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Date: April 29, 2024 Mon
Time: 9:12 pm
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Results for multisystemic therapy
5 results foundAuthor: Mayfield, Jim Title: Multisystemic Therapy Outcomes in an Evidence-Based Practice Pilot Summary: In 2007, the Washington State Department of Social and Health Services established the Thurston-Mason Children’s Mental Health Evidence-Based Practice Pilot Project (Pilot) to provide mental health services to children. The first evidence-based practice selected by the Pilot was Multisystemic Therapy (MST), an intensive family- and community-based treatment program for youth. Over a one-year follow-up period, the Institute examined criminal convictions of youth enrolled in the Pilot’s MST program. Compared to youth with similar criminal histories and demographic characteristics, MST youth were convicted of fewer crimes on average. Due to sample size, statistical significance was not attained in this evaluation of MST outcomes. The effect sizes observed, however, are within the expected range for MST according to other rigorous studies of that intervention and would likely return a net economic benefit to tax payers and crime victims. Details: Olympia, WA: Washington State Institute for Public Policy, 2011. 8p. Source: Internet Resource: Accessed May 9, 2011 at: http://www.wsipp.wa.gov/pub.asp?docid=11-04-3901 Year: 2011 Country: United States URL: http://www.wsipp.wa.gov/pub.asp?docid=11-04-3901 Shelf Number: 121680 Keywords: Evidence-Based PracticesJuvenile Offenders (Washington State)Mental Health ServicesMultisystemic Therapy |
Author: Cunningham, Alison Title: One Step Forward: Lessons Learned from a Randomized Study of Multisystemic Therapy in Canada Summary: Five years ago, a committed and energetic group of people in four southern Ontario communities embarked upon a process that brought a promising intervention for serious young offenders to Canada. Multisystemic Therapy (MST) had attracted attention in the United States where two randomized studies showed dramatic success in reducing arrests and incarceration. Ontario’s Ministry of Community and Social Services supported the MST project because it promised to be a cost-efficient way of reducing youth crime. Reductions in offending would, in turn, reduce both losses to crime victims and costs associated with criminal justice processing. The National Crime Prevention Centre (NCPC) supported the evaluation to learn if MST could work in Canada as well as it had in the United States. The follow-up will end in 2004, and few research questions will be left unanswered. There are two parts to this document. The first is a background of the MST project including interim research results on 407 youth. The second is a discussion of “lessons learned” and the related recommendations for policy makers, funding bodies, and researchers. This discussion begins with a description of 10 different ways the wrong conclusion could have been made about the effectiveness of MST in Canada, had a less rigorous methodology been used. Various observations and recommendations flow from the lessons learned. The biggest lesson is clear: the time and effort spent on rigorous research pays off in information that informs the search for effective interventions. Conversely, research that falls short of accepted standards of scientific rigour – unfortunately the norm in Canada – could be justifying the status quo when better interventions should be sought. It might even be pushing practice in the wrong direction. We can look to the United States for examples of how randomized field studies are contributing to the crime prevention knowledge base. While “evidence-based practice” has become a common buzz word, there is little Canadian evidence that can reliably inform our choices of program models. This study suggests caution in assuming American results will replicate in Canada. Even in the United States, crime prevention is driven more by rhetoric than reality because current research results should really be viewed with no more than cautious optimism.[1] Some may be tempted to label this study a failure because we are not able to recommend the adoption of MST in Canada. Quite the opposite. We learn a great deal from finding out what does not work. MST is probably not the answer for this client group, but the current interventions did not fare well either. It would be a mistake to take these results as proof that existing practice is effective. This study puts us one step forward in the journey to find effective interventions for serious young offenders. It is a worth-while trip because the goal is community safety. Details: London, ONT: Centre for Chidlren and Families in the Justice System, London Family Court Clinic, 2002. 32p. Source: Internet Resource: Accessed August 23, 2011 at: http://www.lfcc.on.ca/One_Step_Forward.pdf Year: 2002 Country: Canada URL: http://www.lfcc.on.ca/One_Step_Forward.pdf Shelf Number: 122467 Keywords: Alternatives to IncarcerationCommunity-Based TreatmentCosts of Criminal JusticeJuvenile Offenders (Canada)Multisystemic Therapy |
