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Violence > Therapeutic Foster Care Reduces Violence
Therapeutic Foster Care Reduces Violence among Chronically Delinquent Juveniles; More Evidence Needed to Determine Effectiveness among Children with Severe Emotional Disturbance
Juvenile violence is a substantial problem in the United States. On the basis of reports by victims, juvenile perpetrators committed violence at a higher rate than persons of any other age group. Since the 1970’s, juveniles aged 10-17 years, who constitute <12% of the population, have been involved as offenders in approximately 25% of serious violent crimes. Risk factors for juvenile violence include low socioeconomic status, inadequate parental supervision, harsh and erratic discipline, and delinquent peers. Youth violence then, like so much else in public health has at its root, modifiable causes. The question is then: The question is: what strategies are effective in preventing or reducing youth violence?
A team of experts, working on behalf of the Task Force on Community Preventive Services, conducted a systematic review of published studies to assess the effectiveness of therapeutic foster care with two groups:
- chronically delinquent juveniles; and
- children with severe emotional disturbance.
Results showed that therapeutic foster care programs are effective in reducing violent crimes among adolescent’s ages 12-18 with a history of chronic delinquency. On the basis of sufficient evidence of effectiveness, the task force recommends that these programs be implemented or continued.
Available studies did not, however, provide sufficient evidence to determine the effectiveness of therapeutic foster care among children with severe emotional disturbance. This does not mean that this intervention is ineffective with this population, but that additional research is needed to determine its effects.
Background on Therapeutic Foster Care
- Therapeutic foster care, also known as therapy foster care, cluster therapeutic foster care and family-based treatment is provided as an alternative to incarceration, hospitalization, or other forms of group and residential treatment for adolescents with a history of chronic antisocial behavior, delinquency, or emotional disturbance. It is also used to advance multiple public health goals among a number of populations.
- Participants are placed for several months in foster families (one or two participants per family) who are specially trained and compensated for their work. During the program, participants are provided a structured environment where they are rewarded for positive social behavior and penalized for disruptive and aggressive behavior. Therapeutic foster care also separates program juveniles from their delinquent peers and provides close supervision at school as well as home.
Findings from the Systematic Review
- Five studies meeting the Community Guide quality criteria were reviewed.
- Three studies evaluated therapeutic foster care for reduction of violence by chronically delinquent adolescents.
- Two studies assessed therapeutic foster care for the reduction of violence by children with severe emotional disturbance and results were inconsistent.
- Based on the evidence, therapeutic foster care for chronically delinquent adolescents was found to reduce violent crime by approximately 70%, when compared with similar youth in standard group residential treatment facilities. The age of participants was between 12-18 years and the average duration of these programs was 6-7 months.
- Total cost benefits of program intensive foster care for this population ranged from $20,351 to $81,664 per youth. It is estimated that, for every dollar invested in therapeutic
foster care, approximately $14 are saved in justice system costs.
- Therapeutic foster care programs may also improve school performance and lower rates of general delinquency.
- A potential challenge for therapeutic foster care is recruiting and retaining foster families.
Publications:
The findings and conclusions in this report have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.
The Guide to Community Preventive Services (Community Guide) provides recommendations on population-based interventions to promote health and to prevent disease, injury, disability, and premature death, appropriate for use by communities and healthcare systems. For more information about the Community Guide (including links to publications and a variety of resources) see www.thecommunityguide.org and for more information about the violence prevention review see www.thecommunityguide.org/violence/
This information is in the public domain. Copying and disseminating freely is encouraged. However, citation to source is appreciated.
Updated – July 1, 2004
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