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Added a paragraph to the lead describing retention rates of social workers, the conditions that cause this, and the effects this has on the quality of care provided. |
→Therapeutic intervention: Added two paragraphs describing a therapeutic treatment plan enacted by foster care service providers. I also inserted a link to the trauma- and violence-informed care Wikipedia page. |
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Children in the child welfare system have often experienced significant and repeated traumas and having a background in foster homes—especially in instances of sexual abuse—can be the precipitating factor in a wide variety of psychological and cognitive deficits<ref>{{cite journal | last1 = Racusin | first1 = R | last2 = Maerlender | first2 = AC Jr | last3 = Sengupta | first3 = A | display-authors = etal | year = 2005 | title = Psychosocial treatment of children in foster care: a review | url = https://digitalcommons.unl.edu/cgi/viewcontent.cgi?article=1719&context=psychfacpub| journal = Community Ment Health J. | volume = 41 | issue = 2| pages = 199–221 | pmid = 15974499 | doi=10.1007/s10597-005-2656-7| s2cid = 17728425 }}</ref> it may also serve to obfuscate the true cause of underlying issues. The foster care experience may have nothing to do with the symptoms, or on the other hand, a disorder may be exacerbated by having a history of foster care and attendant abuses. The human brain however has been shown to have a fair degree of [[neuroplasticity]].<ref>{{cite journal | last1 = Johansen-Berg | first1 = H | title = Structural plasticity: rewiring the brain | journal = Current Biology | volume = 17 | issue = 4 | pages = R141–4 | year = 2007 | pmid = 17307051 | doi = 10.1016/j.cub.2006.12.022 | s2cid = 15766149 | doi-access = free }}</ref><ref>{{cite journal | last1 = Duffau | first1 = H | title = Brain plasticity: from pathophysiological mechanisms to therapeutic applications | journal = Journal of Clinical Neuroscience | volume = 13 | issue = 9 | pages = 885–97 | year = 2006 | pmid = 17049865 | doi = 10.1016/j.jocn.2005.11.045 | s2cid = 6060894 }}</ref><ref>{{cite journal | last1 = Holtmaat | first1 = A | last2 = Svoboda | first2 = K |author2-link=Karel Svoboda (scientist)| title = Experience-dependent structural synaptic plasticity in the mammalian brain | journal = Nature Reviews. Neuroscience | volume = 10 | issue = 9 | pages = 647–58 | year = 2009 | pmid = 19693029 | doi = 10.1038/nrn2699 | s2cid = 16384008 }}</ref> and adult [[neurogenesis]] has been shown to be an ongoing process.<ref>{{cite journal | last1 = Ge | first1 = S | last2 = Sailor | first2 = KA | last3 = Ming | first3 = GL | last4 = Song | first4 = H | title = Synaptic integration and plasticity of new neurons in the adult hippocampus | journal = The Journal of Physiology | volume = 586 | issue = 16 | pages = 3759–65 | year = 2008 | pmid = 18499723 | pmc = 2538931 | doi = 10.1113/jphysiol.2008.155655 }}</ref>
Multidimensional Treatment Foster Care (MTFC), also referred to as Treatment Foster Care Oregon (TFCO) and Treatment Foster Care (TFC) is a community-based intervention that was created in 1983 by Dr. Patricia Chamberlain and her associated colleagues with the initial design intended to offer a replacement for group facilities.<ref name=":6">{{Cite journal |last=Ladner-Graham |first=Jennifer |date=2019-01-01 |title=Empirical Support for Multidimensional Treatment Foster Care (MTFC): A Critical Review |url=https://egrove.olemiss.edu/etd/1714 |journal=Electronic Theses and Dissertations}}</ref> MTFC has differing approaches for different age groups. Preschoolers receive “a behavior-management approach and intensively trains, supervises, and supports foster caregivers to provide positive adult support and consistent limit setting” coupled with “coordinated interventions with the child’s biological parents.”<ref name=":7">{{Cite journal |last=Leve |first=Leslie D. |last2=Harold |first2=Gordon T. |last3=Chamberlain |first3=Patricia |last4=Landsverk |first4=John A. |last5=Fisher |first5=Philip A. |last6=Vostanis |first6=Panos |date=2012-12 |title=Practitioner Review: Children in foster care – vulnerabilities and evidence-based interventions that promote resilience processes |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505234/ |journal=Journal of child psychology and psychiatry, and allied disciplines |volume=53 |issue=12 |pages=1197–1211 |doi=10.1111/j.1469-7610.2012.02594.x |issn=0021-9630 |pmc=3505234 |pmid=22882015}}</ref> MTFC for adolescence consists of individual placement with an intensely trained foster family providing “coordinated interventions in the home, with peers, [and] in educational settings.”