Teaching Family Model

The Teaching Family Model, implemented in all CTH programs, is an organized, fully integrated system of care to provide humane, effective, individualized and trauma-informed treatment and services to individuals, families and children.

Through research and scrutinized clinical practice, an integrated set of procedures emerged that has been developed and advanced resulting in a Model that is cost efficient, replicable, and highly effective. The Model is also a philosophy of care and treatment that prioritizes therapeutic relationships with staff as the primary conduit of effective treatment. Family-style relationships are seen as essential to healthy development of social and interpersonal skills.

Weaving advanced cognitive behavioural techniques, and person-centered interventions into daily life moments between youth and highly skilled staff, results in an unparalleled therapeutic environment. The Teaching Family Model is defined by standards of service and standards of ethical conduct which form the foundation of Model fidelity. The Teaching Family Association (TFA) develops and oversees the implementation of these standards in all accredited agencies through an annual review process. Standards reflect essential elements of the Model as they apply to integrated service delivery systems.

Teaching Family Model Goals

  • Humane and Respectful Practices that ensure the safety, well-being, and rights of the person served
  • Effective Treatment that has measurable outcomes and achieves child, youth, and family goals
  • Individualized Treatment that meets the social, emotional, cognitive and developmental needs of the person served
  • Trauma-Informed Approach to understanding and responding to individual life experiences
  • Quality Assurance Systems that are responsive to participant feedback and program outcomes

The Teaching Family Model is an Evidence-based & Trauma-informed best practice treatment approach for clients in care. The Teaching-Family Association (TFA) defines and implements standards and review procedures related to the actual performance and quality of treatment and service delivery systems at all organizational levels. Accreditation in the Teaching Family Model is designed to provide the highest quality and support best practices for clients, caregivers, and robust organizational systems.

The Teaching Family Model is recognized to be cost-effective, replicable, and highly effective for all participants.

The Teaching Family Model is defined by Standards of Service and Ethical Conduct. This allows agencies to implement treatment with fidelity and reliability. The Teaching-Family Association oversees the implementation of these standards through a robust review process guided by the Accreditation and Ethics (A&E) Committee and directed by TFA’s Board of Directors. Accreditation includes peer oversight of initial and triennial on-site reviews by qualified teams leading, when successful, to international accreditation status. Additionally, annual reports and outcome data are required in years between on-site reviews. These reports are reviewed, discussed, and must be accepted by the A&E Committee.

Accredited Member Agencies maintain their autonomy as a recognized Model provider agency and have a voice in the development and application of the International Association standards. Members have access to a Model of treatment supported by ongoing research and maintain viable connections to a network of agencies, and their collaborative expertise. The TFM is a premier model of practice, specifically designed for group care and other in-care services, and a wide array of Model adaptations including, but not limited to Home-based treatment, School-based programs, Mental Health programs, Treatment Foster Care, Family Homes, and Adults with Developmental Disabilities.

The TFM is fully integrated at both individual and organizational levels. It provides effective individualized and trauma-informed treatment services to children, youth, adults, and families. Through peer-reviewed research and clinical practice, the Teaching Family Model is recognized to be cost-effective, replicable, and highly effective for all participants.

Evidence-based & Trauma-informed

The Teaching-Family Model is an evidence-based approach which is fully integrated at both the individual and the organizational level. It provides effective individualized and trauma-informed treatment services to children, youth, adults, and families.

Through peer-reviewed research and clinical practice, the Teaching-Family Model is recognized to be cost-effective, replicable, and highly effective for all participants.

Teaching Family Association

The Teaching Family Association is a network of organizations around the world, supporting common elements and tenets of the TFM across an array of programs and services. Today, the TFM serves a wide range of vulnerable individuals and families in a comprehensive continuum of environments including family homes, foster homes, community and residential group homes, shelters, hospitals, schools, community settings, transitional living and other individualized settings.

