Program Helps Troubled Boys Reduce Substance Abuse

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Photo of a boy with and adult looking on Fostering Self Control: Youth in Multidimensional Treatment Foster Care live with foster parents who help them develop control over their behavior. Foster parents implement a system in which youths earn praise and privileges for positive behaviors but have perks removed or are assigned chores for rule violations and minor behavior problems. Credit: Getty Images

A foster care program that was previously shown to reduce delinquency also decreases illicit drug use among teenage boys, report Dr. Patricia Chamberlain and colleagues at the Oregon Social Learning Center. A group of seriously and chronically delinquent boys aged 12 to 17 reported 30 percent less use of abused drugs other than marijuana (i.e., cocaine, amphetamines, LSD, heroin, mushrooms, phencyclidine, morphine, and inhalants) a year following their placement in Multidimensional Treatment Foster Care (MTFC) than during the 6 months prior to placement in the program. A comparison group of boys who had been placed in community-based group care (GC) also reduced their use of these drugs, but only by 15 percent. Both groups of boys reported less use of marijuana, as well as the other drugs, 18 months after placement in the programs compared to the 6 months prior to placement; once again, the MTFC group’s use rates were lower than the GC group’s.

The 79 boys who participated in the study were randomly assigned to MTFC or GC. Although their primary problem was delinquent behavior, 90 percent reported using tobacco, alcohol, or an illicit substance during the 6 months before the study, an observation that accords well with the results of prior research on delinquent boys.

The MTFC program trains foster parents in daily behavior management techniques that include clear and consistent rules, frequent reinforcement and increasing privileges for good behavior, and mild punishments such as loss of privileges for undesirable behavior. Counselors help parents tailor the techniques for the needs of each youth, provide ongoing support, and prepare the youths’ biological parents (or others who will have custody) for family reunification. The intense supervision and monitoring in MTFC decreases the time the teens spend with peers who act out and enhances their relationships with adults.

The results add to the previously reported benefits of MTFC (see "Program Reduces Girls' Delinquent Behavior,"), which the researchers say is the only evidence-based program designed explicitly for delinquent youths in foster care. Dr. Chamberlain and colleagues suggest that the same elements of MFTC that help reduce delinquent behavior also counteract youth substance abuse. The researchers have recently described models whereby intervention researchers and community stakeholders collaborate to implement evidence-based treatments such as MTFC on a larger scale.

Moving in a Good Direction: Boys who participated in Multidimensional Treatment Foster Care reported greater declines in substance use 18 months after placement than those in community-based group care.
  Multidimensional Treatment Foster Care Community-Based Group Care
Marijuana -39 percent -11 percent
Other Illicit Drugs -33 percent -14 percent
Alcohol -30 percent -25 percent
Tobacco -3 percent +11 percent


Administration and Policy in Mental Health [Epub ahead of print June 28, 2011]. [Abstract]

Journal of Child and Adolescent Substance Abuse 19(4):343–358, 2010. [Full Text (PDF, 238KB)]