Therapeutic Foster Care Program (TFCP) is an intensive, support-driven initiative crafted to deliver comprehensive, multidisciplinary treatment to children within a nurturing family home environment. This program is specifically tailored for children under the care of Child Protective Services (CPS) who present with significant needs and a background of complex trauma, necessitating specialized therapeutic interventions.
The primary objective of the Therapeutic Foster Care Program is to provide stability for children at risk of being placed in group care facilities or psychiatric hospitals due to emotional, behavioral, or mental health challenges. TFCP is dedicated to facilitating successful transitions to less restrictive living situations as children progress through the program. It is designed to serve children and youth up to the age of 17.
For prospective foster parents wondering if this program aligns with their capabilities, please review the examples of children in the program and the inspiring success stories from TFCP.
Current participants or those with further inquiries are encouraged to explore the program overview below and consult the Q&A section at the end of this guide. Should you not find the answers you seek, you are welcome to direct your questions to the TFCP mailbox.
How Therapeutic Foster Care Homes Differ from Traditional Foster Care Settings
A Therapeutic Foster Care Program (TFCP) home distinguishes itself by prioritizing the active involvement of the child’s next permanent caregiver right from the outset of the placement. Every child enrolled in TFCP will have a designated caregiver who will work closely with the therapeutic foster parent throughout the placement period. The TFCP treatment team ensures the identified caregiver is integral to treatment planning meetings, offering coaching, resources, and continuous after-care support to guarantee the child’s ongoing needs are effectively met. These concerted efforts are crucial in preparing the child for a successful transition beyond the TFCP program.
Therapeutic Foster Care Program homes are characterized by:
- Specialized Training: Foster parents receive evidence-based, specialized training focused on addressing the mental and behavioral health needs of children with complex challenges.
- 24/7 Case Management Support: Round-the-clock on-call case management ensures the child’s safety and security, providing continuous monitoring and immediate on-site intervention when necessary.
- Comprehensive Wraparound Services: Access to wraparound services delivered by a highly skilled treatment team that includes therapists, case managers, and psychiatric consultants.
- Low Child-to-Caregiver Ratio: A low ratio of children to professional foster parents allows for more individualized attention and care, fostering a therapeutic environment.
Duration of Placement in the Therapeutic Foster Care Program
The DFPS Therapeutic Foster Care Program is structured as a short-term intervention, typically lasting nine months. There is a provision for a one-time extension of up to three months, which requires authorization from the Associate Director of Placement, ensuring flexibility based on the child’s progress and needs.
TFCP is intentionally designed as a brief but impactful treatment phase aimed at facilitating a transition to permanency. If achieving permanency is not immediately feasible, the program’s focus shifts to transitioning the child to a traditional foster care setting, ensuring a continuum of care.
Discharge planning is initiated from the moment a child is placed in a TFCP home. CPS is mandated to prepare and plan for the child’s subsequent placement no later than 30 days following the TFCP placement, emphasizing proactive and timely transitions.
The State Office may convene a meeting upon discharge to strategically discuss permanency options and outline the next steps, ensuring a collaborative approach to the child’s future care.
After-Care Services and Ongoing Support Post-Discharge
Following discharge from the Therapeutic Foster Care Program, providers continue to offer after-care services for six months. These services are designed to ensure sustained support for both the child and their subsequent placement. After-care includes ongoing behavioral support, routine follow-up consultations, home visits, and potential respite care options. In the event of a placement disruption, the Therapeutic Foster Care Program provider will be consulted to explore possible re-placement solutions, ensuring continuous support and stability for the child.
Who are the Therapeutic Foster Care Program Providers?
Currently, there are three Child Placing Agencies in Texas authorized to provide Therapeutic Foster Care Program services: (List of agencies would be here in a complete article, but is omitted as per instructions to focus on content generation based on provided text).
Examples of Children in Therapeutic Foster Care Program
To illustrate the types of children who benefit from the Therapeutic Foster Care Program, consider the following examples:
Anna
Anna is a 12-year-old girl requiring a specialized level of care. Described as intelligent and affectionate, Anna needs a stable, structured, and loving environment. Since a disrupted adoption in 2015, Anna has struggled with escalating emotional and behavioral issues stemming from feelings of rejection. She experiences frequent tantrums and has recently shown physical aggression towards peers. Other behaviors include stealing, lying, property destruction, and bed-wetting. In 2022, Anna was hospitalized for psychiatric evaluation following a severe tantrum involving property damage and self-harm. She is considered at risk of requiring placement in a Residential Treatment Center (RTC).
Psychological Evaluation (January 22, 2023): Diagnoses include Unspecified Disruptive, Impulse-Control, Conduct Disorder; Disruptive Mood Dysregulation Disorder; and Attachment Disturbance.
