Article

Multisystemic treatment: A meta-analysis of outcome studies

School of Psychology, Massey University, Palmerston North, New Zealand.
Journal of Family Psychology (Impact Factor: 1.89). 10/2004; 18(3):411-9. DOI: 10.1037/0893-3200.18.3.411
Source: PubMed

ABSTRACT 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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Available from: Nicola M Curtis, Aug 24, 2015
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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.
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    • "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. "
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    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. DOI:10.1016/j.drugalcdep.2013.10.012 · 3.28 Impact Factor
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    • "In addition, historical data based on the systematic review conducted by Curtis, Ronan, and Borduin (2004) concluded that youth and families treated with MST were functioning better than 70% of youth and families in the comparison groups. Because a noninferiority margin is chosen as the smallest value that would be a clinically important effect (Wiens, 2002), a 15% noninferiority margin for this study was consistent with and supported by the historical data (Curtis et al., 2004). A post hoc power analysis with PASS v12 was conducted to examine the power of the present analysis to detect differences with the current sample. "
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    ABSTRACT: Objectives: This study examined the treatment outcomes of integrated families and systems treatment (I-FAST), a moderated common factors approach, in reference to multisystemic therapy (MST), an established specific factor approach, for treating at-risk children and adolescents and their families in an intensive community-based setting. Method: This study used a nonrandomized noninferiority trial design to compare the outcomes of 79 families who received I-FAST, the test intervention, to 47 families who have received MST, the reference intervention. Results: I-FAST was noninferior to MST in reducing problem severity and improving functioning based on youth, parents, and workers' assessments. Conclusions: While the nonrandomized design of this study precludes any definitive conclusions, implications of the study were discussed with respect to the debate regarding common factors and specific factor approaches to family treatment and implementation of evidence-based treatments.
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