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Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders
Abstract
In a randomized clinical trial, multisystemic family preservation was shown to significantly reduce rates of criminal activity and incarceration in a sample of 84 serious juvenile offenders and their multi-need families. In the current study, archival records were searched for re-arrest an average of 2.4 years post-referral. Survival analysis showed that youths who received multisystemic family preservation were less likely to be re-arrested than were youths who had received usual services. Such results represent the first controlled demonstration that family preservation, when delivered via a clearly specified treatment model, has lasting effects with serious juvenile offenders. Implications for family preservation and juvenile justice research are discussed.
... Sinds de jaren tachtig van de vorige eeuw wordt er echter steeds meer waarde gehecht aan hulp gericht op het voorkomen van uithuisplaatsing en de aanpak van het kindgedrag in de gezinscontext. Deze gezinscontext wordt niet alleen gezien als de natuurlijke omgeving waarin gedragsproblemen optreden (Henggeler et al., 1993) maar ook als een belangrijke bron van kracht en ondersteuningsmogelijkheden om deze problemen op te lossen (MacKean et al., 2005). Inmiddels hebben tal van programma's deze focus overgenomen, zoals Functionele Gezinstherapie (FFT), Multisysteem Therapie (MST) en Families First (Lee et al., 2008;Lee et al., 2014;Nelson et al., 2009;Van Assen et al., 2020). ...
... Deze programma's ondersteunen allemaal gezinnen met complexe en meervoudige problemen; hebben als doel uithuisplaatsing van kinderen te voorkomen; baseren zich op vergelijkbare theoretische benaderingen (bv. ecologische systeemtheorie en cognitieve leertheorie) waarbij beschermende en risicofactoren in de gezinsomgeving worden aangepakt om gunstige veranderingen teweeg te brengen; benadrukken de rol van ouders hierin, en sluiten met hun interventies aan op de gezinsbehoeften (Henggeler & Schaeffer, 2016;Henggeler, et al., 1993;Nelson et al, 2009;Van der Steege et al., 2013;MacKean et al., 2005). ...
... We denken dat de bufferende werking van empowerment ontstond omdat de gezinsgerichte interventies tijdens de hulp zich richtten op ondersteuning van ouders in de gezinscontext. Deze context is niet alleen de natuurlijke omgeving waarin problemen zoals in het gedrag van kinderen voorkomen maar vormt ook een belangrijke bron van krachten om deze problemen aan te pakken (Henggeler et al., 1993;MacKean et al., 2005). Omdat ouders tijdens de gezinsgerichte hulp in deze gezinscontext werden gestimuleerd om met omge- vingsstressoren om te gaan, ontwikkelden ze meer copinggedrag en passende strategieën om de problemen aan te pakken waar ze zijn (gedragscontrole component van empowerment). ...
In gezingsgerichte hulp wordt het vergroten van de empowerment van ouders als een belangrijke manier gezien om positieve behandeluitkomsten te bereiken, zoals in het probleemgedrag van hun kinderen. Empirisch onderzoek is echter schaars en alleen gericht op ontwikkelingen tijdens gezinsgerichte hulp. De voorliggende studie onderzocht In gezingsgerichte hulp wordt het vergroten van de empowerment van ouders als een belangrijke manier gezien om positieve behandeluitkomsten te bereiken, zoals in het probleemgedrag van hun kinderen. Empirisch onderzoek is echter schaars en alleen gericht op ontwikkelingen tijdens gezinsgerichte hulp. De voorliggende studie onderzocht hoe de empowerment van ouders en de gedragsproblemen van kinderen zich ontwikkelen tijdens en na gezinsgerichte hulp. Ook werd de hypothese getoetst dat empowerment van ouders aan het einde van gezinsgerichte hulp een buffer vormt tussen de negatieve invloed van ouderlijke stress op de gedragsproblemen van kinderen na gezinsgerichte hulp. In de studie volgden we 275 gezinnen met meervoudige en complexe problemen voor een lange periode. Deze gezinnen werden ondersteund met Intensieve Ambulante Gezinsbehandeling (IAG). Informatie over de empowerment van ouders (Empowerment Vragenlijst) en gedragsproblemen van kinderen (Strengths and Difficulties Questionnaire) werd verzameld aan het begin en einde van de hulp, en gemiddeld 2.8 jaar (SD = 1.6) later. Op dit follow-upmoment werd ook informatie verzameld over ouderlijke stress en verdere professionele ondersteuning aan het gezin. De gegevens werden geanalyseerd met latente regressieanalyses. Uit de studie bleek dat de gedragsproblemen van kinderen tussen aanvang en einde van gezinsgerichte hulp significant afnemen (effectgrootte = .60) en dat de empowerment van ouders significant toeneemt (effectgrootte = .53). De geboekte vooruitgang in het kindgedrag houdt stand na de hulp. De gedragsproblemen blijven gemiddeld echter ernstig en verdere professionele ondersteuning voor het kind na gezinsgerichte hulp is nodig. Conform onze verwachting vonden we een positieve relatie tussen ouderlijke stress en gedragsproblemen bij kinderen na gezinsgerichte hulp (B = 1.12). We zagen echter ook dat de empowerment van ouders aan het einde van gezinsgerichte hulp een buffer vormt (B = -.53); ouderlijke stress heeft een minder negatieve invloed op de ontwikkeling van gedragsproblemen van kinderen na gezinsgerichte hulp wanneer ouders meer empowered zijn aan het einde van de hulp. Onze studie benadrukt het belang van empowerment van ouders tijdens gezinsgerichte hulp voor de ontwikkeling van de gedragsproblemen van kinderen op langere termijn.
... In these family-centered programs, empowerment of parents is seen as a central element to achieve favorable treatment effects (Dunst, Trivette, & Hamby, 2007;Graves & Shelton, 2007;Henggeler & Schaeffer, 2016). Interventions are carried out in the family environment because this is not only seen as the natural context in which child behavioral problems occur (Henggeler, Melton, Smith, Schoenwald, & Hanley, 1993) but also as a main source of strength and support for ameliorating these problems (MacKean, Thurston, & Scott, 2005). In order to realize this shift, professionals build a collaborative relationship with parents and recognize them as experts regarding their children's needs (Dunst, Boyd, Trivette, & Hamby, 2002;Law et al., 2003). ...
... These preservation programs all support families with multiple problems in preventing out-of-home placement of children; are based on similar integrated theoretical approaches (e.g. ecological system theory and cognitive learning theory) that assume that protective and risk factors in the family environment must be addressed to bring about beneficial changes; emphasize the role of parents in this, and; allow professionals to choose those interventions that are necessary given the family needs (Henggeler & Schaeffer, 2016;Henggeler et al., 1993;MacKean et al., 2005;Nelson et al., 2009;Van der Steege et al., 2013). ...
... In familycentered programs, such as IFT, empowerment of parents is seen as an important factor in achieving positive long-term outcomes (Graves & Shelton, 2007;Henggeler & Schaeffer, 2016). Therefore, interventions are carried out in the family-context, since this is considered not only as the natural environment in which child behavioral problems occur, but also as a main source of strength and support to deal with these problems (Henggeler et al., 1993;MacKean et al., 2005). We think that the familycentered approach of IFT has ensured a buffering effect of empowerment after treatment. ...
The present study examined the long-term treatment outcomes of the family-centered program Intensive Family Treatment (IFT) for families with multiple problems. We also tested the hypothesis that parental empowerment at the end of IFT constitutes a buffer between the negative influences of parental stress on their children’s behavioral problems afterwards. We included 275 families with multiple problems. Information about parental empowerment and child behavioral problems was gathered at the start and end of IFT and at follow-up, on average 2.8 years (SD = 1.6) later. At follow-up, information was also collected about parental stress and professional support. Data were analyzed through latent regression analyses. Significant improvements in child behavioral problems (effect size .60) and parental empowerment (effect size .53) were observed during treatment. Improvements were sustainable for child behavioral problems after IFT. Nevertheless, child behavioral problems remained severe on average and might be a stressor for parents. Together with other environmental stressors after IFT, these problems can increase parental stress and subsequently increase child behavioral problems. However, taking into account that professional support after IFT often still is needed, the findings of our study showed that parental empowerment at the end of IFT constitutes a buffer; parental stress had a less negative influence on child behavioral problems at follow-up when parents had a higher level of parental empowerment at the end of IFT. This study stresses the importance of empowering parents during family treatment to successfully cope with environmental stressors after treatment, including the problematic behavior of the child.
... Shectman also noticed a reduction in violent behaviour with group bibliotherapy, which focuses on enhancing emotional sensitivity within an insight-oriented affective approach. [48], which combines home and agency-based therapies to reduce riskpromoting pathways in aggressive teenage cents. Each of these advertised programmes, with the exception of the Incredible Years programme, was created for children aged 8 and up. ...
... Shectman also noticed a reduction in violent behaviour with group bibliotherapy, which focuses on enhancing emotional sensitivity within an insight-oriented affective approach. [48], which combines home and agency-based therapies to reduce riskpromoting pathways in aggressive teenage cents. Each of these advertised programmes, with the exception of the Incredible Years programme, was created for children aged 8 and up. ...
