MTFC – en intervention för ungdomar med beteendeproblem

Sammanfattning: This thesis examines MTFC (Multidimensional Treatment Foster Care), a multi-modal treatment programme for youth with severe behaviour problems) in a Swedish context. In the United States, the programme has demonstrated encouraging treatment results using specialized foster homes as an alternative to restrictive residential care or group care. The foster parents provide a structured and therapeutic living environment. The first study explores the frequency of premature termination – placement breakdown – for teenagers placed in different types of out-of-home care in Sweden: between 30 and 37% of all placements were prematurely terminated. The lowest rates of breakdown were found in kinship care and secure units, the highest in non-kinship foster homes. Antisocial behaviour increased the risk of breakdown. The results indicated that placement breakdown is a major problem in the Swedish child welfare system. The second study compares placement breakdown rates between three samples of antisocial youth: a Swedish MTFC programme, a MTFC programme in United States, and a sub sample from a Swedish national cohort study. Irrespective of gender, type of care, and time of breakdown, MTFC youth in Sweden showed lower breakdown rates compared to the youth in the other two studies. The third study examines how foster parents worked in a manual-based treatment programme for antisocial youth. As a group, 80% of the foster parents rated all the programme components the highest possible positive value. The highlight of the study is the positive attitude towards the MTFC programme manual. The fourth study examines two years post-treatment outcomes for 35 Swedish antisocial youth. They were randomly assigned to MTFC or treatment as usual (TAU). The treatment results, mostly in favour of MTFC showed both statistically and clinical significant positive treatments effects. The effect size favoured MTFC in all variables. This thesis indicates that MTFC is an effective method in treating youth with behavioural problems. It has shown good potential in keeping youth in treatment. The majority of foster parents are very optimistic about using the MTFC manual and the evaluation of the programme indicates promising treatment results. This programme ought to be of great interest for Swedish social services as an alternative to traditional care.