Background: Multisystemic Therapy® (MST®) is an intensive, home-based intervention for families of youth with social, emotional, and behavioural problems. MST therapists engage family members in identifying and changing individual, family, and environmental factors thought to contribute to problem behaviour. Intervention may include efforts to improve communication, parenting skills, peer relations, school performance, and social networks. MST is widely considered to be a wellestablished, evidence-based programme. Objectives: We assessed (1) impacts of MST on out-of-home placements, crime and delinquency, and other behavioural and psychosocial outcomes for youth and families; (2) consistency of effects across studies; and (3) potential moderators of effects including study location, evaluator independence, and risks of bias.

This Campbell systematic review examines research on the effectiveness of early, computerized brief interventions on alcohol and cannabis use by young people who are high or risky consumers of either one or both of these substances. The review summarises findings from 60 studies from 10 countries. The participants were young people between the ages of 15 and 25, defined as risky consumers of alcohol or cannabis or both. The review included 33,316 participants. The interventions significantly reduce alcohol consumption in the short‐term compared to no intervention, but the effect size is small, and there is no significant effect in the long‐term. There are also shortcomings in the quality of the evidence. Interventions which provide an assessment of alcohol use with feedback may have a larger effect that those which do not, but again, the evidence is weak. The few studies on cannabis did not show significant effects in the reduction of cannabis consumption. There was no evidence of adverse effects. Plain language summary Computerized brief interventions seem to reduce risky alcohol use among young people; no evidence of effect on cannabis consumptionYoung people who abuse alcohol or cannabis are at risk of immediate and long‐term health and legal consequences. There is some evidence of an impact on alcohol use. Findings are hampered by a lack of rigorous evidence, so further research is needed. What did the review study?Alcohol abuse and use of recreational drugs among young people are significant public health concerns. These should be addressed by effective interventions that provide assistance and counselling to drug and alcohol users.A computerized brief intervention is any preventive or therapeutic activity delivered through online or offline electronic devices, such as a mobile phone, and administered within an hour or less, even a few minutes, of the substance abuse. Such interventions aim to reduce alcohol abuse or drug abuse in general. This review assesses research on the effectiveness of early, computerized brief interventions on alcohol and cannabis use by young people who abuse either one or both of these substances. What studies are included?The included studies employed randomized controlled trials and reported on any computerized brief intervention used as a standalone treatment aimed at reducing alcohol and cannabis consumption. The secondary outcome measured was reported adverse outcomes.The studies were conducted in the United States, New Zealand, The Netherlands, Sweden, Australia, Germany, Switzerland and Brazil, with one study conducted in several countries (Sweden, Belgium, the Czech Republic and Germany).The participants were consumers of alcohol or cannabis or both, and aged 15 to 25 years. A total of 60 studies with a sample size of 33,316 participants were included in the review. What are the main findings of this review?The interventions significantly reduce alcohol consumption in the short‐term compared to no intervention, but the effect size is small, and there is no significant effec...