Purpose: To conduct a systematic review study of school based interventions to decrease aggressive behaviour among adolescents. The main goal of this review is to know about various interventions and to evaluate the effect of interventions on aggressive behaviour. The study's second goal is to find research gaps that could lead to more research in this area. The findings could be used as a foundation for developing interventional programs aimed at reducing adolescents' aggression. Design/Methodology/Approach: The purpose of this study is to develop a module as coping techniques to reduce the aggressive behaviour and analyse the ABCD model of the same. For this purpose we conducted a search 122 articles for relevant articles in the specified area. We looked for articles published between 2000 and 2022 using the primary databases; Google Scholar, Research Gate, Academia, SSRN, Shodhganga, PubMed, Rayyan and Elsevier. The words like aggressive behaviour, interventions and aggression were used for searching articles. All abstracts and entire articles were scrutinized to see various interventions as a coping strategy to decrease aggressions among students. Findings/Result: These findings reveal a clear link between self-control abilities and aggressive behaviour: those with greater self-control have less aggression, while people with lower self-control have more aggression. This relationship shows to hold true across a range of ages i.e. from childhood onwards. Based on these review study it also discussed and put forward future research into various interventions and strategies for regulating aggressiveness. Originality/Value: This review summarizes selected studies identifying the effect of various interventions on aggressive behaviour and find out the coping strategies. The future direction of existing research on emotional stability, first focusing on stressors and barriers associated with aggressive behavior, and considering the increased risk of stress, anxiety, and depression reported in this population. Next, it then describes recent trends and issues and seeks to fill gaps in existing literature that require additional research effort. We also conclude that there exists a need for future research on psychological intervention and coping strategies, cognitive behavioral therapy, parent management training, anger rumination and relaxation therapy for enhancing emotional well being and self-control of adolescents. Implementing parental interventions in parallel with the child's interventions may raise mental health.
... In PMTO, for example, twice monthly supervision is employed (Akin, 2016). In Multisystem Therapy (Henggeler et al., 1993) weekly supervision is the norm. Research in the application of supervision in evidence-based intervention shows that in practice supervision occurs less frequently than prescribed in the intervention. ...
Competent delivery of interventions in child and youth social care is important, due to the direct effect on client outcomes. This is acknowledged in evidence-based interventions (EBI) when, post-training, continued support is available to ensure competent delivery of the intervention. In addition to EBI, practice-based interventions (PBI) are used in the Netherlands. The current paper discusses to what extent competent delivery of PBI can be influenced by introducing supervision for professionals. This study used a mixed-method design: (1) A small- n study consisting of six participants in a non-concurrent multiple baseline design (MBL). Professionals were asked to record conversations with clients during a baseline period (without supervision) and an intervention period (with supervision). Visual inspection, the non-overlap of all pairs (NAP), and the Combinatorial Inference Technique (CIT) scores were calculated. (2) Qualitative interviews with the six participants, two supervisors, and one lead supervisor focused on the feasibility of the supervision. Four of six professionals showed improvement in treatment fidelity or one of its sub-scales. Had all participants shown progress, this could have been interpreted as an indication that targeted support of professionals contributes to increasing treatment integrity. Interviews have shown that supervision increased the professionals’ enthusiasm, self-confidence, and awareness of working with the core components of the intervention. The study has shown that supervision can be created for PBI and that this stimulates professionals to work with the core components of the intervention. The heterogeneous findings on intervention fidelity can be the result of supervision being newly introduced.
... MST has been studied in seven randomized clinical trials and the outcomes indicated that the model decreased the risk for maltreatment of children (Brunk et al., 1987), improved family relationships, prevented criminal behaviour and further arrests (Henggeler, Melton, Smith, Schoenwald, & Hanley, 1993), reduced substance use (Henggeler et al., 1991), and decreased behavioural problems and delinquent peer group associations (Sutphen, Thyer, & Kurtz, 1995). ...
STR8 UP 10,000 Little Steps to Healing Inc. is a non-profit organization which aims to support individuals who want to abandon their gang lifestyle by providing them services and intervention programs. STR8 UP works in Saskatoon and the surrounding region with ex-gang members and their families to help support individuals as they embark on a healthier path.
This report aims to inform the program delivery of STR8 UP by providing:
a) a literature review of effective gang intervention models and practices;
b) an updated description of STR8 UP’s programs and services; and
c) a cost analysis of the services and programs provided by STR8 UP between 2015 and 2019.
... Perhaps more poignantly, research on multisystemic therapy for adjudicated youth has shown promising results in reducing perpetration of violence (Henggeler et al. 1996). Using a randomized clinical trial design, Henggeler et al. (1993) found that youth who received multisystemic family preservation therapy were far less likely to be re-arrested that youth did not receive multisystemic family preservation therapy. While the study did not specifically analyze family violence as an outcome, other research projects have also found that multisystemic therapy that involves family members promotes prosocial outcomes among high-risk youth (Sawyer and Borduin 2011, see also Perkins-Dock 2001). ...
The central role of family within the process of juvenile reentry from a term of incarceration has been well documented by researchers and practitioners alike. However, family violence among previously incarcerated youth remains alarmingly high across the United States. Drawing from differential coercion and social support theory, we examine how family dynamics may simultaneously promote and/or inhibit family violence perpetration among youth undergoing the process of reentry. Four waves of panel data from the male-only youth subsample of the Serious and Violent Offender Reentry Initiative are analyzed using a series of dynamic panel data models. Findings demonstrate that both pre- and post-release levels of family conflict are significantly associated with increased family violence during reintegration. Mechanisms of family support, however, are not associated with post-release family violence. Results from this study highlight the salience of family conflict in understanding family violence perpetration among recently released juveniles and their families.
... Borduin, Henggeler, Blaske, and Stein (1990), in the fi rst controlled study of adolescent sexual offenders to appear in the literature, showed that MST reduced three-year recidivism for both sexual offenses and criminal offenses when compared with individual outpatient counseling. Preliminary fi ndings from two studies ( Borduin et al., 1995;Henggeler, Melton, & Smith, 1992;Henggeler, Melton, Smith, Schoenwald, & Hanley, 1993) showed that MST reduced drug use and abuse in samples of serious juvenile offenders ( Henggeler et al., 1991). A long-term targeted outcome is that the youth's behavior can be managed in the least restrictive school setting and no longer presents problems that overwhelm the school's resources. ...
A multitiered approach to school improvement and safety
... In Standard MST and all adaptations, a therapist adherence measure taps adherence to the model which is defined as whether these nine principals are being followed. In randomized trials, scores on the therapist adherence measure have been shown to predict reductions in youth arrests, incarceration, substance abuse, and aggression, and improvements in family functioning (Henggeler et al. 1993(Henggeler et al. , 1997Huey et al. 2000;Schoenwald et al. 2000Schoenwald et al. , 2003. ...
Families experiencing physical abuse and/or neglect are at risk of continued difficulties that may involve long-term monitoring by Child Protective Services (CPS) and perhaps even removal of the child. Interventions needed to help the family remain intact safely and reduce both the clinical challenges they are experiencing and risk of further maltreatment will need to meet the multiple needs of all family members and involve a positive, collaborative working relationship with CPS. If services that are typically provided at outpatient clinics are used, the CPS case worker may be tasked with linking the family to many providers. When the family cannot make all the appointments, they are at further risk of removal of their child. In this article we present Multisystemic Therapy for Child Abuse and Neglect (MST-CAN), an ecologically based treatment for families experiencing physical abuse and/or neglect in which research-supported mental health services are delivered in the home by one clinical team to families who have serious clinical needs. To date, MST-CAN has been implemented with families experiencing the most serious levels of risk, but application is feasible for families with lower risk levels. Among high-risk families, MST-CAN has been shown effective for reducing out-of-home placement, abusive or neglectful parent behavior, and parent and child mental health difficulties and for increasing natural social supports. Two specialty population programs based on MST-CAN are also presented. These are MST – Building Stronger Families, a specialty program for parents who are experiencing abuse or neglect co-occurring with substance abuse, and MST for Intimate Partner Violence for families experiencing abuse or neglect and intimate partner violence. All models are based on the core Standard MST model. We trace the history of model development to dissemination.
... Early quasi-experimental (Henggeler et al., 1986) and randomized (Borduin et al., 1995;Henggeler, Melton, & Smith, 1992) trials by the MST developers indicated that the model produced significant reductions, relative to usual mental health (i.e., individual or group) treatment or probation services, in youth behavior problems, rearrests, weeks incarceration, association with deviant peers, and youth and family psychiatric symptoms, as well as increases in family functioning and peer relations. Long-term follow-ups of those randomized trials demonstrated that reductions in arrest rates were robust for as long as 2.4 years (Henggeler, Melton, Smith, Schoenwald, & Hanley, 1993) to 21.9 years (Sawyer & Borduin, 2011) post-treatment. Furthermore, for families in the Borduin et al. study, MST also produced reductions in arrests and incarceration for closest-in-age siblings and primary caregivers (Johnides, Borduin, Wagner, & Dopp, 2017) over 20 years post-treatment. ...
... Prior research suggests that when family issues remain unaddressed, there is a significant correlation between youth experiencing family conflict and poor outcomes such as further delinquency and violence (Thornberry, 1994 Family Therapy in reducing recidivism . In the broader sense, various forms of family therapy have been shown to produce better outcomes for youth when compared with other treatment types (Chamberlain & Rosicky, 1995;Henggeler et al. 1993 ...
The purpose of this study was to collect data to evaluate youth outcomes associated with the implementation of an evidence-based screening and assessment tool and with the use of evidence-based treatment programs. Conclusion-- Assessments of treatment and custody need, as well as dangerousness and risk for violence, are a critical practice in juvenile justice. At the same time, relying on treatment services that have been shown to be effective in reducing violent and delinquent behavior among juvenile offenders is also a key element to a successful juvenile justice system. The Jefferson Parish Probation Department has recently embraced these practices with the use of the SAVRY and increased use of evidence-based treatment services. The results of this study underscore the importance of the sustained use of the SAVRY for informing treatment and custody need as well as Brand EBPs for reducing future violence and delinquent behavior.
... When compared with conventional services offered by juvenile offending services, MST was associated with a significant reduction in the likelihood of reoffending, 71 maintained 2 and 4 years post-treatment. 72,73 Offenders engaging in MST are reported to be significantly less likely to become involved in serious and violent offending. 73,74 Significant improvements have also been observed in both self-and parent-reported delinquency, 74 family relations and interactions, 73 and home, school, community and emotional functioning. ...
