Multisystemic therapy: an effective violence prevention approach for serious juvenile offenders

Henggeler, Scott W.; Cunningham, Phillippe B.; Pickrel, Susan G.; Schoenwald, Sonja K.; Brondino, Michael J.

doi:10.1006/jado.1996.0005

Cited by 135 publications

(75 citation statements)

References 26 publications

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“…Consistent with social ecological theories of human development, this broader focus is based on the view of the programme developers -that children's difficulties are caused and maintained by multiple factors within these systems and their interaction. The intervention therefore focuses on identifying and targeting these factors in order to reduce symptoms and distress 142,794 and promote health.…”

Section: Multisystemic Therapymentioning

confidence: 99%

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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BackgroundChild maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems.ObjectivesTo synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment.Study designFor effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views.ParticipantsChildren and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months.InterventionsAny psychosocial intervention provided in any setting aiming to address the consequences of maltreatment.Main outcome measuresPsychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability.MethodsYoung Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible.ResultsWe identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive–behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) –0.44 (95% CI –4.43 to –1.53)], depression [mean difference –2.83 (95% CI –4.53 to –1.13)] and anxiety [SMD –0.23 (95% CI –0.03 to –0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist–child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself.ConclusionsIt is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions.LimitationsStudies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses.Future workStudies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes.Study registrationThis study is registered as PROSPERO CRD42013003889.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Multisystemic Therapymentioning

confidence: 99%

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

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“…71 Likewise, recognizing mental health needs may be of relevance for programs designed at reentering the community. While several community-based intervention programs were found to be effective in antisocial adolescents (for example, multisystemic therapy 74 ), the presence of comorbid psychiatric disorders in adolescents assigned to multisystemic therapy was found to be associated with poor outcome. 75 As comorbidity occurs pervasively among detained adolescents, 76 standard intervention programs are likely to be insufficient when not adequately tailored to their needs.…”

Section: Implications For Clinical Practicementioning

confidence: 99%

Psychiatric Disorders in Detained Male Adolescents: A Systematic Literature Review

Colins

Vermeiren

Vreugdenhil³

et al. 2010

Can J Psychiatry

183

125

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Objective: To provide a best estimate of the prevalence of psychiatric disorders among detained male adolescents, with particular emphasis on impairment, multi-informant assessment, and race or ethnicity. Method:Computer-assisted searches were executed to identify relevant studies.Results: Fifteen studies using adolescents as informants met inclusion criteria (n = 3401), of which only 2 reported within a subsample on parent-derived diagnoses. The mean prevalence of any disorder was 69.9% (95% CI 69.5% to 70.3%); with conduct disorder occurring most frequently (46.4%, 95% CI 45.6% to 47.3%), followed by substance use disorder (45.1%, 95% CI 44.6% to 45.5%), oppositional defiant disorder (19.8%, 95% CI 19.2% to 20.3%), and attention-deficit hyperactivity disorder (13.5%, 95% CI 13.2% to 13.9%). Although lower, rates for internalizing disorders were still substantial, with any anxiety disorder found in 15.9% (95% CI 15.6% to 16.1%), major depression in 12.0% (95% CI 11.7% to 12.2%), and posttraumatic stress disorder in 9.6% (95% CI 9.2% to 10.0%). Three studies reported on psychotic disorders, finding low rates (1.35%, 95% CI 1.32% to 1.39%). Estimates of prevalence were only marginally different when impairment was not required, while consistency between adolescents and parents was poor. Findings on the relations between race or ethnicity were too scarce and inconsistent to interpret. Conclusion:Detained male adolescents bear substantial mental health needs, emphasizing the need to organize effective mental health services for this troubled group. However, our knowledge on mental disorders in detained youth should be enhanced, in particular regarding the reliability of adolescents, compared with parent report, and whether clinically relevant differences exist by race or ethnicity.Can J Psychiatry. 2010;55(4):255-263. Clinical Implications· Across countries, detained and incarcerated adolescents have substantial mental health needs. · Standardized mental health screening at detention intakes is warranted. · Effective mental health services should be developed. Limitations· The systematic search of the literature was restricted to detained and incarcerated male adolescents only. · The number of studies on psychiatric disorders in detained male adolescents using a standardized psychiatric interview is still small. · Methodological differences hamper comparison and interpretation of the 15 index study results.

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“…Les modèles les plus prometteurs leur semblent être l'intervention multisystémique (Henggeler et al, 1996) et le placement familial à traitement multidimensionnel (Chamberlain et Reid, 1991). En effet, ces deux approches paraissent donner un avantage évident aux participants et à leur famille lorsqu'on les compare aux interventions traditionnelles.…”

Section: Woolfenden Williams Et Peat (2001 Retenant 8 éTudes)unclassified

“…De manière étonnante, quatre ans après la parution de la recension de Woolfenden et al (2001), dans une nouvelle méta-analyse, il n'existe plus de preuve quant à l'efficacité de l'intervention multisystémique (Henggeler et al, 1996). Les auteurs s'empressent d'ajouter qu'il n'existe pas davantage de preuve que cette approche ait des effets nocifs.…”

Section: Littell Popa Et Forsythe (2005 Retenant 8 éTudes)unclassified

L’intervention de type criminologique à l’aune de la Collaboration Cochrane

Lafortune

Meilleur

Blanchard

2009

crimino

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Résumé Dans les échelles d’appréciation de la qualité scientifique des recherches, les essais randomisés contrôlés (ERC) figurent en haut de la liste. En termes de crédibilité, dans le courant des pratiques fondées sur des données probantes (Evidence Based Practice [EBP]), les résultats qu’ils obtiennent ont la priorité sur les autres. Les recensions Cochrane, qui portent généralement sur l’efficacité d’interventions médicales, s’intéressent aussi aux interventions de type criminologique. À notre connaissance, aucune étude ne s’est encore penchée sur les conclusions dégagées par la Collaboration Cochrane sur ce type d’intervention. Dans le présent article, le contenu de la revue électronique Cochrane Database of Systematic Reviews a été analysé, pour la période allant de 2000 à 2008. Les résultats montrent que 33 recensions Cochrane ont traité d’interventions de type criminologique. Privilégiant les ERC, ces recensions n’ont retenu en moyenne que 2 % de toutes les études publiées dans différents champs d’intervention. Un tel résultat permet de discuter de la pertinence de la méthode Cochrane pour évaluer l’efficacité d’interventions à caractère plus social. Les questions posées concernent la représentativité des milieux où sont implantées les interventions, la concomitance et la complexité des problèmes à résoudre, les apports et limites des « protocoles » d’intervention, ainsi que les risques de retard, voire de paralysie, dans l’implantation d’approches innovantes.

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Multisystemic therapy: an effective violence prevention approach for serious juvenile offenders

Cited by 135 publications

References 26 publications

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Psychiatric Disorders in Detained Male Adolescents: A Systematic Literature Review

L’intervention de type criminologique à l’aune de la Collaboration Cochrane

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