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Date: April 30, 2024 Tue
Time: 12:43 am
Time: 12:43 am
Results for adolescent sex offenders
1 results foundAuthor: Fonagy, Peter Title: Evaluation of Multisystemic Therapy for adolescent problematic sexual behaviour: Research report Summary: The Services for Teens Engaging in Problem Sexual Behaviour (STEPS-B) trial aimed to assess the feasibility of implementation of MST-PSB, a family-based intervention for problematic sexual behaviour. We sought to determine whether Multisystemic Therapy - Problem Sexual Behaviour (MST-PSB) could be implemented fully and at a scale that would warrant a full trial. Multisystemic Therapy (MST) is an intensive clinical treatment programme which aims to involve all environmental factors which affect juvenile offending, including family, school, and the community. MST-PSB is an adaptation of MST aimed at adolescents who have engaged in problematic sexual behaviours and often demonstrated other problem behaviours. It is an intensive family- and home-based intervention uniquely developed to address the multiple determinants of problematic sexual behaviour in adolescents. MSTPSB is designed to reduce problematic sexual behaviours; antisocial behaviours, and out-of-home placements. Supplementary to MST, MST-PSB has a greater focus on safety planning, individual factors (for example, impulsivity, social anxiety) related to problematic sexual behaviours (PSBs), and interventions specific to problem sexual behaviour, such as offence clarification sessions aimed at increasing accountability and safety, and the promotion of normative sexual behaviour. Furthermore, family therapy techniques, such as structural and strategic family therapy interventions, are utilized to a greater extent than in standard MST. In addition, the impact of the young person's own victimization and experience of abuse is assessed. For the purpose of the present trial, PSB is defined as any sexual behaviour which is harmful, either to the victims of the young person's behaviour, or the young person themselves. The primary aim of the STEPS-B trial was determining whether MST-PSB reduces the incidence of out-of-home placement compared to management as usual (MAU). A range of secondary outcomes assessed as part of the trial included sexual and non-sexual offending rates and antisocial behaviours; participant well-being; family functioning, and total service and criminal justice sector costs. The quantitative data, collected at baseline (beginning of treatment), and at 8, 14, and 20 month follow-up points, measured problematic sexual behaviour; associated mental health problems and disorders; emotional and behavioural functioning, as well as domains central to the mechanisms by which MST-PSB is supposed to work: quality of parent-adolescent relationship; parenting skills and parental mental health. Unfortunately, the trial recruited a very low number of families overall; 40 young people and 40 carers were recruited in total (compared with the target of 56 families), with 21 families in the MST-PSB arm, and 19 in the MAU arm. The young people recruited into the study were aged 10-18 (mean 13.4); 36 (90%) of the participants were male. The low sample size resulted in limited statistical analyses comparing MST-PSB to management as usual. There were numerous factors that are likely to have contributed to the low uptake of participants, such as a relatively low pool of adolescents showing problematic sexual behaviour to start with, poor and unintegrated systems for identifying and helping young people showing PSBs, court delays and ongoing police involvement that complicated and prohibited involvement, and the stigma and shame associated with disclosure by young people and their carers. The primary outcome of out-of-home placement was seen in only 4 cases, 2 in each group and therefore was not meaningful as a potential between-group difference. The general trend from analyses of secondary outcomes was that both groups improved over time, which may reflect spontaneous recovery over time in moving from a crisis or intensely difficult period associated with detection and disclosure. Examining the effect sizes of the pre-post analyses of the secondary outcomes suggests that MST would likely have shown significant improvements in parental involvement and the degree to which family members felt connected to each other and supported when compared to MAU. The results of qualitative interviews revealed that young people had strong negative feelings about themselves, were embarrassed or ashamed of the behaviour which led to their engagement with MST-PSB, and had fears about being stigmatised by their family, friends, peers, and society at large. Most parents did not report ongoing problematic behaviour from their child, but experienced the allegations of PSB as unexpected and shocking, and as something which caused them to lose confidence in themselves as parents, and to lose confidence in their child. Parents had similar concerns about stigmatisation, but also felt they needed to protect their child. Overall, both young people and parents felt that they had benefited from MST-PSB. Young people felt that they had an improved attitude towards themselves and improved behavioural regulation, while parents did not report any recurrence of PSB and felt that their relationship with their adolescent had improved, as had their adolescent's behaviour at home and/or at school. Finally, parents felt confident that they would be able to continue using the skills they learned during the programme but also identified residual feelings of guilt and residual behaviour problems. There are strong, positive statements from MST staff that MST-PSB was an exciting and workable framework for working with young people presenting with complex needs: in this case those young people showing PSB. It was clear that MST-PSB was an intervention delivered with strong commitments from MST personnel dedicated to achieving positive outcomes, with families supported by very strong oversight and quality assurance in the form of highly valued supervision and consultation. The extraordinary efforts made to engage and keep families working on problems, the collaborative nature of treatment, including the use of goal-setting processes and outcome tools with families, the quality and frequency of supervision and consultation in keeping the team on target, and working with fidelity to the model were all very positively rated. At the same time, there were some shortcomings or potential limitations identified by staff, such as the degree to which the model and working practices were applicable to the heterogeneity seen in young people (and families) showing PSB, and the degree to which any 1 professional can deal with the complex treatment needs of such a population. Specifically, there was some question as to the degree to which families where trauma was part of the clinical picture with young people and/or their carers would be adequately served within the general 5-7month time frame, and, in this respect, the degree to which all therapists possessed the skills for working with trauma, even with the support provided. In terms of the larger mental health and social network that set the referral context for the trial, unfortunately we confirmed what has been identified as issues for service delivery for this population, such as poor communication between relevant agencies, with inadequate assessment and joint planning, and cases that were slow to go to court, adversely affecting the delivery of appropriate intervention (Hackett, Masson & Phillips, 2005). However, at the same time we saw examples of good practice, such as in the Borough of Southwark, where integrated, inter-agency panels are supported by strong commitment to these young people, recognising the need for on-going training and the implementation of evidence-based models of working Details: Darlington, UK: Department of Education, 2017. 44p. Source: Internet Resource: Accessed September 15, 2017 at: http://dera.ioe.ac.uk/29567/1/Evaluation_of_Multisystemic_Therapy_for_adolescent_problematic_sexual_behaviour.pdf Year: 2017 Country: United Kingdom URL: http://dera.ioe.ac.uk/29567/1/Evaluation_of_Multisystemic_Therapy_for_adolescent_problematic_sexual_behaviour.pdf Shelf Number: 147337 Keywords: Adolescent Sex OffendersAntisocial BehaviorJuvenile OffendersMultisystemic TherapySex Offender Treatment |