This review considers juvenile delinquency and justice from an international perspective. Youth crime is a growing concern. Many young offenders are also victims with complex needs, leading to a public health approach that requires a balance of welfare and justice models. However, around the world there are variable and inadequate legal frameworks and a lack of a specialist workforce. The UK and other high-income countries worldwide have established forensic child and adolescent psychiatry, a multifaceted discipline incorporating legal, psychiatric and developmental fields. Its adoption of an evidence-based therapeutic intervention philosophy has been associated with greater reductions in recidivism compared with punitive approaches prevalent in some countries worldwide, and it is therefore a superior approach to dealing with the problem of juvenile delinquency.
... Although MST is recognised as a preferred evidence-based intervention for antisocial youth in several countries (Butler, Baruch, Hickey, & Fonagy, 2011;Curtis, Ronan, Heiblum, & Crellin, 2009;Harpell, 2006;Henggeler, Melton, Smith, Schoenwald, & Hanley, 1993), the effectiveness of this intervention when operationalised within an Australian child and adolescent mental health service has not been evaluated. The primary aim of the present study was to examine the effectiveness of this intervention in improving Australian young persons' behaviours and emotional states. ...
This study aims to evaluate the effectiveness of the Multisystemic Therapy (MST) intervention for Australian families invloved with the Specialist Child and Adolescent Mental Health Service (CAMHS). This program was implemented within the Western Australian Department of Health in 2005, and has continually operated two small clinical teams within the Perth metropolitan area since then. This intervention was specifically chosen to improve service access, engagement, and intervention with vulnerable families having young persons with a history of significant and enduring behavioural problems. The study reports on data collected from July 2007 to July 2013 which includes baseline, post-treatment, 6-month, and 12-month follow-up. There were 153 MST families participating in the research at all time points (71% male; 11% Australian Aboriginal; average youth age was 13.6 years). Caregivers completed a set of questionnaires including Child Behaviour Checklist, Parenting Styles and Dimensions Questionnaire, and Depression, Anxiety and Stress Scale. One-way repeated measure ANOVA were used to measure changes over time. Significant caregiver-reported improvements in all measures were reported at post-treatment, and most improvements were maintained at the follow-up periods of 6 and 12 months post-intervention. These preliminary outcomes demonstrate that the 4–5 month MST intervention significantly reduces behavioural problems and emotional difficulties in young Australians and these improvements are generally maintained by caregivers over time. Primary caregivers reported improved skills and mental health functioning that were also maintained over the follow-up period. A proposed randomised controlled trial of the program will address potential placebo and selection bias effects. © 2016 Western Australia Child and Adolescent Health Service. Australian and New Zealand Journal of Family Therapy
... or illicit drug use and were not receiving it. The NSDUH (2007) found that 5.6% of this same group was in need of treatment for alcohol use and was not receiving it. Multisystemic therapy (MST) is one such treatment modality which has proven to be effective in reducing substance abuse and other high risk behaviors (Henggelar, Melton, & Smith, 1992;Henggeler, Melton, Smith, Schoenwald, & Hanley. 1993). MST is an intensive family and community based treatment that addresses the factors which contribute to serious antisocial behaviors in juvenile offenders. The treatment modality targets chronic, violent, or substance abusing juvenile offenders at high risk of out-of-home placement and their families. Broduin, Mann. Cone, Henggeler. Fu ...
Substance use and high risk sexual behavior have significant health consequences for adolescents who engage in these behaviors, including HIV, STD transmission, teen pregnancy, and an array of other associated health problems. The Hartford Youth Project (HYP) established by the Connecticut Department of Children and Families, offers a system of substance abuse treatment which has proven to be effective in reducing adolescent engagement in such high risk behavior. In this study, the data generated by the HYP are examined in conjunction with data derived from a qualitative review of existing services in order to identify a sexual risk profile for substance abusing adolescents in Hartford. The majority of both HYP boys and girls (75% of boys and 56% of girls) reported sexual activity in the last three months. Among both boys and girls, more than a third of both reported that they had sex without a barrier. The large number of substance abusing youth having unprotected sexual activity places them at significant risk of HIV/STDs and pregnancy. Nearly a third of both boys and girls also reported having sex while either they or their partner were high on alcohol or drugs. Although available services have proven to be effective in addressing the issue of substance use and abuse among this population, there is clearly a gap in this service system in the area of HI V, STD and pregnancy prevention. The findings of this study highlight the importance of making services available to youth to address their population's need for such appropriate HIV, STD and pregnancy prevention services.
... In adolescents, the risk of committing criminal offenses is related to family factors such as poor parenting skills, lack of emotional support from parents, neglect and physical abuse, and criminal behavior of family members [3]. Family therapy reduces criminal behavior of adolescents [4], and also improves family functioning [5][6][7]. Therefore, intervention programs for delinquent adolescents should focus not only on the youth but also on the family in order to have the adolescent abstain from criminal activities [3,[8][9][10]. Such family-centered intervention programs could include family therapy [11]. ...
Background:
Treatment and rehabilitation interventions in juvenile justice institutions aim to prevent criminal reoffending by adolescents and to enhance their prospects of successful social reintegration. There is evidence that these goals are best achieved when the institution adopts a family-centered approach, involving the parents of the adolescents. The Academic Workplace Forensic Care for Youth has developed two programs for family-centered care for youth detained in groups for short-term and long-term stay, respectively.
Objective:
The overall aim of our study is to evaluate the family-centered care program in the first two years after the first steps of its implementation in short-term stay groups of two juvenile justice institutions in the Netherlands. The current paper discusses our study design.
Methods:
Based on a quantitative pilot study, we opted for a study with an explanatory sequential mixed methods design. This pilot is considered the first stage of our study. The second stage of our study includes concurrent quantitative and qualitative approaches. The quantitative part of our study is a pre-post quasi-experimental comparison of family-centered care with usual care in short-term stay groups. The qualitative part of our study involves in-depth interviews with adolescents, parents, and group workers to elaborate on the preceding quantitative pilot study and to help interpret the outcomes of the quasi-experimental quantitative part of the study.
Results:
We believe that our study will result in the following findings. In the quantitative comparison of usual care with family-centered care, we assume that in the latter group, parents will be more involved with their child and with the institution, and that parents and adolescents will be more motivated to take part in therapy. In addition, we expect family-centered care to improve family interactions, to decrease parenting stress, and to reduce problem behavior among the adolescents. Finally, we assume that adolescents, parents, and the staff of the institutions will be more satisfied with family-centered care than with usual care. In the qualitative part of our study, we will identify the needs and expectations in family-centered care as well as factors influencing parental participation. Insight in these factors will help to further improve our program of family-centered care and its implementation in practice. Our study results will be published over the coming years.
Conclusions:
A juvenile justice institution is a difficult setting to evaluate care programs. A combination of practice-based research methods is needed to address all major implementation issues. The study described here takes on the challenge by means of practice-based research. We expect the results of our study to contribute to the improvement of care for adolescents detained in juvenile justice institutions, and for their families.
... Nonetheless, a review conducted by Piquero and colleagues (2009) shows strong support for family and parenting programs as an efficacious approach to delinquency and problem behavior reduction (Piquero, Farrington, Welsh, Tremblay, & Jennings, 2009). And individual evaluations of some programs have shown significant and long term impacts of family focused programs (see for instance, Alexander et al, 1998;Borduin et al., 1995;Henggeler, Melton & Smith, 1992;Henggeler, Melton, Smith, Schoenwald, & Hanley., 1993;Olds et al., 1998;Reynolds et al., 2007;Reynolds, Magnuson & Ou, 2010;Schaeffer & Borduin, 2005;Sexton & Turner, 2010). ...
Because serious crime has widespread negative effects on communities, families and our nation's young people--we must make our "go to" responses--such as policing, probation and incarceration--more effective. The current study will examine an intervention that aims to reduce recidivism through support and supervision of serious youthful offenders who live in high-crime urban neighborhoods. The program aims to bridge a critical tension faced by probation--the dueling goals of social control and social welfare (i.e., punishment and rehabilitation). Specifically, this research will aim to 1) determine the extent to which the program causes decreases in recidivism and 2) explore if level of contact with program staff (street workers) is related to recidivism outcomes. The information gleaned from this study will be useful to both researchers interested in serious and persistent youthful offenders and to practitioners and policy makers aiming to reduce serious crime and optimize community corrections.
... As a whole, the observed differences between leaders and followers have important implications for the risk and needs assessments of serious juvenile offenders who commit crimes in groups. Practitioners should consider that youth who report being leaders of group crime may lack positive, supportive familial bonds that are important for decreasing continued antisocial behavior (Henggeler, Melton, Smith, Schoenwald, & Hanley, 1993). Therefore, to improve the behavioral outcomes of leaders, it may be especially important to engage leaders' families in treatment, as well as connect youth to other caring, supportive, perhaps non-familial adults. ...
This study of 179 recently incarcerated male adolescent offenders examined how leaders and followers in juvenile offending differed across offense, demographic, intraindividual, contextual, and social domains, and how leader/follower status affected the association between facility peer misbehavior and youth’s own institutional behavior over the first month of incarceration. Results indicated that leaders were older, more criminally experienced, reported higher levels of contextual risk, yet reported lower feelings of social isolation than followers. For followers, early exposure to facility peer drug sales was especially impactful on their subsequent institutional substance use, while facility peer antisocial behavior was related concurrently to all youth’s institutional antisocial behavior at each week of incarceration. Findings suggest that leaders and followers have distinct correlates and may require differential intervention, and heightened vigilance of facility peer relations is important throughout youth’s transition to juvenile incarceration.
