of educational attendance, achievement and rate of offending.


The MTFC-A group showed a non-significant improvement in CGAS outcome in both the randomised cohort (n = 34, adjusted mean difference 1.3, 95% CI -7.1 to 9.7, P = 0.75) and in the trimmed observational cohort (n = 185, adjusted mean difference 0.95, 95% CI -2.38 to 4.29, P = 0.57). No significant effects were seen in secondary outcomes. There was a possible differential effect of the intervention according to antisocial behaviour.


There was no evidence that the use of MTFC-A resulted in better outcomes than usual care. The intervention may be more beneficial for young people with antisocial behaviour but less beneficial than usual treatment for those without.


  • Funding

    The project was funded by a grant from the UK Department for Children, Schools and Families to the Institute of Psychiatry (reference: PACLBMC). It was sponsored by the University of Manchester.

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