Treatment Foster Family Care (TFFC) is an innovative program meticulously crafted to deliver comprehensive, multi-disciplinary treatment services to children with significant needs within a nurturing family home environment. Specifically designed for children under the conservatorship of the Department of Family and Protective Services (DFPS) who have experienced complex trauma and require intensive therapeutic intervention, TFFC offers a specialized approach to care.
The primary objective of Therapeutic Foster Family Care is to provide stability for children at imminent risk of placement in congregate care settings or psychiatric hospitals. These are children grappling with emotional, behavioral, or mental health challenges that necessitate a higher level of support. TFFC is dedicated to facilitating successful transitions for these children towards less restrictive and more permanent placements as they progress through the program. This vital program extends its services to children aged 17 years and younger.
To help you determine if becoming a therapeutic foster parent within this program aligns with your capabilities and passion, explore compelling examples of children in the program and inspiring success stories.
For current participants or those seeking deeper insights, delve into the detailed program overview and consult the comprehensive Q&A section at the end of this page. Should you have further inquiries that remain unanswered, please don’t hesitate to reach out to the TFFC mailbox.
How Therapeutic Foster Care Homes Differ from Traditional Foster Homes
A Therapeutic Foster Family Care (TFFC) home distinguishes itself by prioritizing the active involvement of the child’s next potential permanent caregiver right from the outset of placement. For every child benefiting from TFFC services, there is an identified caregiver who is integral to the foster parent partnership throughout the placement duration. The TFFC treatment team ensures this collaboration by including the identified caregiver in crucial treatment planning meetings. Furthermore, the team provides essential coaching, resources, and comprehensive after-care services, all aimed at guaranteeing the child’s continued well-being and progress even after transitioning from the TFFC program. This proactive and inclusive approach significantly enhances the likelihood of a child’s long-term success beyond the program.
Therapeutic Foster Family Care homes are characterized by several key features:
- Specialized Training: Foster parents receive evidence-based, specialized parenting training focused on the unique mental and behavioral health needs of high-needs children. This equips them with advanced skills and knowledge to provide effective care.
- 24/7 On-Call Support: Around-the-clock on-call case management is available to ensure the child’s safety and security. This includes frequent monitoring and the capacity for immediate on-site response in crisis situations, providing a robust safety net.
- Wraparound Services: Children and foster families benefit from wraparound services delivered by a highly trained, multi-disciplinary treatment team. This holistic approach addresses all facets of the child’s needs.
- Low Child-to-Caregiver Ratio: Professional foster parents maintain a low child-to-caregiver ratio, allowing for more individualized attention and intensive support tailored to each child’s specific therapeutic requirements.
Duration of Placement in the TFFC Program
The DFPS Therapeutic Foster Family Care Program is structured as a short-term, intensive intervention, with placements typically lasting up to nine months. In certain circumstances, a one-time extension of three months may be authorized by the Associate Director of Placement, allowing for a maximum program duration of twelve months.
TFFC is intentionally designed to be a temporary therapeutic solution aimed at facilitating a path towards permanency for the child. If reunification with family or adoption is not immediately feasible, the program focuses on transitioning the child to a traditional foster home setting that can provide ongoing stability and care.
Discharge planning is a proactive process that commences from the very beginning of a TFFC placement. CPS is mandated to initiate planning for the child’s subsequent placement no later than 30 days after the child enters a TFFC home, ensuring a smooth transition and continuity of care.
The State Office may convene a meeting at the time of discharge to collaboratively discuss permanency options and determine the most appropriate next steps for the child’s long-term well-being.
After-Care Services Following TFFC Discharge
Upon discharge from the Therapeutic Foster Family Care program, comprehensive after-care services are provided to ensure ongoing support for the child and their subsequent placement for a period of six months. These after-care services encompass continued behavioral support strategies, regular follow-up contacts, scheduled home visits, and access to respite care options if needed. In the event of a placement disruption, the Therapeutic Foster Family Care provider will be contacted to explore potential re-placement alternatives, ensuring a safety net for the child even after program completion.
Who are the Therapeutic Foster Care Providers?
Currently, there are three Child Placing Agencies in Texas authorized to provide Therapeutic Foster Family Care services. For specific agency names and contact information, please refer to the DFPS website. [Note: In the original article, the names of providers were intentionally left blank. For a live article, you would insert the names and links to the Child Placing Agencies here.]