Author: Leschied, Alan Title: Seeking Effective Interventions for Serious Young Offenders : Interim Results of a Four-Year Randomized Study of Multisystemic Therapy in Ontario, Canada Summary: This report contains interim outcome data from a four-year randomized study of Multisystemic Therapy (MST) in four southern Ontario communities. With therapy teams in London, Mississauga, Simcoe County and Ottawa, about 200 families received MST between 1997 and 2001. At the same time, about 200 families continued with the usual services available through the local youth justice and social service systems. These services typically took the form of probation supervision augmented as seen necessary by referral to specialized programming. Group assignment was determined randomly so the two groups were equivalent at the outset. That being true, the behaviour of the usual services group reflects the behaviour of the MST recipients, had they not received MST, and any post-intervention differences can be attributed to MST. Ontario’s Ministry of Community and Social Services supported the project because MST promised to be a cost-efficient way of reducing youth crime. Reductions in offending would, in turn, reduce both losses to crime victims and costs associated with criminal justice processing. The National Crime Prevention Centre (NCPC) in Ottawa supported the evaluation to learn if MST could be a cost-efficient intervention for youth crime and if it might be a viable alternative to custody for serious offenders. This is the final report to the National Crime Prevention Centre pursuant to that funding. Because each youth will be tracked for three years, the study will not be complete until 2004. The multi-site nature of the project permitted comparisons across different types of communities under variable conditions of implementation. The intent was to implement the same intervention across the sites and all teams had the same training, were supervised by the same MST consultant, and met quarterly for boosters. A standard research protocol was used. Other important features of the study were intake screening against inclusionary and exclusionary criteria, a large sample, a valid measure of outcome, and long-term follow-up. The data collection strategy was specifically designed to answer research questions posed by stakeholder groups. Considerable care and expense were expended to ensure fidelity to the treatment model. The outcome measure involved real behaviour in the community, not in-program changes in attitudes or clinical symptoms. The research was designed and conducted by investigators independent of the method’s developer, the funder, and the agencies delivering the program. Details: London, ON: Centre for Children & Families in the Justice System of the London Family Court Clinic, 2002. 151p., app. Source: Internet Resource: Accessed November 12, 2011 at: http://www.lfcc.on.ca/seeking.html Year: 2002 Country: Canada URL: http://www.lfcc.on.ca/seeking.html Shelf Number: 123318 Keywords: Juvenile Offenders (Canada)Juvenile ProbationMultisystemic TherapyTreatment Programs, Juveniles |
Author: Mitchell-Herzfeld, Susan Title: Effects of Multisystemic Therapy (MST) on Recidivism Among Juvenile Delinquents in New York State Summary: Two sets of findings resulted from this study. Regarding the impact of the therapy, the study found that multisystemic therapy (MST) was not effective in decreasing recidivism rates among juvenile delinquents released from an OCFS (Office of Children and Family Services) facility, and few subgroup differences in treatment were found across the four sample sites. Regarding implementation of the program, the study found that while OCFS’s implementation of the program was unique, the services provided by the department adhered to the MST treatment principles and analytic model; the problems faced by the youth and families served by the MST program were multiple and severe; the recidivism rates were higher for youth when their families had mental health, criminal affiliation, and family conflict issues; and program outcomes were not associated with treatment duration or intensity but did vary with treatment content. This report examines the effectiveness of MST on the recidivism rates of youth who have been released from an OCFS facility. MST is a short-term, intensive treatment program that focuses primarily on environmental systems, with services provided in the family home or at community-based locations at times that are convenient for the youth and their families. A sample of 898 youth released from OCFS facilities between March, 2000, and May, 2004, were included in the study. The study was divided into two parts: to evaluate the effectiveness of MST on recidivism rates of youth recently released from an OCFS facility, and to examine the State’s adherence to the principles of MST. Results of the study indicate that MST was ineffective for treating youth released from OCFS facilities for two reasons: the severity and intractability of the problems facing OCFS youth and their families, and the decision to use MST as a post-release service. Recommendations for future use of the program are discussed. Details: Renssaelaer, NY: New York State Office of Children and Family Services, 2008. 112p. Source: Internet Resource: Accessed February 28, 2012 at http://www.ocfs.state.ny.us/main/reports/FINAL%20MST%20report%206-24-08.pdf Year: 2008 Country: United States URL: http://www.ocfs.state.ny.us/main/reports/FINAL%20MST%20report%206-24-08.pdf Shelf Number: 124314 Keywords: Juvenile DelinquentsJuvenile RecidivismMultisystemic Therapy |
Author: 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 |