It takes a lot: Exploring implementation of therapeutic foster care as an alternative to residential care

Purpose: This process study evaluated the implementation of a 5-year Therapeutic Foster Care (TFC) pilot in Illinois as an alternative model to residential care. Methods: Focus groups with nine staff and leaders of a private TFC provider and five state child welfare agency liaisons were conducted. Focus groups were recorded, transcribed, and coded to identify key themes about the implementation and lessons from the pilot. Results: Key themes included the vital role of TFC parents and aftercare families; more observed successes among younger youth in TFC; TFC team communication, support, and continuity as key considerations; identifying a stable aftercare home as both essential for successful youth outcomes and a major challenge. Conclusions: Findings highlight key considerations for supporting youth, parents, and TFC providers through trauma-informed and culturally-responsive engagement, promoting sustainability, development, and fidelity of delivering TFC programming as a viable community-based option for youth.