A randomized clinical trial evaluated the efficacy of multisystemic therapy (MST) versus usual community services (UCS) for 48 juvenile sexual offenders at high risk of committing additional serious ...crimes. Results from multiagent assessment batteries conducted before and after treatment showed that MST was more effective than UCS in improving key family, peer, and academic correlates of juvenile sexual offending and in ameliorating adjustment problems in individual family members. Moreover, results from an 8.9-year follow-up of rearrest and incarceration data (obtained when participants were on average 22.9 years of age) showed that MST participants had lower recidivism rates than did UCS participants for sexual (8% vs. 46%, respectively) and nonsexual (29% vs. 58%, respectively) crimes. In addition, MST participants had 70% fewer arrests for all crimes and spent 80% fewer days confined in detention facilities than did their counterparts who received UCS. The clinical and policy implications of these findings are discussed.
Objective: Although current evidence suggests that the positive effects of multisystemic therapy (MST) on serious crime reach as far as young adulthood, the longer term impact of MST on criminal and ...noncriminal outcomes in midlife has not been evaluated. In the present study, the authors examined a broad range of criminal and civil court outcomes for serious and violent juvenile offenders who participated on average 21.9 (range = 18.3-23.8) years earlier in a clinical trial of MST (C. M. Borduin et al., 1995). Method: Participants were 176 individuals who were originally randomized to MST or individual therapy (IT) during adolescence and averaged 3.9 arrests for felonies prior to treatment. Arrest, incarceration, and civil suit data were obtained in middle adulthood when participants were on average 37.3 years old. Results: Intent-to-treat analyses showed that felony recidivism rates were significantly lower for MST participants than for IT participants (34.8% vs. 54.8%, respectively) and that the frequency of misdemeanor offending was 5.0 times lower for MST participants. In addition, the odds of involvement in family-related civil suits during adulthood were twice as high for IT participants as for MST participants. Conclusions: The present study represents the longest follow-up to date of an MST clinical trial and demonstrates that the positive impact of an evidence-based youth treatment such as MST can last well into adulthood. Implications of the authors' findings for policymakers and service providers are discussed.
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.
What is the public health significance of this article?
Family-based treatments have the potential to reduce the social and financial consequences of juvenile crime while improving public safety. The results of the present meta-analysis suggest that family-based treatments for serious juvenile offenders produce modest but long-lasting effects when compared to usual community services.
Youth antisocial behavior exacts a tremendous toll on society and often persists into adulthood. Although researchers have identified a number of psychosocial interventions that prevent or reduce ...youth antisocial behavior in the short term, evidence of long-term intervention benefits has only recently become available. In addition, research on such interventions spans two substantial but largely separate bodies of literature: prevention and therapy. The present study used meta-analysis to integrate research on the long-term effects of preventive and therapeutic interventions for youth antisocial behavior and examined potential moderators of these effects. Results from 66 intervention trials (i.e., 34 prevention, 32 therapy) indicated that a broad range of youth psychosocial interventions demonstrated modest effects on antisocial behavior (mean d=0.31, 95% confidence interval=0.23–0.39) for at least one year beyond the end of interventions relative to control conditions. Among other findings, moderator analyses revealed that inclusion of a peer group intervention component was associated with reduced intervention effects for samples consisting predominantly of boys or older youths. The results of this study have important implications for service providers, administrators, and policymakers involved in the implementation of preventive and therapeutic interventions targeting youth antisocial behavior.
•The study integrates prevention and therapy research on youth antisocial behavior.•Modest long-term benefits were evident for 66 intervention trials (mean d=0.31).•Several interactions between participant, intervention, and methodological factors moderated effects.•For example, peer interventions were less effective for samples with more boys or older youths.•Results have important implications for intervention selection and development.
Objective: Although there is evidence that the positive impact of multisystemic therapy for problem sexual behaviors (MST-PSB) reaches as far as young adulthood, the longer-term effects of MST-PSB ...into midlife are unknown. The present study examined criminal and civil court outcomes for sexually offending youths who participated on average 24.9 years earlier in a clinical trial of MST-PSB (Borduin et al., Journal of Consulting and Clinical Psychology, 2009, 77, p. 26). Method: Participants were 48 individuals who were originally randomized to MST-PSB or usual community services (UCS) and were at high risk of continued criminality. Arrest, incarceration, and civil suit data were obtained in middle adulthood when participants averaged 39.4 years of age. Results: Intent-to-treat analyses showed that MST-PSB participants had 85% fewer sexual offenses and 70% fewer nonsexual offenses than did UCS participants. In addition, MST-PSB participants were sentenced to 46% fewer days of incarceration and had 62% fewer family-related civil suits. Moreover, the favorable effects of MST-PSB on participants' crimes and civil suits were mediated by improved peer and family relations during treatment. Conclusion: The current study represents the longest and most comprehensive follow-up to date of an MST-PSB clinical trial and demonstrates that the positive effects of an evidence-based youth treatment for sexual crimes can last well into adulthood. Implications of the findings for policymakers, service providers, and researchers are discussed.
What is the public health significance of this article?
This study demonstrates that a comprehensive, family-based treatment for youth sexual offending can have a lasting impact on participants' lives. The findings are useful for policymakers and service providers to consider in their selection of mental health interventions for youths who engage in sexual offenses.