Key Stressors: Prolonged foster care placement, loss of biological family ties, multiple placement changes, failed adoption, and difficulties with education and peer relationships.
John
John is a 7-year-old boy requiring a specialized level of care. Currently in psychiatric hospitalization, John needs placement upon discharge. According to CPS reports, hospitalization followed an incident at school where he was found running in the hallways, expressing suicidal thoughts. John experiences emotional outbursts and tantrums when upset, including rolling on the floor, covering his ears, and hitting walls. He has been physically aggressive towards foster siblings, and occasionally acts out in public. On positive days, he is cooperative and respectful. John is described as good-natured, talkative, and enjoys drawing. Currently, he is not considered a danger to himself or others, with no history of sexual aggression. While he has expressed suicidal ideation, he has not acted upon them. John has a composite IQ of 111 and is in the 2nd grade in regular classes. He has no family visitation.
Psychological Evaluation (March 30, 2023): Diagnoses include Major Depressive Disorder, Recurrent, Moderate; Attention-Deficit/Hyperactivity Disorder, Combined Presentation; and Unspecified Trauma and Stressor Related Disorder.
Nicole
Nicole is a 16-year-old girl requiring an intense level of care. Currently awaiting placement, Nicole has shown cooperation and stable behavior while in the office. She was recently discharged from a psychiatric hospital after achieving her therapeutic goals, marking her third hospitalization in the past year. Nicole struggles with depression, anxiety, and self-harm tendencies. She finds it challenging to express emotions constructively. A survivor of sexual abuse with a history of suicidal ideation, Nicole is on medication and attends 10th-grade special education classes. Her IQ is 82. She has made progress in identifying her triggers and is motivated to manage her anger.
Psychological Evaluation (August 4, 2022): Diagnoses include Adjustment Disorder with Mixed Disturbance of emotions and conduct; Disruptive Mood Dysregulation Disorder; and Depressive Disorder.
Therapeutic Foster Care Success Stories
The positive impact of the Therapeutic Foster Care Program is evident in numerous success stories, such as:
Y.S.’s Story
Y.S. entered a Therapeutic Foster Care (TFC) home at age 10 with a history of depression and suicidal thoughts. She engaged in non-suicidal self-harm, like scratching her arms. The program aimed to reunify Y.S. with her biological mother, who was working towards regaining custody.
In TFCP, Y.S. processed her trauma, developed a safety plan to prevent self-harm, and learned healthy coping mechanisms like journaling and seeking support. The team also worked with her mother, teaching crisis management, effective coping skills, and trigger identification. Upon program completion, Y.S. successfully reunified with her mother.
Post-program, after-care support revealed Y.S. and her family were in therapy, and Y.S. was thriving, off medication for depression and insomnia. Her mother gained full custody of Y.S. and her sibling, demonstrating a lasting positive outcome.
Alice and Trevor’s Story
Siblings Alice and Trevor completed TFCP in December 2022. They entered care due to neglect and abuse. Initially, they struggled with aggression towards each other, a challenge given their limited prior cohabitation. However, TFCP fostered significant growth. Aggressive episodes lessened, and they embraced new activities like cooking, church, and art. Encouraged by their foster parents, they excelled in school. The program included outings, even a trip to New Jersey to meet foster family relatives. They improved coping skills, respectful communication, and conflict resolution. Their efforts led to program completion and a step-down to a moderate care level, marking a remarkable journey of progress.
A.S.’s Story
A.S., age 5, was placed in TFCP due to neglect and diagnoses including Generalized Anxiety Disorder, PICA, ADHD, and Enuresis. His team noted sensory integration challenges, like disruptive sensory-seeking behaviors. Following recommendations, occupational therapy was initiated, alongside speech and individual therapy. A.S. learned about boundaries, coping skills, and verbal expression.
His foster parent reported reduced anger outbursts. A.S. responded well to Trust-Based Relational Interventions, appreciating choices and compromises. He found healthy ways to meet sensory needs, like trampolining and swinging, and overcame PICA. Outings became easier, demonstrating progress from car seat resistance to comfortable short trips. A.S. successfully transitioned to traditional foster care, showcasing substantial growth.
José’s Story
José entered TFCP in November 2020 due to aggressive behaviors towards family and teachers. His cousin, his caregiver, was considering whether she could continue caring for him. Through therapy, program support, and consistency, José’s aggression decreased. Therapy included family sessions with foster parents, José, and his cousin. José learned anger management coping skills. He progressed through day and weekend visits, returning to his cousin’s care in June 2022. José and his cousin maintain contact with the foster family, illustrating a supportive network extending beyond program completion.