As an organized community of practice and accrediting body, the Teaching Family Association holds members accountable for performance standards at the highest level. The TFM is non-proprietary and therefore what is learned in one organization can be shared with others within the Association and incorporated into the standards and quality assurance processes best practices evolve.

In the United States, under a new child welfare law called the Family First Prevention Services Act, service providers are now required to be accredited. Accrediting bodies approved by the United States Federal Children’s Bureau include The Joint Commission, Council on Accreditation (COA), CARF International, EAGLE, and the Teaching Family Association (TFA). Providers in the United States can choose which accrediting body best meets their needs. TFA, like CARF International, accredits programs across the world and is well-respected. TFA is the only accrediting body that supports implementation of, and fidelity to, a specific model used to provide high-quality services to a variety of populations and in a variety of settings.

The Teaching Family Model and Closer to Home

CTH has been an Accredited Teaching Family Model Sponsor Site since 1999. As a Sponsor Site, Closer to Home is currently providing services to organizations in Alaska and Missouri, USA. As a qualified Sponsor Agency with the Teaching Family Association, CTH has supported several child-serving agencies to accreditation status with Teaching-Family Association (TFA).

Evidence-Based Model of Care

Since 2007, Closer to Home Community Services has been actively involved in the dissemination of the Teaching-Family Model with several child and family serving organizations in the United States and New Zealand. To date, CTH has provided purveyor services to a multi-model agency in New Zealand, a large school-based/day treatment agency in Cincinnati, Ohio as well as with two agencies working with dependent adults in both Nashville and Memphis, Tennessee. All four organizations achieved International TFA accreditation status.

The TFM is backed by rigorous research. Recent findings by Dr. Elizabeth M.Z. Farmer Ph.D. (Associate Dean for Research, Virginia Commonwealth University) from a longitudinal quasi-experimental study demonstrates improved outcomes and overall effectiveness in TFM programs. Examples of her findings include:

  • Improvement of Psychiatric Symptoms with significantly better SDQ (Strengths and Difficulties Questionnaire) scores post-discharge (Farmer et al., 2016).
  • Decrease in Negative Post-Discharge Outcomes with clients five-times less likely to be readmitted to residential care and three times less likely to drop-out of school (Trout et al., 2013).
  • Adult Rate of Interpersonal Violence for youth who had experienced significant childhood trauma up to 16 years post TFM is on par with the general population (normative) breaking the intergenerational cycle of violence (Huefner, et al., 2007).
  • Positive Impact on School Performance as evidenced by improved grades – in most cases by a full grade point average, higher rate of school graduation, and increased likelihood to access secondary education (Thompson et al., 1996).

The publication of these results, from the USA National Institute of Mental Health-funded research study (NIMH), prompted the Substance Abuse and Mental Health Services Administration’s (SAMHSA) and the National Registry of Evidence-based Programs and Practices (NREPP) to include the Teaching Family Model of care in their registry.

As of December 5, 2016, NREPP, a highly selective registry of evidence-based practices in mental health services, officially recognizes the Teaching Family Model as a promising evidence-based practice for the treatment of “Non-specific Mental Health Disorders and Symptoms.”  The study published in the Journal of Emotional and Behavioural Disorders found the Teaching Family Model to “produce significantly better outcomes” for youth post-discharge. “Short-term gains are relatively common, but for developing youth, shifts in long-term trajectories form the springboard for improved development, socialization, functioning and flourishing,” write the study authors.

The Teaching Family Model has been recognized as a promising evidence-based practice since 2008 by the California Evidence-Based Clearinghouse for Child Welfare (CEBC), a similar and often cited registry of evidence-based programs. The American Psychological Association has also recognized the Model as an evidence-based practice since 2003, prior to the creation of NREPP or CEBC and the American Psychological Association’s profile of the Teaching-Family Model suggests that the Model has “given hope” that clients “with even the most difficult problems or behaviours can improve the quality of their lives and make contributions to society.”