... These include marital and family therapies, parent training, behavioural and cognitive approaches, supportive therapy, and case management (which may involve liaison with outside agencies). A number of good-quality RCTs of this approach suggest that it is the most effective treatment for delinquent adolescents in reducing recidivism and improving individual and family pathology (Henggeler et al. 1986Henggeler et al. , 1992Henggeler et al. , 1993Henggeler et al. , 1996a Borduin 1999). It is substantially more effective than individual treatment even for quite troubled and disorganized families (Borduin et al. 1995). ...
Multisystemic Therapy (MST) is a family‐based treatment that has demonstrated significant effects on the serious and violent criminal activity of juvenile offenders. MST was developed to address major limitations of existing mental health services for juvenile offenders by (1) addressing key social–ecological factors associated with serious youth antisocial behavior and (2) delivering services in home and other community (e.g., school) settings. This chapter describes how MST interventions address violent and aggressive behaviors of serious juvenile offenders. Specifically, we provide a discussion of the empirical, theoretical, and clinical foundations of MST; a review of findings from clinical trials that demonstrate the clinical and economic benefits of MST; and a description of ongoing efforts to disseminate MST into community settings.
Objective:
This article expands the review of psychosocial treatments for adolescents with disruptive behavior (DB), published previously by this journal. That earlier review focused on DB treatment studies published 1966-2014; the current paper updates the evidence base by incorporating DB treatment studies published 2014-2021.
Method:
A literature search and screening process identified 63 new studies for inclusion in this updated review. The 63 new studies were combined with 86 studies from the prior review and evaluated using Journal of Clinical Child and Adolescent Psychology level of support criteria, which classify studies as well established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy based on the evidence.
Results:
In total, 3 well-established, 7 probably efficacious, and 10 possibly efficacious treatments for adolescents with DB were identified. Further, 52 treatments were classified as experimental and 22 treatments were determined to have questionable efficacy.
Conclusions:
There continues to be a large body of literature building the evidence base for treatments of adolescent DB. With a few exceptions, treatments falling into the top three evidence levels utilized more than one theoretical approach, enhancing each treatment's ability to target DB from multiple angles. Key advances include broad representation of various demographic groups, countries of origin, treatment settings, and provider types in this body of research. Despite these advances, more research is needed to address key gaps in the field, including the need for more studies on treatments tailored to adolescents with DB who are not yet involved with the juvenile justice system.
In addition to mainstream cognitive behavior therapy, behavior modification, and applied behavior analysis, there are many other psychosocial treatments available for individual treatment of aggression and violence. This chapter reviews a selection of these psychosocial treatments. The largest group is a group of therapies focused on couples and families. These include the Duluth model, batterer intervention programs, and various parent training programs, conjoint therapy, and family therapy. Of these therapies, only parent training emerges as a robust strategy to prevent or treat aggression and violence in children and adolescents, including children and adolescents with disabilities. The remaining psychosocial treatments—psychoanalysis, counseling, restorative justice, and combat sports and martial arts—lack robust data to support their use, although there is some support for individual restorative justice and traditional martial arts interventions.KeywordsAggressionViolencePreventionTreatmentDuluth modelBatterer intervention programsParent training programsIncredible Years Parent Training ProgramPositive Parent Training ProgramConjoint therapyFamily therapyPsychotherapyCounselingRestorative justiceCombat sportsMartial arts
When a loved one experiences a substance use disorder (SUD) often, a family member may assume a non-normative and intense caregiving role. Caregivers often experience strain as a result of the care they provide to their loved one experiencing an SUD. While SUDs are conceptualized as a family disease, little is known about caregiver perception of treatment productiveness, or usefulness of the treatment. To begin to address caregiver perception of treatment, we surveyed a national sample of 141 caregivers of a loved one with an SUD to investigate the aspects of family treatment that they felt were most productive in their loved one's recovery using moderation analyses.
Background
Multisystemic Therapy® (MST®) is an intensive, home‐based intervention for families of youth with social, emotional, and behavioural problems. MST therapists engage family members in identifying and changing individual, family, and environmental factors thought to contribute to problem behaviour. Intervention may include efforts to improve communication, parenting skills, peer relations, school performance, and social networks. MST is widely considered to be a well‐established, evidence‐based programme.
Objectives
We assessed (1) impacts of MST on out‐of‐home placements, crime and delinquency, and other behavioural and psychosocial outcomes for youth and families; (2) consistency of effects across studies; and (3) potential moderators of effects including study location, evaluator independence, and risks of bias.
Search Methods
Searches were performed in 2003, 2010, and March to April 2020. We searched PsycINFO, MEDLINE, ERIC, NCJRS Abstracts, ProQuest and WorldCAT dissertations and theses, and 10 other databases, along with government and professional websites. Reference lists of included articles and research reviews were examined. Between April and August 2020 we contacted 22 experts in search of missing data on 16 MST trials.
Selection Criteria
Eligible studies included youth (ages 10 to 17) with social, emotional, and/or behavioural problems who were randomly assigned to licensed MST programmes or other conditions. There were no restrictions on publication status, language, or geographic location.
Data Collection and Analysis
Two reviewers independently screened 1802 titles and abstracts, read all available study reports, assessed study eligibility, and extracted data onto structured electronic forms. We assessed risks of bias (ROB) using modified versions of the Cochrane ROB tool and What Works Clearinghouse standards.
Where possible, we used random effects models with inverse variance weights to pool results across studies. We used odds ratios for dichotomous outcomes and standardised mean differences for continuous outcomes. We used Hedges g to adjust for small sample sizes. We assessed the heterogeneity of effects with χ² and I ². Pairwise meta‐analyses are displayed in forest plots, with studies arranged in subgroups by location (USA or other country) and investigator independence. We provide separate forest plots for conceptually distinct outcomes and endpoints. We assessed differences between subgroups of studies with χ ² tests.
We generated robust variance estimates, using correlated effects (CE) models with small sample corrections to synthesise all available outcome measures within each of nine outcome domains. Exploratory CE analyses assessed potential moderators of effects within these domains.
We used GRADE guidelines to assess the certainty of evidence on seven primary outcomes at one year after referral.
Main Results
Twenty‐three studies met our eligibility criteria; these studies included a total of 3987 participating families. Between 1983 and 2020, 13 trials were conducted in the USA by MST program developers and 10 studies were conducted by independent teams (three in the USA, three in the UK, and one each in Canada, the Netherlands, Norway, and Sweden).
These studies examined outcomes of MST for juvenile offenders, sex offenders, offenders with substance abuse problems, youth with conduct or behaviour problems, those with serious mental health problems, autism spectrum disorder, and cases of child maltreatment. We synthesised data from all eligible trials to test the claim that MST is effective across clinical problems and populations.
Most trials compared MST to treatment as usual (TAU). In the USA, TAU consisted of relatively little contact and few services for youth and families, compared with more robust public health and social services available to youth in other high‐income countries. One USA study provided “enhanced TAU” to families in the control group, and two USA studies compared MST to individual therapy for youth.
The quality of available evidence for MST is mixed. We identified high risks of bias due to: inadequate randomisation procedures (in 9% of studies); lack of comparability between groups at baseline (65%); systematic omission of cases (43%); attrition (39%); confounding factors (e.g., between‐group differences in race, gender, and attention; 43%); selective reporting of outcomes (52%); and conflicts of interest (61%). Most trials (96%) have high risks of bias on at least one indicator.
GRADE ratings of the quality of evidence are low or moderate for seven primary outcomes, with high‐quality evidence from non‐USA studies on out‐of‐home placement.
Effects of MST are not consistent across studies, outcomes, or endpoints. At one year post randomisation, available evidence shows that MST reduced out‐of‐home placements in the USA (OR 0.52, 95% confidence interval [CI] 0.32 to 0.84; P < .01), but not in other countries (OR 1.14, CI 0.84 to 1.55; P = .40). There is no overall evidence of effects on other primary outcomes at one year. When we included all available outcomes in CE models, we found that MST reduced placements and arrests in the USA, but not in other countries. At 2.5 years, MST increased arrest rates in non‐USA countries (OR 1.27, CI 1.01 to 1.60; P = .04) and increased substance use by youth in the UK and Sweden (SMD 0.13, CI −0.00 to 0.27; P = .05). CE models show that MST reducesd self‐reported delinquency and improved parent and family outcomes, but there is no overall evidence of effects on youth symptoms, substance abuse, peer relations, or school outcomes. Prediction intervals indicate that future studies are likely to find positive or negative effects of MST on all outcomes.
Potential moderators are confounded: USA studies led by MST developers had higher risks of bias, and USA control groups received fewer services and had worse outcomes than those in independent trials conducted in other high‐income countries. The USA/non‐USA contrast appears to be more closely related to effect sizes than than investigator independence or risks of bias.
Authors' Conclusions
The quality of evidence for MST is mixed and effects are inconsistent across studies. Reductions in out‐of‐home placements and arrest/conviction were observed in the USA, but not in other high‐income countries. Studies that compared MST to more active treatments showed fewer benefits, and there is evidence that MST may have had some negative effects on youth outside of the USA. Based on moderate to low quality evidence, MST may reduce self‐reported delinquency and improve parent and family outcomes, but there is no overall evidence of effects on youth symptoms, substance abuse, peer relations, or school outcomes.
