Intervenções com crianças e adolescentes em acolhimento institucional: uma revisão sistemática

O objetivo dessa revisão sistemática foi levantar estudos empíricos que tiveram o objetivo de minimizar ou prevenir problemas de comportamento em crianças e adolescentes em situação de acolhimento institucional. Foram utilizadas seis bases de dados: PsycINFO, SageJournals, Web of Science, PubMed/Medline, Lilacs e Scopus. Os critérios de seleção incluíram todos os estudos, publicados em inglês e português, disponíveis entre 2009 e 2019 que tivessem o objetivo avaliar a eficácia e aplicabilidade de intervenções para reduzir ou prevenir problemas de comportamento com essa população. Ao todo foram encontrados 155 estudos e após o processo de exclusão e elegibilidade, restaram 24 artigos incluídos em análise quantitativa. A qualidade dos estudos foi avaliada utilizando Cochrane Riskof Bias Tool e a Quality Assessment Tool. Verificou-se forte evidência do Multidimensional Treatment Foster Care (MTFC) na prevenção e tratamento de problemas de comportamento em crianças e adolescentes em acolhimento institucional.

Treatment Foster Care Oregon for Delinquent Adolescents: A Systematic Review and Meta-Analysis

Purpose: To examine the effects of Treatment Foster Care on youth with serious behavior problems. Method: Included studies are controlled trials with high or medium quality, published between 1990 and September 2017. The control group consists of youth with serious behavior problems in group care, and the follow-up time was at least 12 months. The review also examines ethical and economic aspects. Results: A total of eight controlled studies were included, consisting of 633 young people and 55 effect sizes. All studies examined the same model, Treatment Foster Care Oregon (TFCO). There is moderate certainty of evidence that TFCO reduces the risk of future criminal behavior and the number of days in locked settings. Furthermore, there is low certainty of evidence that TFCO reduces the risk of delinquent peer associations, drug use, and depression. Discussion: TFCO is to be preferred to group care for youth with serious behavior problems. Ethical and economic implications are discussed.

The Therapeutic Family Care Program: A 10-year community implementation of Treatment Foster Care in Ontario, Canada

The present study describes a community implementation of treatment foster care (TFC) for children and youth involved with child welfare in Ontario, Canada. There were two guiding research questions: (1) how are children and adolescents changing over the course of services and (2) how have the placements of children and adolescents changed over time? Clinical outcomes were tracked using the Assessment Checklist for Children (ACC) and Assessment Checklist for Adolescents (ACAs)—clinical tools that were specially designed to assess the functioning of young people in care. There were 1,068 ACCs on 518 children, and 559 ACAs on 222 adolescents. Each additional year of involvement with Therapeutic Family Care Program corresponded to additional improvement for both children, d = −.18; 95% confidence interval (CI) = −.25 to −.12, and adolescents, d = −.11; 95%CI = −.18 to −.03. Moderators and subdomains of clinical improvement were considered, though findings generally revealed significant improvement over time for most youngsters in most clinical areas. At the program level, there has been a significant increase in placement permanence across the last decade (i.e., greater prevalence of birth parent, adoption, and kinship care). In sum, this study illustrates an example of community implementation for TFC in a child welfare setting, which necessarily includes the systematic tracking of outcomes in the context of evidence-supported intervention.