Multisystemic treatment (MST) is a family- and home-based therapeutic approach that has been found to be effective in treating antisocial youths and that has recently been applied to youths with serious emotional disturbances. In light of the increasing dissemination of MST, this review examines the effectiveness of MST by quantifying and summarizing the magnitude of effects (treatment outcomes) across all eligible MST outcome studies. Included in a meta-analysis were 7 primary outcome studies and 4 secondary studies involving a total of 708 participants. Results indicated that across different presenting problems and samples, the average effect of MST was d = .55; following treatment, youths and their families treated with MST were functioning better than 70% of youths and families treated alternatively. Results also showed that the average effect of MST was larger in studies involving graduate student therapists (i.e., efficacy studies; d = .81) than in studies with therapists from the community (i.e., effectiveness studies; d = .26). In addition, MST demonstrated larger effects on measures of family relations than on measures of individual adjustment or peer relations.
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"Findings across these studies have consistently favored MST in comparison with control conditions. A meta-analysis of MST trials (Curtis, Ronan, and Borduin, 2004) included seven of these studies (708 total participants, 35 MST therapists), and effect sizes averaged 0.50 for criminal behavior, 1.01 for arrest seriousness, and 0.29 for substance use. Further, these studies typically have been completed in field settings and included few exclusion criteria, features that strengthen support for treatment effectiveness of MST in real-world community practice settings. "
The Sage handbook of child research, Edited by G.B. Melton, A. Ben-Arieh, J. Cashmore, G.S. Goodman, N.K. Worley, 01/2014: chapter Youth who have broken the law: pages 266-284; Sage Publications.
"ORIGINAL ARTICLE Some studies have addressed cognitive-behavioral treatments or family therapy, but only a few studies have examined psychodynamic therapy (PDT) (e.g. Farmer et al. 2002; Curtis et al. 2004; Rohde et al. 2004; Eyberg et al. 2008; Littell et al. 2009a, b; Woolfenden et al. 2009; Jacobs et al. 2010). Thus, treatment studies for these co-morbid disorders in adolescents are of importance, particularly regarding the evaluation of PDT (cf. "
[Show abstract][Hide abstract] ABSTRACT: Co-morbid disorders of conduct and emotions can be regarded as childhood antecedents of further negative developments (e.g. manifestation of personality disorders in adulthood). We evaluated a manualized psychodynamic therapy (PDT) for adolescents with these co-morbid disorders.
In a randomized controlled trial (RCT), 66 adolescents diagnosed with mixed disorders of conduct and emotions (F92 in ICD-10) were randomly assigned to a manualized in-patient PDT group or a waiting list/treatment-as-usual (WL/TAU) control condition. Diagnoses according to DSM-IV were also documented. Patients were compared using rates of remission as the primary outcome. The Global Severity Index (GSI) and the Strengths and Difficulties Questionnaire (SDQ) were used as secondary measures. Assessments were performed at baseline, post-treatment and at the 6-month follow-up.
The sample consisted of severely impaired adolescents with high rates of further co-morbid disorders and academic failure. Patients in the treatment group had a significantly higher rate of remission [odds ratio (OR) 26.41, 95% confidence interval (CI) 6.42-108.55, p < 0.001]. Compared with the control group, the PDT group resulted in significantly better outcomes on the SDQ (p = 0.04) but not the GSI (p = 0.18), with small between-group effect sizes (SDQ: d = 0.38, GSI: d = 0.18). However, the scores of patients treated with PDT were post-treatment no longer significantly different from normative data on the GSI and within the normal range on the SDQ. The effects in the treatment group were stable at follow-up. Furthermore, most patients were reintegrated into educational processes.
PDT led to remarkable improvement and furthered necessary preconditions for long-term stabilization. In future, PDT should be compared to other strong active treatments.
Psychological Medicine 11/2013; 44(10):1-10. DOI:10.1017/S003329171300278X · 5.94 Impact Factor
"These results suggest that interventions aimed at reducing criminal recidivism by addressing risk and/or protective factors may be less effective in juvenile offenders with substance use problems. This is consistent with findings of Henggeler and colleagues (1999, 2006) in which the well documented capacity of MST to reduce rearrest rates (Curtis et al., 2004; Henggeler, 1999) did not emerge in substance abusing juvenile offenders. These findings suggest that changing offending behavior may be more difficult with increasing levels of substance use problems. "
[Show abstract][Hide abstract] ABSTRACT: Little is known about the needs of substance-using juveniles in treatment aimed at reducing criminal recidivism. Therefore, we aimed to examine treatment needs of substance-using juvenile offenders.
Differences were examined between juvenile offenders who abstain from substance use (ASU; n=1974) and substance-using juvenile offenders without (SU; n=7000) and with substance use problems (SUP; n=3317), in the prevalence of risk/protective factors for criminal recidivism and strength of associations between risk/protective factors and criminal recidivism. We conducted secondary data analysis on recidivism risk assessments, collected with the Washington State Juvenile Court Assessment, and re-offending data. Analyses of variance and Partial correlations, adjusted for age, gender and ethnicity were applied, as well as Fisher's z tests and logistic regression analyses.
Results showed that substance-using offenders, especially those with substance use problems, had more risk factors and less protective factors than ASU youths in the domains of school, use of free time, relationships, family, attitude, aggression and skills. The associations between most of the risk/protective factors and recidivism were stronger in the ASU group than in the SUP group. Substance use uniquely predicted recidivism, net of risk factors.
These results suggest that general interventions for juvenile offenders addressing risk and protective factors with the aim to reduce recidivism may be less effective for offenders with substance use problems, and that substance use (problems) should be addressed, too.
Drug and alcohol dependence 10/2013; 134(1). DOI:10.1016/j.drugalcdep.2013.10.012 · 3.42 Impact Factor