This article updates the earlier reviews of evidence-based psychosocial treatments for disruptive behavior in adolescents (Brestan & Eyberg, 1998; Eyberg, Nelson, & Boggs, 2008), focusing primarily on the treatment literature published from 2007 to 2014. Studies were identified through an extensive literature search and evaluated using Journal of Clinical Child and Adolescent Psychology (JCCAP) level of support criteria, which classify studies as well-established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy based on existing evidence. The JCCAP criteria have undergone modest changes in recent years. Thus, in addition to evaluating new studies from 2007 to 2014 for this update, all adolescent-focused articles that had been included in the 1998 and 2008 reviews were reexamined. In total, 86 empirical papers published over a 48-year period and covering 50 unique treatment protocols were identified and coded. Two multicomponent treatments that integrate strategies from family, behavioral, and cognitive-behavioral therapy met criteria as well-established. Summaries are provided for those treatments, as well as for two additional multicomponent treatments and two cognitive-behavioral treatments that met criteria as probably efficacious. Treatments designated as possibly efficacious, experimental, or of questionable efficacy are listed. In addition, moderator/mediator research is summarized. Results indicate that since the prior reviews, there has been a noteworthy expansion of research on treatments for adolescent disruptive behavior, particularly treatments that are multicomponent in nature. Despite these advances, more research is needed to address key gaps in the field. Implications of the findings for future science and clinical practice are discussed.
The incarceration of mentally ill youth is a serious problem not receiving the same attention as in adults. In this study, we examine the prevalence of psychopathology and level of behavioral symptomatology in incarcerated youth versus youth receiving community mental health services or hospitalization. We randomly recruited youth from middle South Carolina served by a local CMHC (n = 60), youth served by the state adolescent inpatient program (n = 50), and youth in the S.C. Dept. of Juvenile Justice facilities from the same region (n = 75). We used the DISC-PC 2.3 to evaluate DSM-III-R diagnoses and the CBCL and YSR to evaluate behavioral symptomatology. On the DISC, incarcerated youth had significantly higher mean number of diagnoses and symptoms than CMHC youth, but lower numbers than hospitalized youth. Level of “caseness” (at least one diagnosis) was 86% in hospital youth, 72% in incarcerated youth, and 60% in CMHC youth. The groups differed in CBCL mean total T, internalizing T, and externalizing T scores as well as mean YSR internalizing T scores. Our results indicate the comparability in level of psychopathology in incarcerated and community-treated populations of youth, and the need to develop diversionary programs to prevent the entry of such youth into the juvenile justice system.
Tobacco control efforts have been associated with a significant reduction in the prevalence of tobacco use in the United States. Efforts to reduce the incidence of violent crime have been much less successful. This paper argues that progress on tobacco control stems from the existence of a clear, empirically based, and widely understood analysis of the tobacco problem that articulates (a) the harms associated with its use, (b) the causes of tobacco use, and (c) the programs and policies that could reduce tobacco use. This analysis has guided the development of a network of social organizations that have been advocating for policies and programs that are reducing tobacco use. In contrast, there is not a widely shared, cogent, and empirically based analysis of the problem of violent crime. As a result, efforts to combat violent crime are fragmented and it has proven difficult to generate support for preventive programs and policies. Substantial empirical progress has been made, however, on how violent crime could be prevented. That evidence is reviewed. It is argued that the articulation of this evidence is a critical first step for achieving widespread reduction in the incidence of violent crime. Communication of that evidence to audiences that matter will require that behavioral scientists become better organized to advocate for the adoption of empirically supported practices.
The aim of this Campbell Systematic Review was to evaluate the effect of multi‐systemic therapy (MST) on adolescents with social, emotional, and behavioural problems based on the best available evidence. The effect is measured by a range of behavioural and psychosocial outcomes, including the number of institutional placements and arrests, the incidence of drug abuse, and personal relationships, social skills, absence from school, etc.
The review is exclusively based on randomised controlled trials in which random allocation between MST and usual treatment has taken place. 266 reports were selected on the basis of title and abstract. Of these 35 were found actually to be effect studies. And finally, eight of the 35 effect studies met the pre‐set quality criteria laid down in the original Campbell/Cochrane review.
The Campbell/Cochrane review concludes that MST does not have consistently better effects than other types of interventions ‐ for example, restrictive institutional placement. On the other hand, nothing indicates that MST has any negative overall effects. All in all, MST does not seem to be any better or any poorer than other treatments. The Campbell/Cochrane review concludes that there are no consistent differences in outcome between the adolescents subject to MST and those subject to alternative treatment. This conclusion is based on the best available evidence on the effectiveness of MST.
Synopsis
Results of eight randomised controlled trials of Multisystemic Therapy (MST) conducted in the USA, Canada, and Norway indicate that it is premature to draw conclusions about the effectiveness of MST compared with other services. Results are inconsistent across studies that vary in quality and context. There is no information about the effects of MST compared with no treatment. There is no evidence that MST has harmful effects.
Abstract
Background
Multisystemic Therapy (MST) is an intensive, home‐based intervention for families of youth with social, emotional, and behavioral problems. Masters‐level therapists engage family members in identifying and changing individual, family, and environmental factors thought to contribute to problem behavior. Intervention may include efforts to improve communication, parenting skills, peer relations, school performance, and social networks. Most MST trials were conducted by program developers in the USA; results of one independent trial are available and others are in progress.
Objectives
To provide unbiased estimates of the impacts of MST on restrictive out‐of‐home living arrangements, crime and delinquency, and other behavioral and psychosocial outcomes for youth and families.
Search strategy
Electronic searches were made of bibliographic databases (including the Cochrane Library, C2‐SPECTR, PsycINFO, Science Direct and Sociological Abstracts) as well as government and professional websites, from 1985 to January 2003. Reference lists of articles were examined, and experts were contacted.
Selection criteria
Studies where youth (age 10–17) with social, emotional, and/or behavioral problems were randomised to licensed MST programs or other conditions (usual services or alternative treatments).
Data collection & analysis
Two reviewers independently reviewed 266 titles and abstracts; 95 full‐text reports were retrieved, and 35 unique studies were identified. Two reviewers independently read all study reports for inclusion. Eight studies were eligible for inclusion. Two reviewers independently assessed study quality and extracted data from these studies.
Significant heterogeneity among studies was identified (assessed using Chi‐square and I ² ), hence random effects models were used to pool data across studies. Odds ratios were used in analyses of dichotomous outcomes; standardised mean differences were used with continuous outcomes. Adjustments were made for small sample sizes (using Hedges g). Pooled estimates were weighted with inverse variance methods, and 95% confidence intervals were used.
Main results
The most rigorous (intent‐to‐treat) analysis found no significant differences between MST and usual services in restrictive out‐of‐home placements and arrests or convictions. Pooled results that include studies with data of varying quality tend to favor MST, but these relative effects are not significantly different from zero. The study sample size is small and effects are not consistent across studies; hence, it is not clear whether MST has clinically significant advantages over other services.
Reviewers' conclusions
There is inconclusive evidence of the effectiveness of MST compared with other interventions for youth. There is no evidence that MST has harmful effects.
The Redeploy Illinois (RI) program was created to provide services to nonviolent, moderate to high-risk youth who were likely to be committed to the Illinois Department of Juvenile Justice (IDJJ), which oversees juvenile correctional institutions. Participating counties received financial support from the state to offer various community-based services to youth instead of incarceration. The current research evaluated the impact of the RI program in reducing recidivism from the four pilot sites during state fiscal years (FY) 2006 through 2010. Results showed that youth who completed the program had fewer convictions compared with pre-program (Pre-RI) youth as well as those who were deemed unsuccessful. The findings also demonstrated a longer survival time for RI successful youth relative to those who were unsuccessful and pre-program youth. A discussion of limitations, implications, and future directions was also provided.
This is a practice brief that includes resources and general strategies for those helping professionals working with adolescents who have co-occurring (MH & AOD) Disorders.
Im Jugendalter fallen viele Jugendliche durch sog. Problemverhalten wie Substanzkonsum oder Delinquenz auf. Zu einem großen Teil können diese Verhaltensweisen als transitorisch betrachtet werden und liegen an für diese Lebensphase typischen biopsychosozialen (einschließlich neuronalen) Veränderungen. Bei einer Minderheit jedoch sind spezifische Problemlagen, die schon in der Kindheit zu beobachten sind, ursächlich und dieser Entwicklungspfad weist eine hohe Kontinuität bis ins Erwachsenenalter auf. Im vorliegenden Kapitel werden sowohl allgemeine Erklärungsmodelle beschrieben, als auch einzelne spezifische Probleme (legaler und illegaler Drogenkonsum, Delinquenz und Bullying) näher beleuchtet. Dabei wird jeweils auf Möglichkeiten der Prävention eingegangen, die den Beginn und/oder die Eskalation von Problemverhalten bei Jugendlichen anvisieren.
Despite the uniqueness of an incarceration experience for adolescents, there remains a shortage of research on adolescents and emerging adults who have been recently released from detention centers and are returning home during the transitional time period of “reentry”. Drawing from the developmental literature, the current study uses a diverse (54% Black, 20% White, 26% Other Race) longitudinal survey of 337 male adolescents living in the United States to examine the interrelationships among crime, substance use, family conflict, and peer delinquency. A series of cross-lagged dynamic panel data models using four waves of data demonstrate that while family conflict and peer delinquency relate to increased offending and substance use, conflict in the family is a major driving force behind both future family conflict and peer delinquency. Overall, findings suggest that family conflict is an overlooked, but absolutely critical, factor in explaining deviance and deviant peer associations alike for adolescents and emerging adults who have been recently incarcerated and released.
Objective:
Researchers have identified several family-based treatments that hold considerable promise in reducing serious juvenile offending; however, these treatments remain underutilized by youth service systems. In the present study, we used meta-analysis to summarize the findings of research on family-based treatments for serious juvenile offenders.
Method:
We conducted a multilevel meta-analysis that modeled dependencies between multiple effect sizes from the same study. The meta-analysis synthesized 324 effect sizes from 28 studies that met inclusion criteria. Potential moderators (e.g., characteristics of samples, treatments, methods, and measures) were entered as fixed effects in the meta-analytic model.
