title: Multidimensional Treatment Foster Care for Adolescents in English care: randomised trial and observational cohort evaluation.
abstract: BACKGROUND
  Children in care often have poor outcomes. There is a lack of evaluative research into intervention options.
  
  
  OBJECTIVE
  To examine the efficacy of Multidimensional Treatment Foster Care for Adolescents (MTFC-A) compared with usual care for young people at risk in foster care in England.
  
  
  METHODS
  A two-arm single (assessor) blinded randomised controlled trial (RCT) embedded within an observational quasi-experimental case-control study involving 219 young people aged 11-16 years (trial registration: ISRCTN 68038570). The primary outcome was the Child Global Assessment Scale (CGAS). Secondary outcomes were ratings of educational attendance, achievement and rate of offending.
  
  
  RESULTS
  The MTFC-A group showed a non-significant improvement in CGAS outcome in both the randomised cohort (n = 34, adjusted mean difference 1.3, 95% CI -7.1 to 9.7, P = 0.75) and in the trimmed observational cohort (n = 185, adjusted mean difference 0.95, 95% CI -2.38 to 4.29, P = 0.57). No significant effects were seen in secondary outcomes. There was a possible differential effect of the intervention according to antisocial behaviour.
  
  
  CONCLUSIONS
  There was no evidence that the use of MTFC-A resulted in better outcomes than usual care. The intervention may be more beneficial for young people with antisocial behaviour but less beneficial than usual treatment for those without.
authors.affiliation: J. M. Green, BA, MA, MBBS, DCH, FRCPsych, Institute of Brain Behaviour and Mental Health, The University of Manchester, Manchester; N. Biehal, BA, MA, PhD, Department of Social Policy and Social Work, University of York, York; C. Roberts, BSc, MSc, PhD, Centre for Biostatistics, Institute of Population Health, University of Manchester, Manchester; J. Dixon, BA, MA, Social Policy Research Unit (SPRU), University of York, York; C. Kay, BSc, PhD, Institute of Brain Behaviour and Mental Health, The University of Manchester, Manchester; E. Parry, BA, MSc, Mood Disorders Centre, University of Exeter, Exeter; J. Rothwell, BSc, PhD, A. Roby, BSc, MSc, ClinPsyD, D. Kapadia, BSc, MSc, Institute of Brain Behaviour and Mental Health, The University of Manchester, Manchester; S. Scott, MB BChir, FRCP, FRCPsych, Institute of Psychiatry, King's College London, London; I. Sinclair, BA, PhD, Social Policy Research Unit (SPRU), University of York, York, UK.
authors.forename: J M
authors.initials: JM
authors.lastname: Green
authors.forename: N
authors.initials: N
authors.lastname: Biehal
authors.forename: C
authors.initials: C
authors.lastname: Roberts
authors.forename: J
authors.initials: J
authors.lastname: Dixon
authors.forename: C
authors.initials: C
authors.lastname: Kay
authors.forename: E
authors.initials: E
authors.lastname: Parry
authors.forename: J
authors.initials: J
authors.lastname: Rothwell
authors.forename: A
authors.initials: A
authors.lastname: Roby
authors.forename: D
authors.initials: D
authors.lastname: Kapadia
authors.forename: S
authors.initials: S
authors.lastname: Scott
authors.forename: I
authors.initials: I
authors.lastname: Sinclair
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D000294:Adolescent Behavior / Q000523:psychology; D004522:Educational Status; D004739:England; D005581:Foster Home Care / Q000523:psychology; D007604:Juvenile Delinquency; D008603:Mental Health; D016037:Single-Blind Method; D016896:Treatment Outcome; D064887:Observational Studies as Topic