Refining the evaluation of treatment foster care

Treatment foster care (TFC) is a promising alternative intervention for children and adolescents at risk for placement in residential care settings. An examination of the processes and outcomes of TFC is complicated and leads to the conclusions that: (a) TFC is delivered with such variability that conclusions about its effectiveness are difficult to draw; (b) many variables in the child's ecology that potentially confound the effects of the intervention remain unexamined; and (c) service impacts have been defined narrowly. This article synthesizes the state of knowledge in these three domains and discusses how an ecosystemic framework can advance and refine knowledge building in this field of practice.