Condition category
Not Applicable
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status
No longer recruiting
Publication status

Plain English Summary

Background and study aims
The Department for Education and Skills is promoting a new model of treatment foster care (MTFC). This study aims to see how this new type of foster care compares with the other types of care already being used for these young people.

Who can participate?
The young people who are aged 11–16 years and, in a care placement which was unstable, at risk of breakdown or not meeting their assessed needs, or at risk of custody or secure care and, who show complex or severe emotional difficulties and/or challenging behaviour.

What does the study involve?
Two groups of young people in care will be followed up over a 12 month period. One group will be placed in MTFC where they will be looked after by a specially trained MTFC foster carer. The young people will also receive support from a team of mental health and education professionals. When they are in an MTFC placement the young people follow a special programme which includes daily monitoring and a points and levels system. As they move up the levels the young people earn more privileges and when they reach the highest level they graduate from the programme. The other group of young people will receive the usual range of care placements which include normal foster care and residential care.

What are the possible benefits and risks of participating?
We do not anticipate any risks that may adversely affect the participants as a result of taking part in the trial. Young people will be fully informed as to what their participation in the research will involve. We do not anticipate any risks to research staff. All research staff are certificated by the
Criminal Records Bureau.

Where is the study run from?
Universities of York and Manchester

When is the study starting and how long is it expected to run for?
The study started in 2005. Recruitment will ended in 2009 and the final follow-up was in 2010.

Who is funding the study?
Department for Education and Skills

Who is the main contact?
Prof. Jonathan Green

Trial website

Contact information



Primary contact

Prof Jonathan Green


Contact details

Royal Manchester Childrens Hospital
Jean McFarlane Building
Oxford Road
M13 9PL
United Kingdom
+44 (0)161 306 7941

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

Evaluation of treatment foster care in England



Study hypothesis

Placement in Multidimensional Treatment Foster Care (MTFC) will result in enhanced global functioning for the most troubled young people in care in England.

Ethics approval

University of York, IRISS Ethics Committee, 01/06/2005, ref: PKLG

Study design

Two-arm multiple-centre single (assessor) blinded randomised controlled trial embedded in a quasi-experimental
observational study

Primary study design


Secondary study design

Randomised controlled trial

Trial setting


Trial type

Quality of life

Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Evaluation of Multidimensional Treatment Foster Care in England for Adolescents


MTFC represents an enhancement of traditional foster care in two ways.
1. Specialist foster parents will receive training and ongoing supervision in an intensive social learning
2. The provision of multidisciplinary team input including psychiatry and psychology
The treatment as usual (TAU) intervention will be heterogeneous; consisting of existing foster care, residential care, or other placements.

Intervention type



Drug names

Primary outcome measure

Two summative measures of mental health and social and physical functioning:
1. The standard Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) (Gowers, Harrington, Whitton, et al., 1999)
2. Children’s Global Assessment Scale (CGAS, (Shaffer, Gould and Brasic, 1983)

Secondary outcome measures

Participation in education or training and involvement in offending at follow-up

Overall trial start date


Overall trial end date


Reason abandoned (if study stopped)


Participant inclusion criteria

Eligibility for the trial mirrors the eligibility criteria set out by the National Implementation Team for inclusion in the MTFC programme. Young people are eligible for MTFC if they are:
1. Age 11–16 years and
2. In a placement which was unstable, at risk of breakdown or not meeting their assessed needs, or at risk of custody or secure care
3. Showing complex or severe emotional difficulties and/or challenging behaviour

Participant type


Age group




Target number of participants

Total sample size of 220 (75 MTFC, 145 TAU), of which 130 (50, 80) will be in the RCT and 90 (25,65) will be in the case control study.

Participant exclusion criteria

Young people diagnosed with a moderate or severe learning difficulty might not be considered suitable for the MTFC programme and therefore the trial, as it is necessary for those entering MTFC to understand and work within the programme’s points and levels system.

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Royal Manchester Childrens Hospital
M13 9PL
United Kingdom

Sponsor information


University of Manchester (UK)

Sponsor details

Oxford Road
M13 9PL
United Kingdom

Sponsor type




Funder type


Funder name

Department for Education and Skills (UK)

Alternative name(s)

Funding Body Type

Funding Body Subtype


Results and Publications

Publication and dissemination plan

Not provided at time of registration

Intention to publish date

Participant level data

Not provided at time of registration

Basic results (scientific)

Publication list

2013 results in:
2015 results in:

Publication citations

  1. Results

    Green JM, Biehal N, Roberts C, Dixon J, Kay C, Parry E, Rothwell J, Roby A, Kapadia D, Scott S, Sinclair I, Multidimensional Treatment Foster Care for Adolescents in English care: randomised trial and observational cohort evaluation., Br J Psychiatry, 2014, 204, 3, 214-221, doi: 10.1192/bjp.bp.113.131466.

  2. Results

    Sinclair I, Parry E, Biehal N, Fresen J, Kay C, Scott S, Green J, Multi-dimensional Treatment Foster Care in England: differential effects by level of initial antisocial behaviour, Eur Child Adolesc Psychiatry, 2015 .

Additional files

Editorial Notes