Results:
Across studies, family-based treatments produced modest, yet long-lasting, treatment effects (mean d = 0.25 for antisocial behavior, 0.24 overall) relative to comparison conditions. Furthermore, certain characteristics moderated the magnitude of treatment effects; for example, measures of substance use showed the largest effects and measures of peer relationships showed the smallest effects.
Conclusions:
Policymakers, administrators, and treatment providers may find it useful to consider the effects of family-based treatments for serious juvenile offenders in their selection of treatments for this population. In addition, investigators who seek to develop and study such treatments may wish to consider the current findings in their future research efforts. (PsycINFO Database Record
Although major innovations in child and family policy continue to occur primarily at the state and community level, the framework for child and family policy has been set increasingly in federal law. Given this fact and the enormous social importance of child and family welfare, there is a need to ensure that Congress has easy access to relevant social science research and policy analysis. Since 1989, with sponsorship by several units of the American Psychological Association, a national consortium of centers on children, families, and the law has provided an annual series of briefings for congressional staff. Determination of the impact of specific events and actors in the policy process is difficult, but there is evidence that the briefings have affected several important legislative actions.
Improving the Balance between Child Development and Juvenile Punishment in a Comprehensive Strategy: A Comment on Vila - Volume 16 Issue 1 - James C. Howell
This article reviews some of the most effective programmes for saving children from a life of crime, and also presents the results of cost-benefit analyses of some of these programmes. The best programmes include general parent education in home visiting programmes, parent management training, pre-school intellectual enrichment programmes, child skills training, Functional Family Therapy, Multidimensional Treatment Foster Care and Multisystemic Therapy. Communities That Care is a useful overarching programme. Most of these programmes have been shown to reduce crime and save money. The time is ripe to establish national agencies in all countries which will advance knowledge about early risk factors (from longitudinal studies) and about effective developmental interventions (from randomized experiments and cost-benefit analyses).
Across 5 decades, hundreds of randomized trials have tested psychological therapies for youth internalizing (anxiety, depression) and externalizing (misconduct, attention deficit and hyperactivity disorder) disorders and problems. Since the last broad-based youth meta-analysis in 1995, the number of trials has almost tripled and data-analytic methods have been refined. We applied these methods to the expanded study pool (447 studies; 30,431 youths), synthesizing 50 years of findings and identifying implications for research and practice. We assessed overall effect size (ES) and moderator effects using multilevel modeling to address ES dependency that is common, but typically not modeled, in meta-analyses. Mean posttreatment ES was 0.46; the probability that a youth in the treatment condition would fare better than a youth in the control condition was 63%. Effects varied according to multiple moderators, including the problem targeted in treatment: Mean ES at posttreatment was strongest for anxiety (0.61), weakest for depression (0.29), and nonsignificant for multiproblem treatment (0.15). ESs differed across control conditions, with “usual care” emerging as a potent comparison condition, and across informants, highlighting the need to obtain and integrate multiple perspectives on outcome. Effects of therapy type varied by informant; only youth-focused behavioral therapies (including cognitive-behavioral therapy) showed similar and robust effects across youth, parent, and teacher reports. Effects did not differ for Caucasian versus minority samples, but more diverse samples are needed. The findings underscore the benefits of psychological treatments as well as the need for improved therapies and more representative, informative, and rigorous intervention science.
This Practice Parameter is a revision of a previous Parameter addressing reactive attachment disorder that was published in 2005. It reviews the current status of reactive attachment disorder (RAD) and disinhibited social engagement disorder (DESD) with regard to assessment and treatment. Attachment is a central component of social and emotional development in early childhood, and disordered attachment is defined by specific patterns of abnormal social behavior in the context of “insufficient care” or social neglect. Assessment requires direct observation of the child in the context of his or her relationships with primary caregivers. Treatment requires establishing an attachment relationship for the child when none exists and ameliorating disturbed social relatedness with non-caregivers when evident. Key Words: attachment, reactive attachment disorder, disinhibited social engagement disorder, indiscriminate behavior, indiscriminate friendliness, indiscriminate social behavior, practice parameter, practice guideline.
Aggression and antisocial behaviours are the most common mental health and behavioural difficulties experienced by children and young people aged 5 to 16 years (ONS, 2005). These behaviours significantly impact functioning and quality of life during childhood and adolescence, and are associated with an increased rate of mental health need during adulthood (NICE 2013). Children and youth who display antisocial behaviours are more likely to perform poorly in school, abuse substances, have contacts with the criminal justice system (CJS) and experience social isolation during adolescence.
This chapter reviews knowledge about the most important family influences on offending and about the most effective family-based intervention programmes to reduce offending. Prospective longitudinal studies yield the most convincing information about family influences on offending, while randomized experiments yield the most convincing information about the effectiveness of interventions.
A great deal is known about risk factors for offending, but less is known about protective factors. The most important family risk factors include poor child-rearing (poor supervision, harsh or erratic discipline, parental coldness, low parental involvement), teenage parents, child physical abuse or neglect, parental conflict, disrupted families (caused by parental disharmony), criminal parents and large family size.
In risk-focussed prevention, intervention techniques target key risk factors such as poor child-rearing. Home visiting programmes including general parent education, and parent management training that teaches parents child-rearing skills, are both effective in reducing later offending. Named programmes such as The Incredible Years, Triple-P, Functional Family Therapy, Treatment Foster Care and Multi-systemic Therapy, are effective. The financial benefits of these programmes exceed their financial costs. A national prevention agency is needed in all countries to fund and coordinate the delivery of effective prevention programmes.
Bronfenbrenner’s (1979) theory of social ecology provides the underlying theoretical rationale of multisystemic therapy (MST). A key assumption of the theory of social ecology is that behavior is multi determined from the interplay of individual characteristics and the multiple, interrelated systems in which individuals are embedded. For children and adolescents, these systems include the family, peers, school, neighborhood, community (including social support network), and the larger macrosystem (e.g., the organizational culture, political climate). A second assumption is that interpersonal behavior is reciprocal and bidirectional. That is, individuals and systems influence each other in an ongoing and recursive fashion.
This article updates the earlier reviews of evidence-based psychosocial treatments for disruptive behavior in adolescents (Brestan & Eyberg, 1998; Eyberg, Nelson, & Boggs, 2008), focusing primarily on the treatment literature published from 2007 to 2014. Studies were identified through an extensive literature search and evaluated using Journal of Clinical Child and Adolescent Psychology (JCCAP) level of support criteria, which classify studies as well-established, probably efficacious, possibly efficacious, experimental, or of questionable efficacy based on existing evidence. The JCCAP criteria have undergone modest changes in recent years. Thus, in addition to evaluating new studies from 2007 to 2014 for this update, all adolescent-focused articles that had been included in the 1998 and 2008 reviews were reexamined. In total, 86 empirical papers published over a 48-year period and covering 50 unique treatment protocols were identified and coded. Two multicomponent treatments that integrate strategies from family, behavioral, and cognitive-behavioral therapy met criteria as well-established. Summaries are provided for those treatments, as well as for two additional multicomponent treatments and two cognitive-behavioral treatments that met criteria as probably efficacious. Treatments designated as possibly efficacious, experimental, or of questionable efficacy are listed. In addition, moderator/mediator research is summarized. Results indicate that since the prior reviews, there has been a noteworthy expansion of research on treatments for adolescent disruptive behavior, particularly treatments that are multicomponent in nature. Despite these advances, more research is needed to address key gaps in the field. Implications of the findings for future science and clinical practice are discussed.
This chapter has two main aims. First, it summarizes the major risk factors for conduct problems and delinquency and, second, it reviews the scientific evidence on the effectiveness of interventions to prevent conduct disorder and delinquency. The chapter focuses on risk factors discovered in prospective longitudinal surveys and on successful interventions demonstrated in randomized controlled experiments. (For descriptions of longitudinal surveys, see Kalb et al. 2001; for reviews of risk factors, see Hawkins et al. 1998; for reviews of intervention studies, see Farrington and Welsh 2003.) It also focuses mainly on young people aged 10–17 and relies on research carried out in North America, Great Britain, or similar Western countries. Most research has been carried out with males, but studies of females are included where applicable (e.g., Moffitt et al. 2001). The focus is on substantive results rather than methodological and theoretical issues.
The desirability of replacing clinical opinion with reliable, empirically sound observation, ideally based in randomized controlled trials, took hold in an increasing number of areas of medicine throughout the late 1980s and early 1990s. Studies of psychological therapies suddenly became the essential basis for the viability of widely-offered procedures and indeed entire professions. In response to this demand, reviews of “the evidence base” have almost become a cottage industry, whether or not the authors fully understand the limitations of the research on which their reviews are based (Roth and Parry 1997). In this respect it is helpful that carefully framed and consensually developed national policy guidance is emerging in the United Kingdom. As examples, evidence-based psychological therapy services have been identified as a national goal (NHS Executive 1996), and there is now clear guidance regarding referral for major mental health conditions (Department of Health 2001).
Externalizing behavior problems are the most common reasons that children and adolescents are referred for mental health services (Lochman & Lenhart, 1995). Similarly, behavior problems are a common reason for referral to special education services, to school counselors, and to alternative education programs in school settings. Externalizing behavior problems include physical aggression (e.g., hitting, kicking, biting), verbal aggression (e.g., threatening others with use of force), other contranormative or oppositional behaviors (e.g., lying, truancy, running away, theft, fire setting), hyperactivity, impulsive behavior, and weak attentional regulations. In this chapter, we review the characteristics, assessment, and intervention for two subsets of externalizing behavior problems, namely aggressive and oppositional behaviors and attention deficit and hyperactive behaviors.
