Family Care Treatment for dispersed populations of children with behavioral challenges: The design, implementation, and initial outcomes of an evidence-informed treatment

•We describe an application of the principles of MTFC to a rural field setting.•We describe changes in child/youth behavior before and during treatment.•We describe the stability of residential placement.•Results indicate increased pro-social youth behavior and residential stability.

Children and adolescents in rural settings have behavioral needs similar to those living in urban areas, but often have less access to services. The nature of a dispersed population makes factors such as transportation and the availability of trained personnel barriers to the needed services. Multidimensional Treatment Foster Care (MTFC) is an especially effective example of an evidence-based, community-integrated service delivery option that advances positive child outcomes. Although aspects of Multidimensional Treatment Foster Care are not functional for many rural settings the principles of MTFC such as, consistently applied contingencies and parent-as-interventionist are applicable. This manuscript describes the principles-based application of MTFC in a rural area and discusses how principles-based treatment can produce outcomes predicted by more systematic replications. These outcomes include enhancing the stability of residential placement for children and youths, increasing pro-social child behavior and use of the least restrictive strategies and settings.