Effects of Regular foster care compared to Therapeutic foster care for young foster children with psychological problems.

Many foster children show attachment and behavioral problems, abnormal cortisol
levels and atypical physiological responses within caregiver-child interactions
(Fisher, Stoolmiller, Gunnar & Burraston, 2007; Fisher & Stoolmiller, 2008;
Oosterman, de Schipper, Fisher, Dozier & Schuengel, 2010). All this jeopardizes
the stability of placements (Cook, Blaustein, Spinazzola, & Van der Kolk, 2003;
Oosterman, Schuengel, Slot, Bullens & Doreleijers, 2007). Placement failure may
start a vicious circle in which the chance of another failure increases with
every breakdown. The final option, institutional placement, is wrought with its
own risks for pathological outcomes (Curtis, Alexander & Lunghofer, 2001).

In order to prevent children from residential rearing it is important to
provide foster children of the most suitable form of foster care, as early in
life as possible. Foster care is offered in two variants: (1) Regular Foster
Care, *care* is limited to minor foster parent and foster worker contacts and
(2) Treatment Foster Care, wherein children receive intensive and active forms
of treatment (MTFC-P and TFC).

The study *Effects of Regular foster Care compared to therapeutic foster care
for young foster children with psychological problems* compares the development
of children in regular and therapeutic foster care in order to provide foster
care workers of tools to consider which of the child* problems will reduce
after foster family placement a which problems require active forms of
treatment.

Aim is to compare the development of children placed in foster care without
receiving treatment (regular foster care) and children placed in foster care
and receiving treatment (therapeutic foster care).

Research outcomes determine the effect of foster family placement on children*s
development and subsequent, comparison with children in therapeutic foster care
establishes the effect of treatment over the effect of foster family placement.

Using a quasi experimental design (researchers are blind), we include 40 foster
children without receiving treatment and compare them to 80 children receiving
a protocollised treatment; MTFC-P or TFC (random allocation). Propensity score
matching will statistically correct for confounders.

The study consists of five measurements:
1. 4-6 weeks after start
2. after 3 months
3. after 6 months
4. after 9 months
5. after 12 months (end of treatment)

No more risks are expected for foster children that participate in the study.