Multisystemic therapy (MST) delivered through a community mental health center was compared with usual services delivered by a Department of Youth Services in the treatment of 84 serious juvenile offenders and their multiproblem families. Offenders were assigned randomly to treatment conditions. Pretreatment and posttreatment assessment batteries evaluating family relations, peer relations, symptomatology, social competence, and self-reported delinquency were completed by the youth and a parent, and archival records were searched at 59 weeks postreferral to obtain data on rearrest and incarceration. In comparison with youths who received usual services, youths who received MST had fewer arrests and self-reported offenses and spent an average of 10 fewer weeks incarcerated. In addition, families in the MST condition reported increased family cohesion and decreased youth aggression in peer relations. The relative effectiveness of MST was neither moderated by demographic characteristics nor mediated by psychosocial variables.
Psychologists studying whether and when events occur face unique design and analytic difficulties. The fundamental problem is how to handle censored observations, the people for whom the target event does not occur before data collection ends. The methods of survival analysis overcome these difficulties and allow researchers to describe patterns of occurrence, compare these patterns among groups, and build statistical models of the risk of occurrence over time. This article presents a unified description of survival analysis that focuses on 2 topics: study design and data analysis. In the process, we show how psychologists have used the methods during the past decade and identify new directions for future application. The presentation is based on our own experience with the methods in modeling employee turnover and examples drawn from research on mental health, addiction, social interaction, and the life course.
This study compared the efficacy of multisystemic therapy (MST) and individual therapy (IT) in the outpatient treatment of adolescent sexual offenders. Sixteen adolescent sexual offenders were randomly assigned to either MST or IT conditions. Youths in the MST and IT conditions received an average of 37 hours and 4S hours of treatment, respectively. Recidivism data were collected on all subjects at an approximately 3-year follow-up. Betweengroups comparisons showed that significantly fewer subjects in the MST condition had been rearrested for sexual crimes and that the frequency of sexual rearrests was significantly lower in the MST condition than in the IT condition. The relative efficacy of MST was attributed to its emphasis on changing behavior and interpersonal relations within the offender's natural environment.
A replication of Alexander's behavioral-systems family therapy model was attempted for lower socioeconomic status juvenile offenders, most of whom had multiple offenses, including misdemeanors and felonies. Twenty-seven male and female delinquents who had either recently been placed out of the home or for whom placement was imminent were court referred to in-home time-unlimited family therapy (mean sessions=16). A comparison group of 27 lower risk delinquents received only probation. Outcome was measured by the number and severity of offenses during a 2-year period following group assignment. The delinquents receiving the family therapy had a recidivism rate of 11% vs. 67% for the comparison group. Sex differences are presented, as well as differences between Alexander's studies and the present one which may account for the improved outcomes with more difficult families.
In a study spanning 22 years, data were collected on the aggressiveness of over 600 subjects, their parents, and their children. Subjects who were the more aggressive 8-year-olds at the beginning of the study were discovered to be the more aggressive 30-year-olds at the end of the study. The stability of aggressive behavior was shown to be very similar to the stability of intellectual competence, especially for males. Early aggressiveness was predictive of later serious antisocial behavior, including criminal behavior, spouse abuse, traffic violations, and self-reported physical aggression. Furthermore, the stability of aggression across generations within a family when measured at comparable ages was even higher than the within individual stability across ages. It is concluded that, whatever its causes, aggression can be viewed as a persistent trait that may be influenced by situational variables but possesses substantial cross-situational constancy. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
57 delinquent adolescents received family ecological treatment, 23 delinquent adolescents received an alternative treatment, and 44 normal adolescents served as developmental controls. The mean age of the adolescents at pretreatment was 14.8 yrs. Pre- and posttreatment assessments were conducted with the adolescent and his/her parents. Measures included the Behavior Problem Checklist, the Eysenck Personality Inventory, and self-report and observational measures of family relations. Ss who received family ecological treatment evidenced significant decreases in conduct problems, anxious-withdrawn behaviors, immaturity, and association with delinquent peers. The mother–adolescent and marital relations in these families were significantly warmer, and Ss were significantly more involved in family interaction. In contrast, the families who received the alternative treatment evidenced no positive change and showed deterioration in affective relations. The normal families manifested relationship changes that were consistent with those identified by investigators of normal adolescent development. Findings support a multisystemic model of behavior disorders and treatment. (59 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
The role of cognitive mediators in identifying differences in aggression was examined. Male and female adolescents incarcerated for antisocial aggression offenses and high-school students rated as either high or low in aggression were compared in terms of two sets of cognitive mediators: skills in solving social problems and beliefs supporting aggression. Antisocial-aggressive individuals were most likely (and low-aggressive individuals were least likely) to solve social problems by: defining problems in hostile ways; adopting hostile goals; seeking few additional facts; generating few alternative solutions; anticipating few consequences for aggression; and choosing few "best" and "second best" solutions that were rated as "effective." Antisocial-aggressive individuals were also most likely to hold a set of beliefs supporting the use of aggression, including beliefs that aggression: is a legitimate response; increases self-esteem; helps avoid a negative image; and does not lead to suffering by the victim. The ways in which these findings further elaborate a model of social-cognitive development and extend it to antisocial-aggressive adolescents are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A 12-session intervention program, based on a model of social–cognitive development, was designed to remediate cognitive factors identified as correlates of aggression (R. G. Slaby and N. G. Guerra; see record
1989-01839-001). 120 male and female adolescents incarcerated for aggression offenses participated in either the cognitive mediation training program, an attention control group, or a no-treatment group. Compared with Ss in both control groups, Ss in the treatment group showed increased skills in solving social problems, decreased endorsement of beliefs supporting aggression, and decreased aggressive, impulsive, and inflexible behaviors, as rated by staff. Posttest aggression was directly related to change in cognitive factors. No group differences were detected for number of parole violators up to 24 months after release. The ways in which changes in cognitive skills and beliefs may mediate changes in aggressive behavior are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This study evaluated the relative efficacy of two promising treatments of child abuse and child neglect: parent training and multisystemic therapy. Subjects included 18 abusive families and 15 neglectful families who were randomly assigned to the treatment conditions. Self-report and observational measures were used to evaluate the effects of treatment at three levels that have been associated with child maltreatment: individual functioning, family relations, and stress/social support. Statistical analyses revealed that families who received either treatment showed decreased parental psychiatric symptomology, reduced overall stress, and a reduction in the severity of identified problems. Analyses of sequential observational measures revealed that multisystemic therapy was more effective than parent training at restructuring parent–child relations. Parent training was more effective than multisystemic therapy at reducing identified social problems. The differential influences of the two treatments were probably associated with differences in their respective treatment contexts and epistemologies. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This article examined the long-term effects of multisystemic therapy (MST) vs. individual therapy (IT) on the prevention of criminal behavior and violent offending among 176 juvenile offenders at high risk for committing additional serious crimes. Results from multiagent, multimethod assessment batteries conducted before and after treatment showed that MST was more effective than IT in improving key family correlates of antisocial behavior and in ameliorating adjustment problems in individual family members. Moreover, results from a 4-year follow-up of rearrest data showed that MST was more effective than IT in preventing future criminal behavior, including violent offending. The implications of such findings for the design of violence prevention programs are discussed.
Psychologists studying whether and when events occur face unique design and analytic difficulties. The fundamental problem Is how to handle censored observations, the people for whom the target event does not occur before data collection ends. The methods of survival analysis overcome these difficulties and allow researchers to describe patterns of occurrence, compare these patterns among groups, and build statistical models of the risk of occurrence over time. This article presents a. unified description of survival analysis that focuses on 2 topics: study design and data analysis. In the process, we show how psychologists have used the methods during the past decade and identify new directions for future application. The presentation is based on our own experience with the methods in modeling employee turnover and examples drawn from research on mental health, addiction, social interaction, and the life course.
To understand the way children develop, Bronfenbrenner believes that it is necessary to observe their behavior in natural settings, while they are interacting with familiar adults over prolonged periods of time. His book offers an important blueprint for constructing a new and ecologically valid psychology of development.
This paper identifies and explores the implications of the ecological paradigm for child, youth, and family services. Historical and theoretical roots of the "person-in-environment" configuration are examined along with recent empirical evidence that suggests the complementarity of "life skills teaching" and "social support facilitation" as elements of effective service programs for children, youths, and families. Implications are drawn for policy development and implementation as well as for the design of service programs.
This article describes the values and program components of an intensive home-based family preservation service program called Homebuilders, which was designed to treat status-offending youths in danger of imminent out-of-home placement and their families. Data indicated that 87% of 687 youth referred to Homebuilders avoided placement for 12 months after service intake. These results are discussed with respect to program replication, other client populations, and future research directions.
the social ecology of delinquent behavior is examined, and three central themes are developed / first, adolescent criminal activity is embedded within several systemic contexts (e.g., family, peers, school, and neighborhood) that influence such behavior and are influenced by the behavior / second, the consideration of variables within adolescents' broader social environments increases the explanatory power of models of delinquency / and third, the social ecology of delinquency has important implications for the development of effective treatment strategies / in contrast to most existing treatments of delinquency, which focus on the individual adolescent or one pertinent system, the social-ecological perspective suggests that broad-based treatments are more appropriate / before turning to these issues, the significance of delinquency as an area of research and the correlates of delinquency are briefly reviewed (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Identifies 3 distinct models of family-centered placement prevention programs: crisis intervention, home-based model, and family treatment. Prototypical programs within each model are described with respect to their history, theory, base, and practice methods. Data from 3 studies of family-centered programs indicate that the greatest differences among the 3 models occurred in structure and treatment approaches, while the greatest similarities occurred in family characteristics and the commitment to placement prevention and family empowerment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This book reviews studies of the correlates of delinquent behavior that have been published in the psychological, sociological, and psychiatric literatures. The book focuses on the empirical findings in these literatures, rather than on discussions of the numerous theoretical models that have guided research.
