Heterogeneity in Response during Multisystemic Therapy: Exploring Subgroups and Predictors

Mertens, Esther C. A.; Deković, Maja; Asscher, Jessica J.; Manders, Willeke

doi:10.1007/s10802-016-0242-9

Cited by 8 publications

(11 citation statements)

References 50 publications

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“…Whilst the majority of tertiary prevention strategies are provided in prison settings, as demonstrated in IM these can also be provided in the community. Multi-Systemic Therapy (MST; Henggeler et al 1992) is a home-based intervention for adolescents, aged 12-17 years, that have engaged in offending behavior (Mertens et al 2017). According to MST, deviant behavior is a product of the proximal systems (i.e., family, peer groups, school, and community) that the young person belongs to.…”

Section: Tertiary Preventionmentioning

confidence: 99%

Street Gang Intervention: Review and Good Lives Extension

Mallion

Wood

2020

Social Sciences

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Tackling street gangs has recently been highlighted as a priority for public health. In this paper, the four components of a public health approach were reviewed: (1) surveillance, (2) identifying risk and protective factors, (3) developing and evaluating interventions at primary prevention, secondary prevention, and tertiary intervention stages, and (4) implementation of evidence-based programs. Findings regarding the effectiveness of prevention and intervention programs for street gang members were mixed, with unclear goals/objectives, limited theoretical foundation, and a lack of consistency in program implementation impeding effectiveness at reducing street gang involvement. This paper proposes that the Good Lives Model (GLM), a strengths-based framework for offender rehabilitation, provides an innovative approach to street gang intervention. Utilizing approach-goals, the GLM assumes that improving an individual’s internal skills and external opportunities will reduce the need to become involved in street gangs. Wrapping the GLM framework around current evidence-based interventions (e.g., Functional Family Therapy) increases client engagement and motivation to change, which is notably poor amongst those at risk of, or involved in, street gangs.

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Section: Tertiary Preventionmentioning

confidence: 99%

Street Gang Intervention: Review and Good Lives Extension

Mallion

Wood

2020

Social Sciences

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“…MST decreases youth problem behavior including criminal behavior and substance abuse through working directly with families and improving family functioning. However, to our knowledge, except two studies (Halliday-Boykins et al 2004 ; Mertens et al 2017 ), most of the extant studies evaluated the success of MST in reducing serious problem behavior by examining the average changes in the participants. However, the variations across individuals should also be examined to better understand how MST works or for whom.…”

Section: Introductionmentioning

confidence: 99%

“…However, the variations across individuals should also be examined to better understand how MST works or for whom. Halliday-Boykins et al (Halliday-Boykins et al 2004 ), and Mertens et al (Mertens et al 2017 ), on the other hand, examined the trajectories of change in adolescents’ externalizing and/or internalizing behaviors who received MST, and found various subgroups responding differently to treatment. For example, Mertens et al (Mertens et al 2017 ) identified six groups of youth, four of which showed a positive effect of MST with decreases in externalizing behaviors, while two of which displayed poor treatment response by showing either no change or increase in externalizing behaviors.…”

Section: Introductionmentioning

confidence: 99%

“…Halliday-Boykins et al (Halliday-Boykins et al 2004 ), and Mertens et al (Mertens et al 2017 ), on the other hand, examined the trajectories of change in adolescents’ externalizing and/or internalizing behaviors who received MST, and found various subgroups responding differently to treatment. For example, Mertens et al (Mertens et al 2017 ) identified six groups of youth, four of which showed a positive effect of MST with decreases in externalizing behaviors, while two of which displayed poor treatment response by showing either no change or increase in externalizing behaviors. Halliday-Boykins et al (Halliday-Boykins et al 2004 ), on the other hand, identified five trajectories following psychiatric crisis, based on change in externalizing and internalizing symptoms as a result of either MST or psychiatric hospitalization.…”

