Research Watch

Adolescent girls’ pregnancy rates lower for Multidimensional Treatment Foster Care versus Group Care

Year of Publication
Reviewed By
Nicole Petrowski

Kerr, D. C. R., Leve, L. D., & Chamberlain, P. (2009). Pregnancy rates among juvenile justice girls in two randomized controlled trials of multidimensional treatment foster care. Journal of Consulting & Clinical Psychology, 77(3), 588-593.


Researchers have found that multidimensional treatment foster care (MTFC) shows some promising results in reducing delinquency among adolescent girls in out-of-home care. MTFC is an alternative to aggregate-care for delinquent youth. Rooted in social learning theory, MTFC provides intense support and treatment in community-based family settings while youth attend public school (Leve & Chamberlain, 2007).The present study aimed to determine whether MTFC, as compared to typical group care (GC), was effective at reducing pregnancy rates among girls involved with juvenile justice mandated to out-of-home care. Two consecutively run randomized controlled trials assigned 166 girls aged 13-17 at baseline to either MTFC or GC. Baseline measures of each girl’s criminal referral history, sexual activity (self-report), and pregnancy history (self and caregiver-report) were taken. Trial 1 measured pregnancies at 12 and 24 months post-baseline and Trial 2 included follow-ups at 6, 12, 18, and 24 months post-baseline.

Results revealed that 26.9% of girls who had participated in MTFC reported a pregnancy at follow-up compared to 46.9% of girls in the GC condition. The effect of MTFC versus GC remained significant after controlling for the following significant predictors of pregnancy: criminal referrals, sexual activity, and pregnancy history. Specifically, girls in the GC condition were 2.44 times more likely to become pregnant during follow-up than girls in MTFC.

These findings lend support to the notion that interventions for delinquent girls which address general problem/risk behaviours may be more effective at preventing teen pregnancy than targeting risky sexual behaviours.

Methodological Notes

All the participants were randomly assigned to either the experimental MTFC intervention or the control GC condition; however, participation in either Trial 1 or Trial 2 was based on when girls were court-mandated to out-of-home-care. Therefore, it is unclear if the results would apply for girls allowed to remain in their homes. Logistic regressions predicted rates of pregnancy across follow-up periods with the inclusion of potential covariates. Interestingly, older girls were no more likely than younger girls to become pregnant at follow-up, which may be partly explained by the severity of problems experienced by girls that become involved in the juvenile justice system at a young age. Limitations noted by the authors include a possible lack of generalization, incomplete “blindness” of some assessment staff at follow-up, and no medical verification of pregnancies. Findings should be interpreted with caution as it is unclear to what extent the lower pregnancy rates for girls in MTFC are a positive effect of this particular intervention or further support for the documented negative effects of group care for some youth.