• By Dartington SRU
• Posted on Friday 01^st August, 2014

The problems of analysing whether interventions works #2

Delinquent behavior is deeply ingrained in the lives of many young people and no method has been found to be especially effective, even though very contrasting approaches have been advocated and tried.

One initiative adopted in England has been multi-dimensional treatment foster care, which was developed in the 1980s by the Oregon Social Learning Center, USA. It offers foster care as an alternative to custody and complements this placement with a clear treatment programme, delivered by highly trained professionals and carers. Previous evaluations had suggested positive effects. But would this be effective in England?

The key elements of the intervention are the provision of a consistent reinforcing environment in which the young people are mentored and encouraged; a clear structure with specified boundaries and sanctions; close supervision of young people’s activities; diversion of young people from others of their own age who engage in anti-social activities; and the formation of more positive relationships. The project is led by programme supervisors who direct therapists to work with the young people, carers and birth families, and community facilities, such as schools, colleges and youth centres.

The young people selected were all at risk of receiving a custodial sentence and met set criteria with regard to family problems, psychological health and vulnerable lifestyles. A group of 23 youngsters who were placed in foster care were compared with a matched group of 24 who went elsewhere, 20 of them to custody.

Just over four-fifths of the study groups were male, with a mean age of 15. All had accumulated a lengthy criminal record and a third had been in custody before. Half had histories of neglect and abuse and a third displayed literacy and numeracy difficulties. Only half were living at home with parents when convicted.

The young people were followed-up for two years to chart their criminal behavior and the factors likely to influence it.

Time in the foster placement lasted from one week to nearly 17 months, with the majority (two-thirds) staying for nine months or more.

After a year, the results were encouraging in that they showed a significant difference between the two groups in offending rates, time before committing the next offense and number of offenses committed, with far lower rates for the intervention group.

However, by the end of the second year, these differences diminished and the results for the adolescents who received the intervention and adolescents who did not were much closer. Yet still the reduction in entry to custody remained for the intervention group, even if the difference was not quite as large as during the first year.

Intensive fostering is clearly effective at reducing custody, delaying reconviction and reducing the number of offenses while the young people are in their placements, but less so in the longer-term. It seems that the learned positive social behavior was not sufficiently internalised, causing it to be swamped by environmental forces, especially criminal peer groups, poor supervision by professionals and weak support from families.

It is clear from the evidence that multi-dimensional foster care does have an effect in preventing young people from becoming further embroiled in the criminal justice system but this benefit is increasingly difficult to maintain once they have left foster care, although in a few areas, such as entry to custody, some gains endure. Better after-care and attention to environmental factors, such as employment, accommodation and pro-social leisure activities, might help individuals but, unfortunately, the evidence over time confirms once again the enduring nature and damaging consequences of persistent offending by older teenagers.

These results from England are somewhat at odds with those obtained from USA studies and it is difficult from a single evaluation to know whether this is due to the programme, its implementation, the quality of support services, or some aspects of English society. More research is needed to understand what effect these factors may have.

Biehal, N., Ellison, S. & Sinclair, I. (2011). Intensive fostering: An independent evaluation of MTFC in an English setting. Children and Youth Services Review, 33, 2043-2049.

Chamberlain, P. (2003). The Oregon Multidimensional Treatment Foster Care model; features, outcomes, and progress in dissemination. Cognitive and Behavioral Practice, 10 (4), 303-312.