Section: Introductionmentioning

confidence: 99%

“…A substantial proportion of youth representing three trajectories displayed sustained high levels of symptoms, while two trajectories showed a decrease in the symptoms. However, their sample consisted of youth with severe psychiatric symptoms requiring hospitalization, hence not representing the target group of standard MST directed at youth with externalizing problems (Mertens et al 2017 ).…”

Section: Introductionmentioning

confidence: 99%

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Identification of Multisystemic Therapy (MST) Subgroups with Distinct Trajectories on Ultimate Outcomes in Norway

Keles

Taraldsen

Olseth

2021

Res Child Adolesc Psychopathol

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The effect of Multisystemic Therapy (MST) treatment for serious behavior problems among adolescents has been established through multiple studies. However, variations across individuals should also be examined to better understand how MST works or for whom. In this study, we explored and identified subgroups of youth with serious problems in Norway regarding their responses to MST in terms of ultimate MST outcomes (e.g., living at home, abstaining from violence) over time. We further explored whether immigrant background, in addition to gender and age of the youth at intake, predicted belonging to the subgroups. Data came from 1674 adolescents (MeanAge = 14.55, SDAge = 1.58; 60.7% boys) and their families referred to MST treatment by the municipal Child Welfare Services for serious and persistent antisocial behavior. The outcomes were assessed at five time-points from intake to 18-months after discharge for youth and families who completed the treatment. Latent class growth analyses revealed heterogeneous trajectories regarding youths’ responses to MST. Results indicated a high and sustained degree of improvement across the ultimate outcomes for the vast majority of the youths. However, there was still variation in the groups, with improvement and deterioration trajectories for various outcomes. Most of these trajectories were predicted by gender and youth’s age at intake, but not by immigrant status. Not every youth-at-risk responds similarly to MST, and more studies examining heterogeneity will help us to identify factors to be targeted to better tailor the MST interventions for youth with serious problems.

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Differential Treatment Responses of Maltreated and Neglected Children and Adolescents Following an Evidence-based Multisystemic Intervention

Buderer,

Kirsch,

Pérez

et al. 2024

Res Child Adolesc Psychopathol

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Limited studies have investigated differential treatment responses to family-based treatment programs and subgroup trajectories in youth in a high-risk context. This study pioneered an examination of Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) and built on prior research that identified subgroups with different psychopathologies. Participants included 208 parent–child dyads enrolled in the MST-CAN evaluation in Switzerland. Parents reported their children’s (Mage = 10.27 years, SDage = 3.5, 44.2% girls, 55.8% boys, 98.6% White) emotional and behavioral problems. Longitudinal data were examined to analyze the differential changes within the pre- and post-treatment (T1 and T2) subgroups. The T1 cluster and T2 cluster were cross-tabulated to examine changes in the symptom class over time. Overall, the treatment proved to be highly beneficial. Subgroup analyses revealed that four out of the five subgroups (80%) showed positive changes in at least two outcome measures. The treatment was most successful for children with externalizing symptoms. Children with multiple symptoms also showed improvements across different symptoms. Regarding specific symptoms, children with anxious-avoidant symptoms benefited from the treatment. Additionally, the treatment was beneficial for children with normative emotions and behavior. Meanwhile, the treatment did not have any significant effects for children with internalizing symptoms. Notably, child neglect was reduced in three (60%) subgroups. The symptom class remained stable across time for children with externalizing and multiple symptoms. Ultimately, MST-CAN reduced emotional and behavioral problems and child neglect in most families. Understanding children’s differential treatment responses to complex treatment programs is essential to adequately address different needs.

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Heterogeneity in Response during Multisystemic Therapy: Exploring Subgroups and Predictors

Cited by 8 publications

References 50 publications

Street Gang Intervention: Review and Good Lives Extension

Street Gang Intervention: Review and Good Lives Extension

Identification of Multisystemic Therapy (MST) Subgroups with Distinct Trajectories on Ultimate Outcomes in Norway

Differential Treatment Responses of Maltreated and Neglected Children and Adolescents Following an Evidence-based Multisystemic Intervention

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