KEEP originated from Treatment Foster Care Oregon (TFCO), formerly Multidimensional Treatment Foster Care (MTFC), a program developed as a family-based alternative for teenagers with chronic delinquency and mental health problems. Instead of relying on group or residential care centers outside of their communities, children and teenagers in TFCO are placed in well-trained supported foster homes and provided with an array of therapeutic services. Numerous well-controlled, randomized studies have shown that outcomes for youth in TFCO compared very favorably to those who had been placed in group or residential care. For information on TFCO, see http://www.tfcoregon.com/.
Given these results, the developers wanted to know if parts of the TFCO model could be used with the foster and kinship parents who work in state child welfare systems. These early questions ultimately led to development of KEEP. In 1996, researchers and foster parents teamed up to create a KEEP group for foster parents who were caring for children with challenging behaviors and emotional problems. From 1999-2005 they conducted a large scale effectiveness trial with 700 foster families in the San Diego child welfare system. Since then, additional randomized controlled trials conducted in Oregon and California have validated the effectiveness of the KEEP model.