The effectiveness of Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) for young children with severe behavioral disturbances: study protocol for a randomized controlled trial

BACKGROUND Among children placed out of home, behavioral and relationship functioning is often problematic. When placed in foster care, problems tend to persist or even worsen and increase the risk of placement breakdown. Multidimensional Treatment Foster Care for Preschoolers is an intensive behavior-focused program for young foster children (3 to 7 years) aiming to provide children with a positive and stimulating foster family setting and individually tailored behavioral interventions. This study will be the first to examine the effectiveness of Multidimensional Treatment Foster Care for Preschoolers outside the US and to examine the effectiveness across a broader range of problems related to foster care. METHODS This is a randomized controlled trial, wherein we expect to include 80 child-foster carer dyads. Forty dyads will be assigned to Multidimensional Treatment Foster Care for Preschoolers and 40 to treatment as usual, following pre-randomization. Data to be gathered concern problem behavior, symptoms of attachment disorder, post-traumatic stress symptoms, quality of life, hypothalamic-adrenal-pituitary axis functioning, parental stress and autonomic reactivity, to be collected via questionnaires, observations, interviews, saliva and recording at six time-points over 24 months. To compare treatment outcomes, Fisher's exact tests and repeated measures (mixed models) and independent t-tests will be used. All analyses will be performed following the intention-to-treat principle. DISCUSSION Examining the generalizability of previous findings in the US and extending these previous findings is a step towards improving knowledge about treatment of young foster children with severe behavioral, emotional and attachment problems. TRIAL REGISTRATION NTR1747.