Examples of Children in the TFFC Program
The Therapeutic Foster Family Care program is designed to support children with a wide range of complex needs. Here are examples of children who have benefited from TFFC:
- Anna:
- John:
- Nicole:
Anna
Anna is a 12-year-old girl requiring a specialized level of care. Anna is an intelligent and affectionate child who needs stability, accountability, patience, love, and structure in her life. Since experiencing a disrupted adoption in 2015, Anna’s behavior has progressively deteriorated due to the emotional trauma of rejection and the fear of not returning to her adoptive home. Anna experiences frequent tantrums, and recently her behaviors have escalated to physical aggression towards peers. Other concerning behaviors include stealing, lying, property destruction, and bedwetting. In 2022, Anna was hospitalized in a psychiatric facility after a severe tantrum involving property damage (breaking windows) and self-harm. She is considered at risk of requiring a Residential Treatment Center (RTC) placement.
Psychological Evaluation (January 22, 2023): Diagnoses include Unspecified Disruptive, Impulse-Control, and Conduct Disorder; Disruptive Mood Dysregulation Disorder; and Attachment Disturbance.
Key Stressors: Long-term placement in foster care, loss of all biological family members, numerous placement changes since removal from her biological family, the trauma of adoptive placement disruption, and ongoing educational and peer relationship challenges.
John
John is a 7-year-old boy requiring a specialized level of care. John is currently hospitalized in a psychiatric facility and requires placement upon discharge. According to CPS reports, John was admitted after running through school hallways stating he was going to harm himself. John experiences significant emotional outbursts when upset and displays tantrum behaviors when redirected, including rolling on the ground, covering his ears, and hitting walls. He has exhibited physical aggression towards foster siblings, including hitting, pushing, and pinching, and has occasionally acted out in public settings. On positive days, John can follow instructions and demonstrate respect. He is described as a good-natured and talkative young boy who enjoys drawing. Currently, John is not considered a danger to himself or others and shows no signs of sexual aggression. While he has expressed suicidal ideations, he has never acted on them. He has no known physical illnesses and has a composite IQ of 111. John is in the 2nd grade in regular classes. There are no family visits scheduled.
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. Nicole is currently in an office setting awaiting placement. She has been cooperative with staff and has not exhibited significant behavioral issues recently. She was recently discharged from a psychiatric hospital after successfully achieving her therapeutic goals during her third hospitalization in the past year. Nicole struggles with depression, anxiety, and self-harming tendencies. She finds it challenging to express her emotions in healthy and constructive ways. Nicole is a survivor of sexual abuse and has a history of suicidal ideations. She is currently on medication and attends 10th-grade special education classes. Her IQ is 82. Nicole has made progress in identifying her emotional triggers and expresses a desire to manage her anger effectively.
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 Therapeutic Foster Care is evident in the lives of children and families it serves. Here are some inspiring success stories:
- Y.S.’s Story
- Alice and Trevor’s Story
- A.S.’s Story
- José’s Story
Y.S.’s Story
Y.S. was a 10-year-old girl when she entered a Treatment Foster Care (TFC) home. Y.S. had a history of depression and suicidal ideations. She also engaged in non-suicidal self-injurious behaviors, such as scratching her arms with pencils or fingernails. The primary goal for Y.S. was reunification with her biological mother, who was actively participating in services to facilitate Y.S.’s return home.
During her time in the TFC program, Y.S. was able to process her trauma openly. She actively participated in developing a personalized safety plan to prevent self-harm or harm to others. Y.S. learned effective coping mechanisms, including journaling, going for walks, and seeking support from trusted caregivers. Y.S.’s treatment team also collaborated closely with her mother, educating her on how to support Y.S. during crises, reinforcing effective coping skills, and identifying potential triggers. Upon successful completion of the program, Y.S. was joyfully reunified with her mother.
Through ongoing aftercare support, Y.S.’s mother reported that the family was engaged in both family and individual therapy. Y.S. was thriving, as evidenced by self-reports and her mother’s observations. Y.S. remained stably at home with her family, and her mother reported no further incidents of self-harm or suicidal ideation. Y.S. was successfully weaned off her depression and insomnia medications. Furthermore, Y.S.’s mother achieved full custody of Y.S. and her sibling, marking a complete family restoration.
