Extended the findings from previous meta-analytic work by comparing the effectiveness of behavioral parent-training (BPT) and cognitive-behavioral therapy (CBT) for youth with antisocial behavior problems. Youth demographic variables were also examined as potential moderators of the effectiveness of these 2 types of interventions. Thirty BPT studies and 41 CBT studies met inclusion criteria for this meta-analysis. The weighted mean effect size (ES) for all interventions was 0.40. Youth age was found to moderate the outcome of the 2 interventions, with BPT having a stronger effect for preschool and school-aged youth and CBT having a stronger effect for adolescents. The results also indicate that there may be systematic differences in the outcomes associated with BPT and CBT when the setting of the intervention is considered, suggesting the need to carefully consider the effect of setting in future research. This study also highlights the need for outcome research dealing with more diverse populations and the better classification of research participants on different developmental trajectories of antisocial behavior.
In spite of 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 U.S. Youth were randomized to MST (n = 67) or treatment as usual for juvenile sexual offenders (TAU-JSO; n = 60). Outcomes through 12 months post recruitment 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 Correspondence concerning this article should be addressed to Elizabeth J. Letourneau, Family Services Research Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, McClennan Banks Building 4 th Floor, 326 Calhoun St. STE MC406, Charleston, South Carolina, 29425. Electronic mail may be sent to letourej@musc.edu. The second 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 third author is a board member of MST Associates, LLC, the organization that provides training in MST for youth with problem sexual behaviors. 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/fam/. Policy discussions regarding the legal and treatment dispositions of adolescents arrested for sexual offenses have been contentious, with some policy makers and treatment professionals arguing for lifelong placement on sexual offender registries and extended residential treatment (e.g., J. Ring, quoted in Michels, 8/16/2007), and others emphasizing the generally low recidivism rates of such youth and their need for strength-focused, community-based services (e.g., Chaffin, 2008). Regardless of these different perspectives, however, virtually all stakeholders agree that the scope of sexual offending by juveniles is substantial and warrants the development of effective interventions. NIH Public AccessRegarding the scope and consequences of adolescent sexual offending, official records indicate that minors account for about 20% of all serious sexual crimes (Pastore & M...
Using a nationally representative sample of 3614 adolescents, age 12 to 17 years, this study examines longitudinal associations among interpersonal victimization (i.e., sexual abuse, physical abuse and/or assault, and witnessed community and domestic violence) and high risk behavior (i.e., alcohol use, drug use, and delinquent behavior). A bidirectional relationship was hypothesized between high risk behavior and victimization for the full sample. Descriptive results indicated that a high correlation between types of high risk behavior, with over 50% of adolescents having engaged in at least one type of high risk behavior by Wave 2 in the study. Results suggested strong links between victimization and high risk behaviors, whereas sequential order of the constructs across time was dependent on gender and type of victimization. Specifically, hypotheses concerning victimization and high risk behavior were fully supported with boys, but different patterns emerged in the data for girls.
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...
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