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: 10.1037/0893-318.104.22.1681
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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- "In addition, MST has higher rates of treatment completion than treatment as usual (Hunsley & Lee, 2007), with an average completion rate of 86% (Curtis et al., 2004). Studies have found that, consistent with other types of interventions, the effect sizes for MST are larger in efficacy trials (i.e., delivered by graduate students supervised by MST developers, d = 0.81) than in effectiveness trials (i.e., delivered in real-world settings , d = 0.26; Curtis et al., 2004). Although much of the research on the effectiveness of MST has been conducted by MST developers, several independent replications have yielded positive results, including a four-way randomized trial in Norway (Ogden & Hagen, 2006) and several independent studies in the United States (Stambaugh et al., 2007; Timmons- Mitchell, Bender, Kishna, & Mitchell, 2006). "
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- "Therapists work with parents and caregivers to help them facilitate behavioral improvement in their children. MST has been shown to be effective in decreasing arrests and delinquency and improving school attendance and family functioning in youth (Curtis, Ronan, & Borduin, 2004), but there is little evidence that it relieves parental distress. Family-focused interventions are therefore needed that specifically address the burdens experienced by the caregivers of adolescents with DBD. "
ABSTRACT: Adolescents with disruptive behavior disorders (DBD), including oppositional defiant disorder and conduct disorder, present unique challenges for their families. Although, most empirically supported treatments for DBD are family-based, the emphasis is typically on the behavior of the child rather than on the life challenges and resultant distress experienced by the family members. Fifteen families of adolescents with DBD were recruited from a large publicly funded Community Mental Health Center. For this report, data from in-depth interviews with the adolescents' primary caregivers were analyzed by standard content analytic procedures to describe the challenges they experienced living with and caring for the adolescents. The primary caregivers reported that the challenges were overwhelming, demanding, and unrelenting. The two most salient challenges were (a) managing the adolescents' aggressive, defiant, and deceitful behaviors, and (b) interacting frequently with a number of child-serving agencies. A number of clinical implications are drawn from these findings. © The Author(s) 2014.
- "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. "
Chapter: Youth who have broken the law