The ongoing evaluation of Training for Adoption Competence (TAC) has established a substantial body of evidence that TAC is an effective training model that increases knowledge and influences clinical practices in ways consistent with specified learning objectives. The logical next step – beyond confirming TAC is an effective model of training was to test TAC’s theory of change by studying the effects of TAC on the quality and effectiveness of clinical services in real-world settings, collecting data from adoptive families about their treatment experiences and outcomes. That study was completed in 2020 using data from 89 adoptive families treated by 34 TAC-trained clinicians and 70 adoptive families treated by 36 comparably qualified clinicians who were not TAC-trained.