Several chapters address important areas of research that have been largely neglected by previous reviewers. Studies by researchers who have recently developed multidimensional causal models of delinquent behavior are examined in Chapter 4. In Chapter 5 the correlates of delinquent behavior in female adolescents are reviewed. And the small extant literatures regarding the correlates of sexual offending and violent offending are examined in Chapter 6.
Chapters 7 and 8 examine treatments that focus on individual adolescent offenders and treatments that focus on important systems of the offenders, respectively. . . . Finally, methodological and conceptual recommendations for future research are presented in Chapter 9. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
we will be describing studies that were carried out more than a decade ago but still represent the best examples of research into the efficacy of institutional treatment for juvenile delinquents
does anything work / what can be expected to work / what is institutional treatment / experiments in institutional treatment / an overview of treatment effectiveness / component analysis: order out of chaos (PsycINFO Database Record (c) 2012 APA, all rights reserved)
report the results of a recent evaluation of the effectiveness of one type of home-based service: intensive home-based family preservation services (IFPS)
resurgence of intensive home-based preservation services / the "Homebuilders model" of intensive home-based family preservation treatment / the effectiveness of family-centered and intensive family preservation services (PsycINFO Database Record (c) 2012 APA, all rights reserved)
the Functional Family Therapy (FFT) model is a family-based approach, developed for treating juvenile delinquency, that integrates behavioral, systems and cognitive intervention strategies / purpose of this chapter is to describe the elements and philosophy of this model, highlighting the model's particular strengths / these strengths include a strong research base: the inclusion of all three major components identified in Garrett's (1985) and Gendreau and Ross's (1980) reviews (a family focus, the use of cognitive techniques, and the use of specific behavior change techniques with consequences for behavior); a dialectical flavor of both generality and specificity that includes a multivariate and multilevel focus; and a careful specification of the different phases of intervention (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Evaluated the relative effectiveness of components of home-based family therapy through interviews with 41 single- and 2-parent families and 17 therapists. Based on critical incidents occurring during treatment, 8 qualitatively derived dimensions of family-based treatment were identified. These categories involved treatment interruption/disruption, client training, concrete assistance, clinical assessment, client interactions with helping networks, discussion of events outside sessions, events identified as both helpful and not helpful, and conflict. The provision of concrete assistance to families and the number of treatment session interruptions were positively associated with successful outcomes. Findings suggest the importance of expanding the definition of treatment activities that are considered therapeutic. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Functional Family Therapy (FFT) is all about helping youth and families who are in trouble. Central to FFT is the belief this
can be accomplished by changing family interactions and improving relationship functioning as the primary vehicle for changing
dysfunctional individual behaviors. FFT shares many similarities with other systems approaches; however, FFT offers a comprehensive
framework for understanding adolescent behavior problems that is quite unique. This framework provides the context for integrating
and linking behavioral and cognitive intervention strategies to the specific familial and ecological characteristics of each
family. As such, FFT is also about therapists, about training and supervision, and about treatment and other (educational,
judicial, religious, cultural, political, economic, marketing) systems that surround families, therapists, and agencies.
Focusing on the family rather than the individual offender is important in juvenile justice cases. This analysis of family characteristics, service characteristics, and case outcomes of 159 families referred for status offenses or juvenile delinquency in eight family-based placement prevention programs found a high incidence of parent-child, marital, and family relationship problems. Family-based services were more successful in preventing placement if the highest-risk child attended most or all of the treatment sessions (p < .001) and was enrolled in a regular class in school (p < .05). Substance abuse was the most important predictor of placement in delinquency cases (p < .01) and prior placement was the most important predictor in status offense cases (p < .05). Three-quarters of the families were intact at the time their case was closed, with office-based programs in public agencies having the lowest placement rates. These findings support the use of familybased services with juvenile justice problems.
Typescript (photocopy). Thesis (Ph. D.)--Memphis State University, 1985. Includes bibliographical references (leaves 38-46).
Multisystemic therapy (MST) delivered through a community mental health center was compared with usual services delivered by a Department of Youth Services in the treatment of 84 serious juvenile offenders and their multiproblem families. Offenders were assigned randomly to treatment conditions. Pretreatment and posttreatment assessment batteries evaluating family relations, peer relations, symptomatology, social competence, and self-reported delinquency were completed by the youth and a parent, and archival records were searched at 59 weeks postreferral to obtain data on rearrest and incarceration. In comparison with youths who received usual services, youths who received MST had fewer arrests and self-reported offenses and spent an average of 10 fewer weeks incarcerated. In addition, families in the MST condition reported increased family cohesion and decreased youth aggression in peer relations. The relative effectiveness of MST was neither moderated by demographic characteristics nor mediated by psychosocial variables.
The randomized controlled clinical trial (RCT) is a prospective study using random assignment of subjects to treatment groups to compare the effect and value of a therapeutic intervention against a control. The RCT is the most definitive clinical research tool for evaluating the efficacy of a new therapy in human subjects. Often the outcome of interest in an RCT is the length of time until an event occurs after treatment or intervention. In this article we introduce statistical methods for evaluating differences in the patterns of time to response between two groups of subjects to determine whether one therapy is better than another. The collection of methods for analyzing such data, known as survival data, is called survival analysis. Using data from a hypothetical clinical trial for the prevention of the recurrence of depression, we illustrate two elementary methods for analyzing survival data. We also discuss generalizations of these methods to incorporate covariates and conclude with a general discussion of clinical trials of psychiatric therapies.
A number of previous reviews of studies evaluating the effectiveness of family therapy have varied in their conclusions. This review is the first attempt at an integrated statistical analysis of family therapy effectiveness research. Family therapy was found to have positive effects compared with both no-treatment and alternative treatment controls, as measured by family interactions and behavior ratings. Follow-up data demonstrated that family therapy continued to show positive effects over time, but the effects were diminished and more variable than at posttreatment assessment. Future research should concentrate on comparative outcome studies with specific populations and with both legitimate alternative treatments and placebo controls. In addition, researchers need to describe in greater detail the family therapy procedures that are used. Outcome measures should represent multiple vantage points and should include measures of family interactions, preferably using both self-report and observational methods. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A critical review of the theoretical and outcome studies on family therapy with delinquents is presented. Assessment of the theoretical developments reveals that families of delinquents may be distinguishable from other families by their interactional sequences and processes. The available outcome studies within the field indicate that family therapy is viable for interventions with this population, with behavioral, structural, strategic, and communication approaches receiving the most support, but more specific and robust evidence is still needed. Trends in the research and critical issues are identified and used to provide suggestions for future research and practice.
Studies on the stability of antisocial and delinquent behavior are reviewed, showing that children who initially display high rates of antisocial behavior are more likely to persist in this behavior than children who initially show lower rates of antisocial behavior. Evidence is presented that chronic delinquents, compared with nonchronic or nondelinquent individuals, tend to have been children who were antisocial in more than 1 setting, who displayed a higher variety of antisocial behaviors, and who showed an early onset of such behaviors. Once high levels of antisocial behavior have been established, youths tend to maintain such levels rather than to revert to lower levels of antisocial behavior. Studies suggest that more children drift into higher levels of antisocial behavior than revert to a lower level. Patterns of antisocial behavior tend to change during preadolescence and adolescence: the number of youths who engage in overt antisocial acts (fighting, disobedience, etc.) declines between ages 6 and 16, whereas in that period the number of youths who engage in covert antisocial acts (theft, alcohol and drug use, etc.) increases. Implications are discussed for the early identification of chronic offenders.
IntroductionFamily preservation services research and evaluation (pp. xiii-xxiii)
- D E Biegel
- K Wells
An evaluation of the effectiveness of intensive home-based services as an alternative to placement for adolescents and their families
- P Auclaire
- I M Schwartz
- P. AuClaire
Theories guiding home-based intensive family preservation servicesImproving practice technology for work with high-risk families: Lessons from the “Homebuilders” social work education project
- R P Barth
Homebuilders' approach to the training of in-home therapists
- D Haapala
- J Kinney
- D. Haapala
Family therapy and beyond: A multisystemic approach to treating the behavior problems of children and adolescents
- S W Henggeler
- C M Borduin
- S. W. Henggeler
Unclaimed children: The failure of public responsibility to children and adolescents in need of mental health services
- J Knitzer
- J. Knitzer
Family preservation services: The policy challenge to state child welfare and child mental health systems
- J E Knitzer
- E S Cole
- J. E. Knitzer
Home-based services for children and families: Policy, practice, and research
- S Maybanks
- M E Bryce
- S. Maybanks
Review of Programs for the prevention and treatment of delinquency (Office of Technology Assessment)
- E P Mulvey
- M A Arthur
- N D Reppucci
- E. P. Mulvey
Do family preservation services work? Findings from a large scale experimental study. Symposium presented at the 6th annual National Association for Family Based Services Empowering Families Conference
- T L Respnicki
- J R Schuerman
- J H Littell
- T. L. Respnicki
Family preservation services as an alternative to the out-of-home placement of adolescents: The Hennepin County experience
- I M Schwartz
- P Auclaire
- L J Harris
- I. M. Schwartz
Home-based structural family therapy for delinquents at risk of placement
- T N Tavantzis
- M Tavantzis
- L G Brown
- M Rohrbaugh
- T. N. Tavantzis
Improving practice technology for work with high-risk families: Lessons from the ?Homebuilders? social work education project
- R P Barth
- R. P. Barth
Family preservation services research and evaluation (pp. xiii-xxiii)
- D E Biegel
- K Wells
- D. E. Biegel
Home-based family treatment: A quantitative-qualitative assessment
- H Frankel
- H. Frankel