Alice and Trevor’s Story
Siblings Alice and Trevor successfully graduated from the TFC program in December 2022. Alice and Trevor entered CPS care due to a background of neglect and physical and emotional abuse. Initially, they struggled with verbal and physical aggression towards each other. Despite sibling affection, the children had not lived together consistently for an extended period, making the transition to cohabitation challenging. However, Alice and Trevor demonstrated remarkable growth throughout the program. Their aggressive episodes decreased significantly in intensity and duration, and they became receptive to new experiences, such as cooking, church activities, and art creation. Motivated by their foster parents, Alice and Trevor excelled academically and passed their classes. During their program participation, they enjoyed outings, including a memorable trip to New Jersey to visit their foster parents’ relatives! These siblings made significant strides in utilizing healthy coping skills, employing respectful communication, and practicing conflict resolution when disagreements arose. Their dedication, openness, and perseverance led to their successful completion of the TFC program, culminating in a transition to a moderate level of care, demonstrating remarkable progress.
A.S.’s Story
A.S. was 5-years-old when he was placed in a TFFC home. A.S. had a history of neglect and diagnoses including Generalized Anxiety Disorder, PICA, ADHD, and Enuresis. A.S.’s treatment team recognized his sensory integration challenges. For instance, A.S. sought sensory input in disruptive ways, such as jumping on furniture or bumping into others. Following the treatment team’s recommendations, the foster parent pursued an occupational therapy evaluation for A.S., which he qualified for. A.S. began sensory integration therapy with an occupational therapist and also qualified for speech therapy for expressive language disorder. Additionally, A.S. participated in individual therapy, where he learned about boundaries, coping skills, and verbalizing his needs.
The foster parent reported a significant decrease in the frequency, intensity, and duration of A.S.’s anger outbursts. A.S. responded positively to Trust-Based Relational Interventions and benefited from having choices and compromises offered to him. A.S. demonstrated the ability to meet his sensory needs in healthy ways, such as using a trampoline, swinging, or appropriately requesting help. The foster parent also noted that A.S. ceased attempting to eat inedible objects, a behavior associated with his PICA diagnosis. A.S. became able to participate in outings with minimal difficulties. The foster parent highlighted A.S.’s substantial progress, from being unable to remain in his car seat to staying seated for short trips. A.S. successfully discharged from the program and transitioned to a traditional foster home, indicating significant overall improvement.
José’s Story
José entered the program on November 30, 2020, due to behavioral challenges that his cousin, his then-caregiver, was struggling to manage. José was regularly hitting his cousin, brother, and teachers. His cousin expressed concerns about her capacity to continue caring for José due to these behaviors. Through consistent therapy, the TFFC program, and a structured environment, José gradually ceased exhibiting these aggressive behaviors. The therapist facilitated family therapy sessions involving the foster family, José, and José’s cousin, as well as family therapy specifically for José, his brother, and cousin. José continued to develop anger management skills and utilize coping strategies. He began with day visits, progressed to weekend visits, and ultimately returned to his cousin’s care on June 30, 2022. José and his cousin maintain contact with the foster family, and he is welcome to call or visit them whenever he wishes, demonstrating a lasting positive connection.
Q&A About Therapeutic Foster Care Program
What if a child requires treatment beyond 9 months?
- Consult with the child’s CPS team and relevant stakeholders to assess the necessity for extended treatment.
- If an extension is deemed necessary, the Child Placing Agency will complete an extension request and submit it to the Centralized Placement Unit (CPU) for review by the child’s legal team.
- CPS will manage the subsequent extension approval process.
- Ensure the Therapeutic Foster Family Care extension request form comprehensively justifies the need for an extension. Clearly articulate the specific goals to be achieved during the extension period and detail the services and plans in place to facilitate the child’s progress towards those goals.
What procedures are in place for placement changes?
- All placement changes or requests must be processed through the Regional Centralized Placement Unit.
- If a Child Placing Agency proposes moving a child to a different Therapeutic Foster Family Care placement, the Centralized Placement Unit must be notified and provide approval prior to the move.
What steps should be taken if a child is experiencing a placement disruption?
In the event of a placement disruption within a Therapeutic Foster Family Care setting, immediately notify the Centralized Placement Unit (CPU). This ensures the CPU is informed of all placement changes and any new placement requests that may arise.
What is the process if a child needs to transition to another foster home within the same agency?
- If the treatment team determines that moving a child to a new Therapeutic Foster Family Care placement within the same agency is in the child’s best interest, the caseworker must be notified, provide approval, and complete any required new documentation. Subsequently, the DFPS Centralized Placement Unit must be formally notified.