BackgroundFunctional Family Therapy (FFT) is a short‐term family‐based intervention for youth with behaviour problems. FFT has been widely implemented in the USA and other high‐income countries. It is often described as an evidence‐based program with consistent, positive effects.ObjectivesWe aimed to synthesise the best available data to assess the effectiveness of FFT for families of youth with behaviour problems.Search MethodsSearches were performed in 2013–2014 and August 2020. We searched 22 bibliographic databases (including PsycINFO, ERIC, MEDLINE, Science Direct, Sociological Abstracts, Social Services Abstracts, World CAT dissertations and theses, and the Web of Science Core Collection), as well as government policy databanks and professional websites. Reference lists of articles were examined, and experts were contacted to search for missing information.Selection CriteriaWe included randomised controlled trials (RCTs) and quasi‐experimental designs (QEDs) with parallel cohorts and statistical controls for between‐group differences at baseline. Participants were families of young people aged 11–18 with behaviour problems. FFT programmes were compared with usual services, alternative treatment, and no treatment. There were no publication, geographic, or language restrictions.Data Collection and AnalysisTwo reviewers independently screened 1039 titles and abstracts, read all available study reports, assessed study eligibility, and extracted data onto structured electronic forms. We assessed risks of bias (ROB) using modified versions of the Cochrane ROB tool and the What Works Clearinghouse standards. Where possible, we used random effects models with inverse variance weights to pool results across studies. We used odds ratios for dichotomous outcomes and standardised mean differences for continuous outcomes. We used Hedges g to adjust for small sample sizes. We assessed the heterogeneity of effects with χ2 and I2. We produced separate forest plots for conceptually distinct outcomes and for different endpoints (<9, 9–14, 15–23, and 24–42 months after referral). We grouped studies by study design (RCT or QED), and then assessed differences between these two subgroups of studies with χ2 tests. We generated robust variance estimates, using correlated effects (CE) models with small sample corrections to synthesise all available outcome data. Exploratory CE analyses assessed potential moderators of effects within these domains. We used GRADE guidelines to assess the certainty of evidence on six primary outcomes at 1 year after referral.Main ResultsTwenty studies (14 RCTs and 6 QEDs) met our inclusion criteria. Fifteen of these studies provided some valid data for meta‐analysis; these studies included 10,980 families in relevant FFT and comparison groups. All included studies had high risks of bias on at least one indicator. Half of the studies had high risks of bias on baseline equivalence, support for intent‐to‐treat analysis, selective reporting, and conflicts of interest. Fifteen studies had incomplete reporting of outcomes and endpoints. Using the GRADE rubric, we found that the certainty of evidence for FFT was very low for all of our primary outcomes. Using pairwise meta‐analysis, we found no evidence of effects of FFT compared with other active treatments on any primary or secondary outcomes. Primary outcomes were: recidivism, out‐of‐home placement, internalising behaviour problems, external behaviour problems, self‐reported delinquency, and drug or alcohol use. Secondary outcomes were: peer relations and prosocial behaviour, youth self esteem, parent symptoms and behaviour, family functioning, school attendance, and school performance. There were few studies in the pairwise meta‐analysis (k < 7) and little heterogeneity of effects across studies in most of these analyses. There were few differences between effect estimates obtained in RCTs versus QEDs. More comprehensive CE models showed positive results of FFT in some domains and negative results in others, but these effects were small (standardised mean difference [SMD] <|0.20|) and not significantly different from no effect with one exception: Two studies found positive effects of FFT on youth substance abuse and two studies found null results in this domain, and the overall effect estimate for this outcome was statistically different from zero. Over all outcomes (15 studies and 293 effect sizes), small positive effects were detected (SMD = 0.19, SE = 0.09), but these were not significantly different from zero effect. Prediction intervals showed that future FFT evaluations are likely to produce a wide range of results, including moderate negative effects and strong positive results (−0.37 to 0.75).Authors’ ConclusionsResults of 10 RCTs and five QEDs show that FFT does not produce consistent benefits or harms for youth with behavioural problems and their families. The positive or negative direction of results is inconsistent within and across studies. Most outcomes are not fully reported, the quality of available evidence is suboptimal, and the certainty of this evidence is very low. Overall estimates of effects of FFT may be inflated, due to selective reporting and publication biases.

Background Few studies have examined how parenting influences the associations between prenatal maternal stress and children's mental health. The objectives of this study were to examine the sex-specific associations between prenatal maternal stress and child internalizing and externalizing symptoms, and to assess the moderating effects of parenting behaviors on these associations. Methods This study is based on 15 963 mother–child dyads from the Norwegian Mother, Father, and Child Cohort Study (MoBa). A broad measure of prenatal maternal stress was constructed using 41 self-reported items measured during pregnancy. Three parenting behaviors (positive parenting, inconsistent discipline, and positive involvement) were assessed by maternal report at child age 5 years. Child symptoms of internalizing and externalizing disorders (depression, anxiety, attention-deficit hyperactivity disorder, conduct disorder, and oppositional-defiant disorder) were assessed by maternal report at age 8. Analyses were conducted using structural equation modeling techniques. Results Prenatal maternal stress was associated with child internalizing and externalizing symptoms at age 8; associations with externalizing symptoms differed by sex. Associations between prenatal maternal stress and child depression, and conduct disorder and oppositional-defiant disorder in males, became stronger as levels of inconsistent discipline increased. Associations between prenatal maternal stress and symptoms of attention-deficit hyperactivity disorder in females were attenuated as levels of parental involvement increased. Conclusions This study confirms associations between prenatal maternal stress and children's mental health outcomes, and demonstrates that these associations may be modified by parenting behaviors. Parenting may represent an important intervention target for improving mental health outcomes in children exposed to prenatal stress.

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