Abstract Objective To examine the relative contribution of family functioning to friendship quality in youths with autism spectrum disorder (ASD). Background Youths with ASD often experience problems ...in their friendships. Although researchers have identified linkages between individual youth characteristics and friendship difficulties in youths with ASD, much less is known about the possible linkages between family and friendship problems in this population. However, the family system is an important context in which youths with ASD can learn skills that are necessary for developing friendships. Method The current study examined the relations of key dimensions of family functioning and caregiver romantic relationships to central domains of friendship quality in youths with ASD, while also accounting for individual characteristics of the youths. Participants included youths with ASD ( N = 93) and their primary caregivers who completed measures that assessed family, caregiver, and friendship variables. Results Hierarchical linear regression models revealed that family functioning and caregiver romantic relationships explained significant variance in domains of youth friendship quality above and beyond individual youth characteristics. Conclusion Friendships in youths with ASD were more strongly related to important elements of the family system than to various characteristics of the individual youth. Implications Family relations should be considered in interventions that aim to improve peer relations for youth with ASD.
In this study, the authors examined the long-term criminal activity of 176 youths who had participated in either multisystemic therapy (MST) or individual therapy (IT) in a randomized clinical trial ...(
C. M. Borduin et al., 1995
). Arrest and incarceration data were obtained on average 13.7 (range = 10.2-15.9) years later when participants were on average 28.8 years old. Results show that MST participants had significantly lower recidivism rates at follow-up than did their counterparts who participated in IT (50% vs. 81%, respectively). Moreover, MST participants had 54% fewer arrests and 57% fewer days of confinement in adult detention facilities. This investigation represents the longest follow-up to date of a MST clinical trial and suggests that MST is relatively effective in reducing criminal activity among serious and violent juvenile offenders.
Abstract This study aimed to characterize aggressive behaviors in autistic youths and to identify the social environment variables most strongly linked with aggression in this clinical population. ...Participants were 2142 caregivers of autistic youths (ages 6.0–17.9) recruited from autism research centers across the United States. Caregivers completed self‐report and behavior rating inventories that assessed both verbal and physical aggression as well as characteristics of the individual youths (sleep quality, gastrointestinal GI symptoms, and autism characteristics) and their families (caregiver stress, global family functioning, and sibling relations), peers (emotional bonding, number of friends), schools (academic functioning), and neighborhoods (perceived community safety). We used descriptive analyses to identify which aggressive acts were most common among autistic youths, and we performed bivariate correlations and multiple linear regression analyses to determine which characteristics of the youths and their social environments were most strongly linked with youth aggression. Verbally aggressive youth behaviors were endorsed by caregivers most frequently. Youth age and sex were not associated with verbal or physical aggression. A combination of youth and social environment characteristics accounted for 42.6% of the variance in verbal aggression and 26.0% of the variance in physical aggression. Thus, those characteristics most strongly linked with verbal and physical aggression were strained sibling relations, caregiver stress, youth sleep problems, and youth repetitive and restrictive behaviors. Viewed together, the results suggest that aggressive behaviors in autistic youths are associated with multiple characteristics pertaining to the individual youths and their immediate social environments. Implications for treatment and research are discussed.
Lay Summary This study examined how a range of different factors was related to verbal and physical aggression in a large sample of autistic youths. Boys and girls showed similar levels of aggressive behavior, and aggressive behavior was not strongly related to youth age. Out of a wide range of variables related to the youths and their social environments, we found that family dynamics, youth sleep problems, and repetitive/restrictive behaviors were most strongly linked with aggression.
This study investigated the economics of multisystemic therapy for problem sexual behaviors (MST-PSB), a family-based treatment that has shown promise with juvenile sexual offenders. We evaluated the ...cost and benefits of MST-PSB versus usual community services using arrest data obtained in an 8.9-year follow-up from a randomized clinical trial with 48 juvenile sexual offenders, who averaged 22.9 years of age at follow-up (Borduin, Schaeffer, & Heiblum, 2009). The net benefit of MST-PSB over usual community services was calculated in terms of (a) the value to taxpayers, which was based on measures of criminal justice system expenses (e.g., police and sheriff's offices, court processing, community supervision); and (b) the value to crime victims, which was based on measures of both tangible (e.g., property damage and loss, health care, lost productivity) and intangible (e.g., pain, suffering, reduced quality of life) losses. Lower rates of posttreatment arrests in the MST-PSB versus usual community services conditions were associated with lasting reductions in expenses for both taxpayers and crime victims, with an estimated total benefit of $343,455 per MST-PSB participant. Stated differently, every dollar spent on MST-PSB recovered $48.81 in savings to taxpayers and crime victims over the 8.9-year follow-up. These findings demonstrate that a family-based treatment such as MST-PSB can produce lasting economic benefits with juvenile sexual offenders. Policymakers and public service agencies should consider these findings when making decisions about interventions for this challenging clinical population.
Despite the serious and costly problems presented by juvenile sexual offenders, rigorous tests of promising interventions have rarely been conducted. This study presents a community-based
...effectiveness
trial comparing multisystemic therapy (MST) adapted for juvenile sexual offenders with services that are typical of those provided to juvenile sexual offenders in the United States. Youth were randomized to MST (
n
= 67) or treatment as usual for juvenile sexual offenders (TAU-JSO;
n
= 60). Outcomes through 12 months postrecruitment were assessed for problem sexual behavior, delinquency, substance use, mental health functioning, and out-of-home placements. Relative to youth who received TAU-JSO, youth in the MST condition evidenced significant reductions in sexual behavior problems, delinquency, substance use, externalizing symptoms, and out-of-home placements. The findings suggest that family- and community-based interventions, especially those with an established evidence-base in treating adolescent antisocial behavior, hold considerable promise in meeting the clinical needs of juvenile sexual offenders.
PDF
