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Family and Children's
Resource Program

Vol. 18, No. 1
January 2013

MTFC-P: An Evidence-Based Intervention for Child Neglect

Adapted from National Scientific Council on the Developing Child, 2012; California Evidence-Based Clearinghouse for Child Welfare, 2012

Multidimensional Treatment Foster Care for Preschoolers

Early intervention model that aims to promote healthy self-regulation, positive relationships
with caregivers and peers, and school readiness in vulnerable young children.

Duration. Six to nine months. Foster parents receive at least seven contacts per week. Each week children in treatment receive a 2-hour therapeutic playgroup and a 2-hour skills training session. Biological families or other long-term placement resources receive a weekly 1-hour skill-building session.

Target Population. Children in foster care aged 3-6.

Program Goals and Intervention Strategies. Help caregivers provide and maintain a positive, responsive, and consistent environment for young children through the use of concrete encouragement to reinforce positive behaviors and effective limit-setting to reduce problematic behaviors. Children also receive support through behavioral therapy in a preschool setting and a weekly playgroup that promotes positive socialization.

Evidence of Effectiveness. Compared with children who received a control intervention, preschoolers in MTFC-P showed improvements in attachment-related behaviors, fewer behavior problems, and improved cortisol rhythms.

Availability in NC
Currently MTFC-P is not available in NC. However, Alexander Youth Network offers a version of MTFC for adolescents.

Those interested in bringing MTFC-P to their communities should contact Rena Gold,,, 541/343-2388.

MTFC-P Lowers Cortisol Levels in Maltreated Preschoolers
Adapted from National Scientific Council on the Developing Child (2012)

Why Cortisol Matters
Regulation of the key stress hormone cortisol is altered in children who experience severe neglect. This can lead to greater risk for anxiety, depression, and, later in life, heart problems.

In typically developing children, cortisol levels increase in the morning (to get the body going for the day), and then steadily decline. Significantly neglected children have cortisol levels that are lower in the morning and flat across the day.

MTFC for Preschoolers
A study by Fisher et al. (2007) found Multidimensional Treatment Foster Care for Preschoolers to be better than traditional foster care at restoring stress hormones to typical levels.

As the figure below shows, children in traditional family foster care showed suppressed cortisol levels, which worsened the longer they were in care. Foster parents trained to provide responsive relationships through MTFC-P restored children's stress hormones to typical levels, as measured in a control group of children from the same community who were not in foster care.

Conclusion: MTFC for Preschoolers improved children's stress-regulatory capabilities, as indicated by patterns of cortisol production indistinguishable from those of non-neglected, healthy children.

References for this and other articles in this issue