June 3, 2009 A program aimed at reducing criminal behavior in juvenile justice teens has yielded a surprising side benefit. The program is also reducing the teens' rate of pregnancy, according to a new study out this week.
David Kerr, an assistant professor in the Department of Psychology at Oregon State University, and Leslie Leve and Patricia Chamberlain of the Eugene-based Oregon Social Learning Center, conducted the research, which will be published in the April edition of the Journal of Consulting and Clinical Psychology. Their work was funded in part by grants from the National Institute on Drug Abuse and the National Institute of Mental Health at the National Institutes of Health (NIH).
The study was conducted with 166 teen girls ages 13-17 with histories of criminal behavior who had been court-mandated to receive out-of-home treatment. The girls were randomly assigned to either receive the Multidimensional Treatment Foster Care (MTFC) program, which involved one-on-one care in the homes of highly trained foster parents, or the services they would have received had they not participated in the study, which was usually treatment in a group care facility.
The results were dramatic, according to lead author Kerr of OSU. About 26 percent of the girls assigned to receive the specialized Treatment Foster Care program became pregnant, compared to almost 47 percent of teens in group care.
"These girls are extremely compromised," Kerr said. "They are not doing well. They have had a hard time in different areas, including criminal behavior, drugs and risky sexual activity. Many of them had already been pregnant before the time of the intervention."
Kerr said while teen pregnancy rates have fallen in recent years, the United States still has one of the highest rates compared to other industrialized nations. And that rate is even higher among females in the foster care system. One survey of child welfare systems in three states found that nearly half of girls in the foster system reported a pregnancy by age 19.
The specialized foster care program places the teen in a highly supervised foster parent setting. The state-certified foster parent or parents have been given additional training on how to work with high-risk youth, and were provided with ongoing consultation, support and crisis intervention services from program supervisors.
"One of the most interesting aspects of this research is that the MTFC program was created to reduce crime, not pregnancy," Kerr said. "It specifically targeted changing the girl's environment: her home, her peers and her school experience. The focus was on giving her lots of supervision, support for responsible behavior, and consistent, non-harsh consequences for negative behavior. And this worked to reduce pregnancy rates."
According to Kerr, each girl and her caregiver were interviewed one and two years into the study. The greater reductions in teen pregnancy, as well as reductions in criminal activity and arrests and increases in school engagement, were found in the group that was assigned to receive the specialized Treatment Foster Care services.
Currently there are 51 of these specialized foster care programs in the US and Canada, 41 in Europe and 1 in New Zealand. New program sites are being trained and certified each year by Eugene-based TFC Consultants, Inc.
The standard group care approach to treating a juvenile justice case costs $7,000 less than using the specialized Treatment Foster Care in the short-term. However, Kerr said that an independent analysis of teen boys showed that the dramatic reductions in criminal activity among teens in the specialized program costs taxpayers and crime victims $78,000 less per teen in the long term.
"The figures aren't available for girls yet, but delaying unintended pregnancies should add to that savings. But aside from the economics," he said, "the real plus is helping a high-risk teen grow up some more before she takes on that important job of motherhood. That's good for everyone."
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- Kerr, David C. R.; Leve, Leslie D.; Chamberlain, Patricia. Pregnancy rates among juvenile justice girls in two randomized controlled trials of multidimensional treatment foster care. Journal of Consulting and Clinical Psychology, 2009; 77 (3): 588-593 [link]
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