Multi-Dimensional Treatment Foster Care (MTFC)

Intervention Basics

Multi-Dimensional Treatment Foster Care (MTFC) is an alternative to group home treatment or State facilities for youth who have been removed from the home due to substance use and/or involvement in the juvenile justice system.

MTFC typically comes after previous family preservation efforts have failed. Referrals come from the juvenile courts, mental health and child welfare agencies. The treatment program works to keep the youth living successfully in their communities and helps prepare their caregivers for a successful reunification.

MTFC is based on social learning theory and has four key elements, which are targeted during foster care placement and aftercare:

  • Providing youth with a consistent, reinforcing environment where they are mentored and encouraged to develop academic and positive living skills
  • Providing youth with daily structure that includes clear expectations, limits, and specified consequences delivered in a teaching-oriented manner
  • Providing close supervision
  • Helping youth to avoid deviant peer associations while providing them with the support and assistance needed to establish pro-social peer relationships.

MTFC is a cost effective alternative to traditional foster care, group or residential treatment and incarceration for problematic adolescents. MTFC can be implemented by any agency or organizations providing services to children with serious behavior problems and their families. 

Expectation of Sessions: 
Number of sessions varies, dependent on the intensity of the treatment. Sessions are created to closely mirror normative life. Typically lasts 6-9 months and includes interventions conducted in the foster home, continuing care works with both the family and with the adolescent individually.

Recommended Populations

  • Youth ages 13-17
  • Girls & Boys 
  • American Indian or Alaska Native; Asian; Black or African American; Hispanic or Latino; and White
  • Residential; Outpatient; Correctional; Home; School; Workplace; and Other community settings
  • Urban; Suburban; and Rural and/or frontier

Special Considerations for Juvenile Drug Courts

Because the criteria for inclusion in this intervention are youth who have been separated from their families, with the goal of establishing permanency or family reunification, this program would only apply to a small population of youth in juvenile drug courts. These youth are often referred as cross-over youth and would be involved in both family dependency court and the juvenile drug court. Youth who have received/are receiving MTFC are more likely to be involved with their biological family in family dependency court and the juvenile justice system; however in a situation where a youth is involved with their family in a family dependency court and in a juvenile drug court, there could be a number of cross-systems issues to navigate. 

Engagement Strategies

Engagement of youth involved among multiple systems can be extremely difficult and great care must be taken when coordinating services. If the JDC does accept a youth involved in multiple systems, the JDC team members will have to be cognizant of the youth’s time, as there will be multiple requirements (i.e., several different court appearances, as well as treatment requirements). JDC programs are generally very intensive and require a huge time commitment, so it is important NOT to set these youth and families up for failure. In addition, there will be a tendency for families, both biological and foster, to confound the efforts of the courts and agencies involved and will want to make sure the dual process is beneficial for the youth, as well as the families.   

The Department of Social Services/Child Protective Services will likely be the lead agency in decision making for these youth, and memorandums of understanding or working agreements between the court and social service agencies should be in place before the youth enters the JDC program.  

Implementation and Training

JDC teams should consider visiting another court that has implemented this treatment and involved in a multi-system approach, as well as undergo an intensive training component. 

Contact Gerard J. Bouwman, (541) 343-2388, to research costs and training opportunities.

For more detailed information regarding research and replications associated with MTFC, visit: