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Affiliation
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Department of Psychiatry & Behavioral Sciences, Family Services Research Center, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC, 29425-0742, U.S.A. |
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Abstract
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This article provides an overview of a treatment approach, Multisystemic Therapy (MST), that has demonstrated long-term reductions in criminal activity and violence among youth at high-risk for perpetrating violence. Importantly, central aspects of MST are consistent with the recent public health agenda of violence prevention in the United States. Moreover, as demonstrated from the findings of controlled clinical trials evaluating MST with serious juvenile offenders, the viability of the public health approach is supported.
VioLit summary:
OBJECTIVE:
The purpose of this paper by Henggeler et al. was to provide an overview of Multisystemic Therapy (MST).
METHODOLOGY:
The authors reviewed literature dealing with MST, including two evaluation studies of sites that implemented MST treatment programs.
FINDINGS/DISCUSSION:
The authors began by explaining public health approaches to violence and linking them with the MST approach. The authors identified three strategies that have been useful in primary prevention within public health: identification of risk factors, identification of protective factors, and interventions that are designed to prevent or block the transmission of risk factors. Although MST was not conceptualized as primary prevention but rather as secondary prevention, the authors stated that it does attempt to accomplish the above and thus is similar to primary preventions of public health models.
The authors stated that an important component to MST is the neutralization of risk factors. They explained that it is necessary to understand the etiological factors associated with antisocial behavior. The authors stated that there are important multidetermined correlates pertaining to the individual, family, peers, schools, and community.
The authors then explained that another important part of an MST program is the promotion of protective factors. They observed that MST focuses on building competencies, resources, and concrete services for participants and their families. The author described MST as empowering both parents and youth to deal with future difficulties.
In the next section, the authors reviewed two clinical trials of MST. First, in Simponsville, South Carolina, it was reported that MST was effective at reducing rates of criminal behavior. At post-treatment, serious offenders who went through MST reported significantly fewer criminal offenses than those who did not go through MST. At the 59 week follow-up, offenders who received MST had significantly fewer arrests and weeks incarcerated than youths who received the usual services. Moreover, families receiving MST reported more cohesion and decreased adolescent aggression within their families.
In Columbia., Missouri, the study compared MST to individual therapy (IT). It was reported that youths receiving MST were significantly less likely to be rearrested and had lower recidivism rates than youths receiving IT. Furthermore, the MST families reported increased cohesion, adaptability, and showed increased supportiveness and decreased conflict hostility. The authors claimed that findings from the trials provide strong evidence that MST can provide both short- and long-term reductions in criminal behaviors of serious juvenile offenders.
The authors next explored the theoretical and clinical features of MST. They stated that the theoretical model of MST is consistent with social ecological models of behavior. They described a social ecology model as one that claims that individuals are part of a "complex of interconnected systems that encompass both proximal (individual, family, peer, school) and distal (neighborhood, community) social influences" (p. 53).
Lastly, the authors described what MST provides clinically: family preservation model of service delivery, treatment specificity, individualized care, empowerment, and accountability. They claimed that the above are based on the following nine intervention principles(1) "the primary purpose is to understand the fit between the identified problems and their broader systemic context; (2) therapeutic contacts should emphasize the positive and use systemic strengths as levers for change; (3) interventions should be designed to promote responsible behavior and decrease irresponsible behavior among family members; (4) interventions should be present-focused and action-oriented, targeting specific and well-defined problems; (5) interventions should target sequences of behavior within or between multiple systems; (6) interventions should be developmentally appropriate and fit the development needs of youth; (7) interventions should be designed to require daily or weekly effort by family members; (8) intervention efficacy should be evaluated continuously from multiple perspectives; and (9) interventions should be designed to promote treatment generalization and long-term maintenance of therapeutic change. The authors claimed that the above principles represent the fundamental nature of MST"(pp.56-58).
The authors concluded by summarizing the two opportunities that MST has to prevent violence. (1) Youth who engage in serious antisocial behavior also engage in behaviors that place them at higher risk for criminal victimization. (2) youthful violent offending may be reduced by targeting high-risk youths whose families may be responsible for the majority of crime in many areas. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
KW - Juvenile Violence
KW - Juvenile Offender
KW - Violence Treatment
KW - Violence Prevention
KW - Multisystemic Therapy
KW - Literature Review
KW - Program Effectiveness
KW - Program Evaluation
KW - Family Preservation
KW - Missouri
KW - South Carolina
KW - Family Based
KW - Family Treatment
KW - Juvenile Antisocial Behavior
KW - Juvenile Behavior
KW - Behavior Treatment
KW - Juvenile Antisocial Behavior
KW - At Risk Juvenile
KW - At Risk Family
KW - At Risk Youth
KW - Crime Prevention
KW - Juvenile Crime
KW - Juvenile Delinquency
KW - Delinquency Prevention
KW - Prevention Program
KW - Behavior Intervention
KW - Behavior Prevention
KW - Blueprints Model Reference
Language: en |