Q&A About Therapeutic Foster Care
What if a child requires treatment beyond 9 months?
- Consult with the child’s CPS team and relevant parties to assess the need for extended care.
- If an extension is deemed necessary, the Child Placing Agency will submit an extension request to the Centralized Placement Unit (CPU) for the child’s legal team’s review.
- CPS will manage the subsequent steps of the extension approval process.
- Ensure the Therapeutic Foster Care Program extension request form clearly justifies the extension, detailing specific goals for the extended period and the services and plans in place to achieve them.
What is the procedure for placement changes?
- All placement changes or requests must be processed through the Regional Centralized Placement Unit.
- If a Child Placing Agency wishes to move a child to a different Therapeutic Foster Care Program placement, the Centralized Placement Unit must be informed and provide approval.
What steps should be taken if a child is experiencing a disruption?
If a child is disrupting a Therapeutic Foster Care Program placement, immediately notify the Centralized Placement Unit (CPU). This ensures the CPU is informed of all placement changes and new requests.
What if a child needs to move to another foster home within the same agency?
- If the treatment team determines that moving a child to a new Therapeutic Foster Care Program placement within the same agency is in the child’s best interest, the caseworker must be notified, approve, and complete any required new documentation. Subsequently, the DFPS Centralized Placement Unit must be notified.
- In the rare instance of a transfer between Therapeutic Foster Care Program homes within the same agency, the 9-month timeframe may restart unless otherwise requested and approved. However, any change in foster home placement necessitates approvals and due diligence checks by DFPS. This policy applies to all foster home transitions within an agency. The contractor must submit Form 2109 Discharge Notice to the Caseworker, Supervisor, Regional Centralized Placement Unit (CPU), and the Therapeutic Foster Care Program mailbox.
When is it necessary to contact the Centralized Placement Unit (CPU)?
- Contact the CPU for any placement changes, including disruptions or admissions to a psychiatric hospital requiring a 24-hour discharge notice.
- Child Placing Agencies should have protocols for respite or transition. CPU approval is not required for respite care.
How frequently is a child’s case reviewed?
- The Child Placing Agency is responsible for initiating a referral to Youth For Tomorrow (YFT) in the following situations:
- 45 days prior to planned discharge.
- In the event of an emergency discharge.
- It is crucial to refer the child to YFT before they leave the TFCP home to ensure continuous service provision.
- You can contact YFT at [email protected].
Where should discharge notices be sent?
Send discharge notices to the child’s Regional Centralized Placement Unit mailbox, and copy the CPS caseworker, supervisor, and the TFCP mailbox.
When should a discharge notice be sent?
Send Form 2109 Discharge Notice in these scenarios:
- At least 30-45 days before a planned successful discharge.
- In case of an emergency discharge or any unsuccessful discharge.
Who should be notified about new openings in Therapeutic Foster Care Program homes?
- Email the TFCP mailbox.
- Also, update the General Placement Search (GPS) application. This allows the Centralized Placement Unit to view the opening.
What is the procedure upon receiving a referral?
- Review each referral received.
- Respond to the Centralized Placement Unit and/or the DFPS TFCP mailbox for every referral. If no homes are available, reply “No home available”.
Who is eligible to become a Therapeutic Foster Care Program foster parent?
Answer: Typically, one or two foster parents highly trained to address the unique needs of the child population. Single parents may qualify if they can ensure quality care.
Quality care is defined as meeting all identified needs of the child, including medical, behavioral, cultural, educational, and spiritual needs. Employed individuals must demonstrate flexibility to meet the child’s needs. The Contractor continuously assesses the TFCP home’s ability to meet these needs, with State Office TFCP Program Specialists available for consultation.
What if CPS or a Judge requests therapy notes or child-related records?
Therapy notes and records are essential for CPS staff to understand a child’s strengths and needs accurately.
The Child Placing Agency must provide all child-related records and information to DFPS upon verbal request in emergencies. Emergency requests include situations like:
- Reviewing a child’s service level for placement changes.
- Emergency Behavior Intervention (EBI) Reports and Serious Incident Reports.
- Court-ordered requests.
- Attorney requests.
Therapeutic Foster Care Program contracts adhere to RCC 24-Hour Requirements, detailed in Section 1721, Providing Access to DFPS, which mandates providers to make all child records available to DFPS upon written request, with a 14-day submission timeframe. Records may also be requested by the Texas State Auditor’s Office (SAO), Federal Government, and their representatives.
If a TFCP provider is unclear about the CPS case details, who should they contact?
Email the TFCP mailbox to request a discussion about the case and next steps with a staff member.
For general inquiries, who should be contacted?
Please direct any general questions to the DFPS Therapeutic Foster Care Program mailbox.