<ref name=":7" /> MTFC has been shown to provide better results than group facilities<ref name=":7" /> and proves to be more cost effective.<ref name=":6" /><ref name=":8">{{Cite journal |last=Åström |first=Therese |last2=Bergström |first2=Martin |last3=Håkansson |first3=Kickan |last4=Jonsson |first4=Ann Kristine |last5=Munthe |first5=Christian |last6=Wirtberg |first6=Ingegerd |last7=Wiss |first7=Johanna |last8=Sundell |first8=Knut |date=2020-05 |title=Treatment Foster Care Oregon for Delinquent Adolescents: A Systematic Review and Meta-Analysis |url=http://journals.sagepub.com/doi/10.1177/1049731519890394 |journal=Research on Social Work Practice |language=en |volume=30 |issue=4 |pages=355–367 |doi=10.1177/1049731519890394 |issn=1049-7315}}</ref> Reports show that Multidimensional treatment has effective results in reducing depression, arrest rates, deviant peer affiliations, placement disruption, and pregnancy rates while having positive replication trials.<ref name=":7" /> It is one method that attempts to incorporate [[trauma- and violence-informed care]] into its design.<ref>{{Cite journal |last=Smith |first=Dana K. |last2=Chamberlain |first2=Patricia |last3=Deblinger |first3=Esther |date=2012-09-01 |title=Adapting Multidimensional Treatment Foster Care for the Treatment of Co-occurring Trauma and Delinquency in Adolescent Girls |url=https://doi.org/10.1080/19361521.2012.697101 |journal=Journal of Child & Adolescent Trauma |language=en |volume=5 |issue=3 |pages=224–238 |doi=10.1080/19361521.2012.697101 |issn=1936-153X}}</ref>
Researchers have faced difficulty when it comes to accurately assessing what makes MTFC and other similar programs that involve multiple levels of intervention successful. It seems to remain in a "black box" scenario where it is unsure what aspect of the treatment plan is actually producing positive effects.<ref name=":6" /><ref name=":9">{{Cite journal |last=Osei |first=Gershon K. |last2=Gorey |first2=Kevin M. |last3=Hernandez Jozefowicz |first3=Debra M. |date=2016-02-01 |title=Delinquency and Crime Prevention: Overview of Research Comparing Treatment Foster Care and Group Care |url=https://doi.org/10.1007/s10566-015-9315-0 |journal=Child & Youth Care Forum |language=en |volume=45 |issue=1 |pages=33–46 |doi=10.1007/s10566-015-9315-0 |issn=1573-3319}}</ref> Multiple peer-reviewed research articles on foster care programs point out a lack of research effectively evaluating the outcomes of specific foster care programs<ref name=":42">{{Cite journal |last=Reimer |first=Daniela |date=2021-05 |title=Better quality in foster care in Europe : how can it be achieved? |url=https://digitalcollection.zhaw.ch/handle/11475/22698 |language=en |publisher=European Commission |doi=10.21256/zhaw-22698}}</ref><ref name=":5">{{Citation |last=Font |first=Sarah A. |title=Foster Care as a Problem and a Solution |date=2020 |url=https://doi.org/10.1007/978-3-030-41146-6_3 |work=Foster Care and Best Interests of the Child: Integrating Research, Policy, and Practice |pages=39–58 |editor-last=Font |editor-first=Sarah A. |place=Cham |publisher=Springer International Publishing |language=en |doi=10.1007/978-3-030-41146-6_3 |isbn=978-3-030-41146-6 |access-date=2022-11-30 |last2=Gershoff |first2=Elizabeth T. |editor2-last=Gershoff |editor2-first=Elizabeth T.}}</ref><ref name=":6" /><ref name=":8" />, calling for more complete assessments to be conducted in order to properly compare outcomes between treatment plans and evaluate what practices in MTFC are most effective.<ref name=":9" /> Ethical concerns have also been raised by Therese Åström and other associated researchers when conducting a systematic review on behalf of the Swedish Agency for Health Technology Assessment and Assessment of Social Services in 2018, noting that on the one hand MTFC is evaluated as effective, however, it tends to be implemented in a way that diminishes the child's agency.<ref name=":8" />
=== Cross-cultural adoption policies ===
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