- In the rare instance of a child transitioning from one Therapeutic Foster Family Care home to another within the same agency, the initial 9-month program timeframe will typically restart, unless a different arrangement is specifically requested and approved. However, any change in foster home placement requires appropriate approvals and due diligence checks by DFPS. This protocol is consistent with any foster home transition within an agency. Therefore, the contractor must submit Form 2109 Discharge Notice to the Caseworker, Supervisor, Regional Centralized Placement Unit (CPU), and the Therapeutic Foster Family Care mailbox.
When is it necessary to contact the Centralized Placement Unit (CPU)?
- Contact the CPU whenever any type of placement change occurs, including disruptions or admissions to a psychiatric hospital that involve a 24-hour discharge notice.
- Child Placing Agencies are expected to have established respite and transition plans in place. CPU approval is not required for respite care.
How frequently is a child’s case reviewed within the TFFC program?
- The Child Placing Agency is responsible for submitting a child’s case information into Youth For Tomorrow (YFT):
- 45 days prior to the planned discharge date.
- In the event of an emergency discharge situation.
- It is crucial to submit the child’s information to YFT before the child leaves the home to ensure continuous service levels without interruption.
- You can contact YFT for assistance at [email protected].
Where should discharge notices be sent?
Discharge notices should be directed to the child’s Regional Centralized Placement Unit mailbox, with copies sent to the CPS caseworker, supervisor, and the TFFC mailbox.
When should a discharge notice be sent?
Form 2109 Discharge Notice should be submitted in the following situations:
- At least 30-45 days prior to a planned successful discharge.
- In the event of an emergency discharge or any other type of unsuccessful discharge.
Who should be notified about new openings for Therapeutic Foster Family Care homes?
- Send an email notification to the TFFC mailbox.
- Additionally, update the availability status in the General Placement Search (GPS) application. This ensures that the Centralized Placement Unit is aware of the opening and can efficiently identify potential placements.
What is the procedure if a referral is received?
- Carefully review each referral received.
- Respond to the Centralized Placement Unit and/or the DFPS TFFC mailbox regarding each referral. If no suitable homes are currently available, reply with “No home available”.
Who is eligible to become a Therapeutic Foster Family Care foster parent?
Answer: Therapeutic foster parents are typically one or two highly trained individuals who are equipped to meet the specialized needs of the children in this program. Single parents may also qualify, provided they can demonstrate the capacity to deliver high-quality care.
Quality of care is defined as comprehensively meeting all identified needs of the child, including medical, behavioral, cultural, educational, and spiritual needs. Employed individuals must demonstrate to the Contractor how their work schedule allows for the necessary flexibility to meet the child’s individual needs. The Contractor will continuously evaluate the TFFC home and the foster parents’ ongoing ability to meet the child’s evolving needs. State Office TFFC Program Specialists are available to assist in these determinations upon request.
What is the process when CPS or a Judge requests therapy notes or other child-related records?
Therapy notes and other child-related records are essential for caseworkers and CPS staff to gain a deeper understanding of a child’s strengths and needs, facilitating more informed decision-making.
The Child Placing Agency is obligated to make any and all records and information pertaining to a child available to DFPS upon verbal request in emergency situations. Emergency requests for records may include, but are not limited to:
- The need to reassess a child’s service level to facilitate a placement change.
- Emergency Behavior Intervention (EBI) Reports and Serious Incident Reports.
- Court-ordered requests.
- Requests from legal counsel.
Therapeutic Foster Family Care contracts are governed by the RCC 24-Hour Requirements, except where exemptions or modifications are specified in the Programmatic Conditions, which are detailed in Section III of the Special, Supplemental, and Programmatic Conditions document, Attachment D.
Within the RCC 24-Hour Requirements, Section 1721 addresses Providing Access to DFPS:
“DFPS has an absolute right of access to, and copies of, Child case records or other information relating to a Child served by the provider. The provider makes available any and all records and information concerning the Child to DFPS upon written request. The provider must forward legible records and information to DFPS within 14 calendar days of receiving the request.”
Furthermore, record requests may originate from the Texas State Auditor’s Office (SAO), the Federal Government, their authorized representatives, and these requests must also be honored and records provided accordingly.
If a TFFC provider is unclear about the status of a CPS case, who should be contacted?
Email the TFFC mailbox to request a consultation with a staff member to discuss the case and determine appropriate next steps.
Whom should I contact for general inquiries about the TFFC program?
For any general questions, please direct them to the DFPS Therapeutic Foster Family Care mailbox.
