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Abstract
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VioLit summary:
OBJECTIVE:
The purpose of this research by Borduin et al. was to compare the effectiveness of two types of therapy in the treatment of adolescent sexual offenders. The study was based in the systems theory approach to behavior modification.
METHODOLOGY:
The authors employed an experimental cross-sectional design with a non-probability sample of 16 male adolescents who had been arrested for sexual offenses. Six of the subjects had been arrested for attempted or completed rape, five for sexual assault, four for sodomy and one for exhibitionism, with most having committed multiple offenses. The majority met the criteria for conduct disorder, and almost all exhibited long-term emotional and interpersonal problems. Subjects were randomly assigned to one of two groups - the treatment group, receiving multisystemic therapy, or the comparison group, receiving individual therapy. The first group received therapy based upon the notion that behavior problems are determined by multiple dimensions and influences, and that interventions must address any or all of these factors. The multisystemic therapy involved sessions with the adolescent alone or with his family, and centered upon the improvement of the subject's cognitive processes (denial, empathy and distortion of thinking), family relations (cohesion and parental supervision), peer relations (the development of prosocial and appropriate relations) and school performance. Individual therapy centered upon personal, family and academic issues, with professional support, feedback and encouragement for a change in behavior. Theoretical approaches included the psychodynamic (a promotion of the subject's insight), the humanistic (the development of warm relationships) and the behavioral (positive reinforcement of prosocial and appropriate behaviors) aspects of therapy. Although six of the subjects did not fully complete their therapy, enough of the treatment was completed to warrant inclusion in the study of data. In order to determine recidivism rates, state police and juvenile and adult court records were searched. Follow-up ranged from 21 months to 49 months, with rearrests being classified as sexual or non-sexual. Analysis involved the examination of frequencies of recidivism, as well as the use of Fisher's Exact Test.
FINDINGS/DISCUSSION:
The authors found significant differences between the two groups in recidivism rates, with the multisystemic therapy group showing 12.5% recidivism for sexual offenses and 25% for non-sexual offenses, while for individual therapy subjects, rates were 75% and 50% for the two types of arrest. Frequency of rearrest was significantly greater for the individual therapy group for sexual offenses, and was also higher, although not significantly so, for rearrest for non-sexual crimes. The authors concluded that treatment effects were longer-lasting for those who had received multisystemic therapy, than for those who had received individual therapy. They suggested that this result was found as the multisystemic approach considers the systems in which the subject is embedded, and is therefore highly contextual. Research has shown that the most effective method for sustaining behavioral changes is to alter a person's systemic context to allow it to support the behavioral changes. By directly addressing dysfunctions in behavior and in relationships as they occurred within their natural environment, the multisystemic treatment group was able to profit on a long-term basis from therapy.
AUTHORS' RECOMMENDATIONS:
The authors recommended further consideration of the multisystemic approach to juvenile offender therapy, as well as a comparison of the approach to established cognitive-behavioral programs in a well-controlled study. They concluded that their findings added to the growing body of knowledge which suggests that multisystemic approaches to individual and family dysfunction could be extremely effective.
EVALUATION:
This study provides a valuable and informative evaluation of the multisystemic approach to the treatment of juvenile sexual offenders. However, its small sample size and lack of control group with no treatment suggests that results be viewed with some caution. Also, reliance upon official data for rates of recidivism might lead to an underestimation of true incidence of offenses. A more detailed discussion of the treatments would have been helpful, in order to determine precisely the methods of therapy employed, and to allow for a more thorough comparison of the two approaches. Despite these limitations, the study provides a valuable basis for further research into the area of multisystemic behavior modification. (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 - Male Offender
KW - Male Violence
KW - Juvenile Male
KW - Juvenile Violence
KW - Juvenile Offender
KW - Offender Treatment
KW - Juvenile Treatment
KW - Sexual Assault Treatment
KW - Outpatient Treatment
KW - Early Adolescence
KW - Late Adolescence
KW - Individual Therapy
KW - Follow-Up Studies
KW - Multisystemic Therapy
KW - Blueprints Model Reference
KW - Recidivism Prevention
KW - Behavior Modification
KW - Cognitive Behavioral
KW - Treatment Techniques
KW - Treatment Program
KW - Sexual Assault Offender
KW - Program Evaluation
KW - Program Effectiveness
KW - Violence Against Women |