Reducing the Need for Out-of-home Placements: A Randomized Controlled Trial to Examine the Effects of Family Centered Treatment on Well-Being Outcomes and Public Dollar Costs

The Duke Endowment has awarded researchers at Duke’s Center for Child and Family Policy (CCFP) a $1.6 million grant to conduct a state-wide randomized controlled study of Family Centered Treatment ®. The project will be implemented in partnership with the Family Centered Treatment Foundation (FCTF), a nonprofit organization serving over 60 sites across 10 U.S. states. FCTF provides licensing, training, and oversight of the Family Centered Treatment (FCT) model to human service organizations. The FCTF’s mission is to enhance the capability of agencies, communities and state systems of care in the implementation of evidence-based programs to better address the needs of families in crisis.

This five-year longitudinal study will examine the effectiveness of the FCT model on youth, family and cost outcomes, relative to out-of-home placements. This study will be the first randomized controlled trial of FCT and, by comparing in-home therapy with residential care for high-risk children/youth, will fill a gap in the evidence base. Other key collaborators include Duke University’s Robert J. Margolis, MD, Center for Health Policy, as well as multiple managed care organizations across North Carolina.

The Center for Child and Family Policy will enroll approximately 750 children/youth and their families in the longitudinal study over 2 ½ years. To monitor progress in child/youth and family well-being across multiple domains, youth and their caregivers recruited into the study will participate in baseline and follow-up interviews conducted by CCFP at six-month intervals for up to 18 months. With consent, participant records will be linked to multiple administrative datasets. Duke University’s Margolis Center for Health Policy will conduct a cost-benefit analysis designed to compare the value of FCT relative to Level III out-of-home placement.