Mediators of change for multisystemic therapy with juvenile sexual offenders.

Abstract

The mediators of favorable multisystemic therapy (MST) outcomes achieved at 12 months post recruitment were examined within the context of a randomized effectiveness trial with 127 juvenile sexual offenders and their families. Outcome measures assessed youth delinquency, substance use, externalizing symptoms, and deviant sexual interest/risk behaviors; and hypothesized mediators included measures of parenting and peer relations. Data were collected at pretreatment, 6 months post recruitment, and 12 months post recruitment. Consistent with the MST theory of change and the small extant literature in this area of research, analyses showed that favorable MST effects on youth antisocial behavior and deviant sexual interest/risk behaviors were mediated by increased caregiver follow-through on discipline practices as well as decreased caregiver disapproval of and concern about the youth's bad friends during the follow-up. These findings have important implications for the community-based treatment of juvenile sexual offenders.The primary purpose of this study was to examine the mechanisms by which an evidence-based treatment of juvenile offenders decreased the antisocial behavior and deviant sexual interest and sexual risk behaviors of juvenile sexual offenders participating in a randomized effectiveness trial. Pertinent antisocial behaviors included criminal offending, substance use, and externalizing problems. Deviant sexual interest and sexual risk behaviors were also examined in light of their hypothesized association with sexual reoffending (Worling & The first author is a board member and stockholder of MST Services, LLC, the Medical University of South Carolina-licensed organization that provides training in MST. The fourth author is a board member of MST Associates, LLC, the organization that provides training in MST for youth with problem sexual behaviors.Correspondence Publisher's Disclaimer:The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The published version is available at http://www.apa.org/journals/ccp/ NIH Public Access Author Manuscript J Consult Clin Psychol. Author manuscript; available in PMC 2010 June 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript Langstrom, 2006). Importantly, and consistent with the recommendations of Weersing and Weisz (2002) pertaining to studies testing mediational models, this effectiveness study focused on real-world clients treated in community-based contexts.Multisystemic therapy (MST;Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998) was selected as the evidence-based treatment model examined in this study (Let...

Construindo conhecimento sobre o adolescente que cometeu ofensa sexual

“…Madanes et al (1997) listam uma série de qualidades que devem caracterizar a abordagem a esses adolescentes e uma delas é o bom acolhimento e o contato empático. Da mesma forma, com relação à família, os pais precisam desenvolver mais assertividade e conhecer de fato o adolescente e poderem promover aproximação (Henggeler et al, 2009;Oliver, 2007). Os autores estudiosos do adolescente agressor sexual, citados até então, concordam em um ponto que é a melhor perspectiva de atendimento a esse adolescente, na medida em que a família participa da terapia e que a mãe, em especial, tem papel preponderante.…”

“…Os trabalhos de avaliação sobre metodologia de abordagem familiar a adolescentes com histórico de transgressões sexuais ou não (tomamos como exemplos: Borduin et al 2009;Henggeler et al, 1992;Henggeler et al, 2009;Swenson et al, 2010) (2006) admitem que em 56% dos casos quem comparece aos atendimentos e/ou responde a questionários sobre esse adolescente é a mãe. Por isso, a atenção à qualidade do contato entre eles deve ser priorizada, e é necessário que escutemos o que ela tem a dizer, como reage às condutas dele, como transmite suas orientações, a despeito da avaliação crítica que possamos fazer sobre a atuação de seu papel de mãe, mesmo porque não conseguimos acesso às mesmas observações do que ocorre com o pai.…”

“…Atualmente, o reconhecimento da agressão sexual contra crianças é inequívoco, e as publicações têm se dedicado a esclarecer a complexidade do tema e a propor avanços metodológicos (Marshall et al, 2005). A abordagem terapêutica depende de muitos fatores que centram nas habilidades pessoais e técnicas do terapeuta (Craig, 2005); na abordagem grupal ao adolescente (Marshall et al, 2005); na consideração da família como parte ativa do processo de ressocialização do jovem (Henggeler et al, 2009); e na participação de recursos da comunidade (Forensic Psychology Practice, 2006;Henggeler et al, 2009;Marshall et al, 2005;Ward et al, 2007).…”

“…No contexto do abuso sexual, perpetrado por adolescentes, esse paradoxo se maximiza e a família, por vergonha, inicia uma trajetória de construir um segredo sobre o ocorrido (Baker et al, 2003;Madanes et al, 1997). A abordagem familiar é valorizada e indicada pelo reconhecimento dessa relação interdependente (Borduin et al,, 2009;Henggeler et al, 2009;Madanes et al, 1997;Marshall, 2001;Oliver, 2007 Instrumento -Entrevista semiestruturada que procurou abordar os seguintes temas: apresentação do adolescente por ele mesmo, escolaridade dele e da família, lazer, dia a dia da família, dados dos outros filhos e do casal, dados socioeconômicos da família; relações familiares e relação conjugal; expressão da violência; condição do abuso sexual; reações da família frente ao abuso; organização da casa; relações afetivas, presença ou não da notificação da violência.…”

Effect of treatment on sex offenders’ recidivism: a meta-analysis.

“…Regarding the type of treatment employed, MST was the most effective intervention in reducing sexual recidivism rates (OR = .23; p < .05); although it should be highlighted that the lack of specific studies on this type of intervention (k = 2; n = 196) meant that only the effectiveness of this therapy on adolescents was analyzed, which was likewise the only intervention applied to this collective Schmucker & Lösel, 2015). According to MST principles (Henggeler et al, 2009b), the effectiveness of interventions stems from attending to all those risk factors for an antisocial behavior in adolescents (e.g., few skills in resolving problems in youth, little supervision and ineffective discipline within their families, relations with other offenders or poor performance in school) through the individualization of the therapy, at the same time as the protective factors for juveniles are increased (Henggeler et al, 2009a). Regarding interventions based on social support provided by volunteers, the results also showed significant treatment effects (OR = .27; p < .05); although the aforesaid effect could be due to the individualization of this type of intervention, or the smaller number of studies analyzed (k = 2; n = 182).…”