Randomized Trials

  • Children and adolescents from CWS leaving a state psychiatric hospital
  • Boys from juvenile justice for chronic delinquency
  • Girls from juvenile justice with severe mental health problems and abuse histories (2)
  • Child welfare “challenging” children
  • Child welfare children receiving a next placement
  • 6th grade girls in foster care
  • Young children in foster care

Boys Follow Up Outcomes


  • ½ the number of arrests (and significantly lower violence rates)
  • 2/3 fewer days incarcerated
  • Significantly less hard drug use


  • Significantly more time living with family
  • Fewer runaways
  • Less time with antisocial friends on the street


  • Higher rates of school attendance and homework completion
  • Higher ratings of life satisfaction


Girls Follow Up Outcomes

  • Reduced delinquency (arrests, days in locked settings)
  • Reduced deviant peer association
  • Increased school attendance & homework time
  • Fewer unintended pregnancies
  • Reduced depressive symptoms
  • Decreased psychotic symptoms


Girls Long Term Outcomes Compared to Treatment as Usual (9.5 yrs.) 

  • Decreased criminal offenses
  • Decreased severity of offenses committed
  • Decreased unintended pregnancies
  • Decreased depressive symptoms
  • Decreased suicidal ideation
  • Partner choice is related to long term substance use outcomes for THC and hard drugs
  • Decreased involvement in Child Welfare system as parent

Cost Savings

TFCO has a demonstrated, long-term cost benefit!

For every $1.00 spent on TFCO treatment compared to usual care, there is a benefit of:

  • $3.15 at 4.5 years, when considering child welfare and criminal justice involvement.
  • $4.35 at 9½ years, when considering child welfare and criminal justice involvement.