Patricia
Chamberlain,
Patricia
Chamberlain,
Primary research and clinical interestsDr. Chamberlain’s interest in developing interventions for children and families emerged from her early work as a special education teacher. She has conducted several studies on treatment for children, youth, and families in the juvenile justice, mental health and child welfare systems. She founded the Multidimensional Treatment Foster Care (www.mtfc.com) and KEEP (www.keepfostering.org) intervention models. MTFC is an alternative to group, residential, and institutional placement for youngsters with severe antisocial behavior and mental health problems. KEEP provides enhanced support and training to state foster and kinship parents to prevent placement disruptions, improve reunification rates, and reduce child behavioral and emotional problems. She has been the Principal Investigator on 8 randomized trials examining the efficacy of parent mediated intervention approaches. A current area of focus is on implementation research which examines what it takes to integrate and scale-up evidence-based practices in to real world agencies and systems. Dr. Chamberlain is also doing research on the development of intervention models for adolescent girls in the juvenile justice and child welfare systems that address girl’s unique needs . In addition to working on research aimed at improving outcomes for youth and foster and biological families, she is interested in how to support child public service systems to improve the efficiency of their routine practices. She is involved in helping communities in the U.S. and Europe implement MTFC and KEEP and is a partner in Treatment Foster Care Consultants Inc.
Lewis, K., & Chamberlain, P. (in press). What works in treatment foster care. In P. A. Curtis (Ed.), What works in Child Welfare. Washington, DC: CWLA Press.
Abstract: The treatment foster care program model (TFC) recognizes that many youth who enter the foster care system require additional services and support. To this end, TFC aims to create a positive environment to keep youth in home-based settings in their community and out of more restrictive care settings such as hospitals, group homes, detention centers, and residential care. More specifically, TFC provides foster youth and families with enhanced services, skills, and support to manage challenging behaviors. This chapter examines the definition and scope of the model, the populations who are served, the existing evidence base for the model, and challenges to implementing TFC in communities. Finally, we comment on future directions for this widely used service model. What works in treatment foster care? A growing body of rigorous research studies indicates that coordinated care across settings, consistency, and ongoing training and support for the foster parents on the front lines result in improved outcomes for youth and families. Further, the studies attest to the model’s effectiveness both in the home and in the wider community—TFC represents a cost-effective alternative in both the short and long terms for youth and taxpayers alike.
Rhoades, K. A., Chamberlain, P., Roberts, R., & Leve, L. D. (in press). MTFC for high risk adolescent girls: A comparison of outcomes in England and the US. Journal of Child and Adolescent Substance Abuse.
Abstract: The current study examined 12-month outcomes for girls enrolled in an implementation trial of Multidimensional Treatment Foster Care (MTFC) in England. In addition to examining changes from pre-treatment to post-treatment, we also compared results for girls enrolled in the England implementation trial to girls enrolled in two randomized controlled trials (RCTs) of MTFC in the United States. The England MTFC sample included 58 girls in foster care between the ages of 12 and 16. The US MTFC intervention samples included 81 girls between the ages of 13 and 17 who were referred to out-of-home care due to chronic delinquency. Results indicated improvement in offending, violent behavior, risky sexual behavior, self-harm, and school activities for girls enrolled in the England implementation trial. The effect sizes of these results were similar to those obtained in the US RCTs, with the exception of substance use which showed significant decreases for girls enrolled in the US RCTs, but not for girls enrolled in the England implementation trial. These results, in combination with other cross-cultural findings, support the notion that MTFC might be relevant across US and European cultures.
Saldana, L., & Chamberlain, P. (in press). Supporting implementation: The role of Community Development Teams to build infrastructure. American Journal of Community Psychology.
Abstract: Evidence-based methods for assisting communities in successfully implementing practices are lacking in the field of implementation science. To fill this gap, the Community Development Teams (CDT) was developed to assist counties in developing peer networks focused on problem-solving and resource sharing to enhance their possibility of successful implementation. The CDT is an interactive, solution-focused approach that incorporates elements of the Interactive Systems Framework (ISF) for Dissemination and Implementation, An ongoing randomized implementation trial of Multidimensional Treatment Foster Care (MTFC) was designed to test the hypothesis that such interactive implementation methods are more successful at helping counties achieve successful and sustainable MTFC programs than standard individualized implementation methods. Using the Stages of Implementation measure, developed for this study, the potential benefit of these interactive methods is examined at different stages of the implementation process ranging from initial engagement to program competency.
Chamberlain, P., & Brown, C. H., & Saldana, L. (2011). Observational Measure of Implementation Progress: The Stages of Implementation Completion (SIC). Implementation Science, 6, 116.
Abstract
Background
An increasingly large body of research is focused on designing and testing strategies to improve knowledge about how to embed evidence-based programs (EBP) into community settings. Development of strategies for overcoming barriers and increasing the effectiveness and pace of implementation is a high priority. Yet, there are few research tools that measure the implementation process itself. The Stages of Implementation Completion (SIC) is an observation-based measure that is used to track the time to achievement of key implementation milestones in an EBP being implemented in 51 counties in 53 sites (two counties have two sites) in two states in the United States.
Methods
The SIC was developed in the context of a randomized trial comparing the effectiveness of two implementation strategies: community development teams (experimental condition) and individualized implementation (control condition). Fifty-one counties were randomized to experimental or control conditions for implementation of multidimensional treatment foster care (MTFC), an alternative to group/residential care placement for children and adolescents. Progress through eight implementation stages was tracked by noting dates of completion of specific activities in each stage. Activities were tailored to the strategies for implementing the specific EBP.
Results
Preliminary data showed that several counties ceased progress during pre-implementation and that there was a high degree of variability among sites in the duration scores per stage and on the proportion of activities that were completed in each stage. Progress through activities and stages for three example counties is shown.
Conclusions
By assessing the attainment time of each stage and the proportion of activities completed, the SIC measure can be used to track and compare the effectiveness of various implementation strategies. Data from the SIC will provide sites with relevant information on the time and resources needed to implement MTFC during various phases of implementation. With some modifications, the SIC could be appropriate for use in evaluating implementation strategies in head-to-head randomized implementation trials and as a monitoring tool for rolling out other EBPs.