Treatment Foster Care Oregon - Adolescents (TFCO-A)

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Target Population: 
Adolescents, Families
Academic Performance, Antisocial Behavior, Behavioral Problems, Mentorship, Parenting, Relationships
Target Audience 

This program is for adolescents who are 12 to 17 years old and who need to be placed in foster care due to acute and persistent misconduct, emotional, and/or behavioral issues and their families.


Treatment Foster Care Oregon - Adolescents (TFCO-A), formerly known as Multidimensional Treatment Foster Care - Adolescents, is a community-based foster care program that is designed to help youth develop life skills and build positive relationships with pro-social peers and adults and, consequently, return to their birth family's home or move to another long-term familial caregiving environment.  This program also helps parents or caregivers cultivate parenting competencies and skills that could eventually help youth maintain positive changes.


Multiple internal and external randomized controlled trials examining TFCO-A have been conducted.  Collectively, these studies demonstrate that youth placed in TFCO-A compared to youth placed in treatment as usual were less likely to engage in delinquent or criminal activities, to run away from their placements, or to be placed in a locked facility.  They experienced higher reunification rates with relatives, greater reductions in externalizing behaviors, and fewer days in locked facilities.  In general, these effects were maintained at least 2 years after participants started the program.


Typically, youth are referred to the TFCO-A program by mental health, juvenile court, or child welfare professionals after other treatment options have not worked.  In the TFCO-A program, youth are placed with trained and supervised foster parents and are immersed in a supportive and safe situation.  Program components emphasized during and after placement include the following:

  • Supportive environment - Mentor and inspire youth to develop skills that could help them thrive in family, school, and community contexts;
  • Daily structure - Provide youth with explicit expectations and boundaries and dispense suitable consequences including positive rewards;
  • Supervision - Monitor youths' activities; and
  • Peer relationships - Encourage youth to build relationships with pro-social peers and avoid irresponsible or reckless connections.

The program also involves the following important professionals:

  • Program supervisor who supports and supervises the foster parents through weekly meetings, daily phone consults, and continuous accessibility (i.e., 24 hours a day/7 days a week);
  • Family therapist who works with and supports the adolescent and his or her birth or other caregiving family;
  • Individual therapist who provides personalized care to the adolescent;
  • Foster parent recruiter/trainer who helps to enlist and prepare qualified foster parents;
  • Two to three skills trainers who help adolescents develop the competencies they are learning; and
  • Parent daily report caller who contacts the foster parents to monitor progress.  
Previous Use 

Since its development in 1983, TFCO-A has reached approximately 4,000 foster children and their families and has been implemented in over 100 sites in the United States, Canada, Denmark, Ireland, the Netherlands, New Zealand, Norway, Sweden, and the United Kingdom.


Prior to implementation, TFC Consultants, Inc., visits the agency site to bring the stakeholders to a common understanding of the model and implementation procedures.  A plan and timeline are developed for training program staff; recruiting, training, and certifying foster parents; and determining placement of children in the foster homes.  The agency staff attend a 4-day training, with program supervisors attending a 5-day training, at the model site in Eugene, Oregon.  Clinical training sessions are scheduled quarterly for replacement staff and new implementation teams.  Training costs are $12,500 per site depending on travel distance.  In addition, a $2,050 certification fee is required.  For more information, please visit


Considerations for implementing TFCO-A include understanding this program is time and resource intensive and involves communication and cooperation among the foster parent(s), aftercare family, and children in the treatment plan; receiving staff and foster parents buy-in; realizing staff must meet certain professional requirements; and acquiring funds for training and implementation.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email


If you are interested in implementing TFCO-A, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email


Adolescents typically receive services for 6 to 9 months.


Costs will vary depending on a variety of factors, such as salaries for professionals and general staff members and foster parent compensation.  In most instances in the United States, total program and implementation costs range from $200 to $225 a day per child.

Evaluation Plan 

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email  


Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email:

You may also contact Gerard Bouwman, TFC Consultants, Inc., by mail 12 Shelton McMurphey Blvd., Eugene, OR 97401, phone 1-541-343-2388 EXT 204, email, or visit

*Resources and associated costs reflect those identified at the time of fact sheet publication.