Article information
Abstract
Multisystemic therapy (MST) is an intensive family and community-based treatment for adolescents presenting serious antisocial behavior and their families. Using a home-based model of service delivery to overcome barriers to service access and a strong quality assurance system to promote treatment fidelity, MST therapists address known risk factors (i.e., at individual, family, peer, school, and community levels) strategically and comprehensively. The family is viewed as central to achieving favorable outcomes, and mediation research supports the emphasis of MST on promoting family functioning as the key mechanism of clinical change. Importantly, 22 MST outcome studies have been published, many of which are independent randomized clinical trials, and the vast majority, including those conducted in Europe, support the capacity of MST to reduce youth antisocial behavior and out-of-home placements. Such outcomes, combined with the advocacy of many juvenile justice stakeholders, have led to the transport of MST programs to more than 500 sites, including 10 nations in Europe.
Keywords:
behavior problems
intervention
multisystemic-therapy
outcomes
randomized clinical-trial
serious juvenile offenders
Resumen
La terapia multisistémica (TMS) es un tratamiento intensivo en el ámbito familiar y comunitario dirigido a adolescentes con comportamientos antisociales graves y a sus familias. Mediante un modelo de atención en el hogar para romper las barreras de acceso al servicio y un sistema de garantías sólido y de calidad para promover la fidelidad al tratamiento, los terapeutas de TMS abordan factores de riesgo conocidos (es decir, a nivel individual, familiar, de iguales y de la comunidad) de forma estratégica y exhaustiva. Se considera a la familia como un elemento fundamental para la obtención de resultados favorables y la investigación sobre variables mediadoras, apoya el énfasis que el TMS pone en promover el funcionamiento familiar como mecanismo clave para el cambio clínico. Es importante señalar que la mayor parte de los 22 estudios de resultados publicados, muchos de ellos ensayos clínicos aleatorios independientes y algunos realizados en Europa, confirman la capacidad de la TMS para reducir la conducta juvenil antisocial y el número de reubicación de menores fuera del hogar familiar. Dichos resultados, junto al apoyo de muchas de las partes implicadas en los procesos judiciales con menores, han propiciado la implementación de programas de TMS en más de 500 lugares, incluyendo 10 naciones europeas.
Palabras clave:
ensayo clínico aleatorio
intervención
problemas de conducta
resultados
terapia multisistémica
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References
[Borduin et al., 1990]
C.M. Borduin, S.W. Henggeler, D.M. Blaske, R. Stein.
Multisystemic treatment of adolescent sexual offenders.
International Journal of Offender Therapy and Comparative Criminology, 35 (1990), pp. 105-114
[Borduin et al., 1995]
C.M. Borduin, B.J. Mann, L.T. Cone, S.W. Henggeler, B.R. Fucci, D.M. Blaske, R.A. Williams.
Multisystemic treatment of serious juvenile offenders: Long-term prevention of criminality and violence.
Journal of Consulting and Clinical Psychology, 63 (1995), pp. 569-578
[Borduin et al., 2009]
C.M. Borduin, C.M. Schaeffer, N. Heiblum.
A randomized clinical trial of multisystemic therapy with juvenile sexual offenders: Effects on youth social ecology and criminal activity.
Journal of Consulting and Clinical Psychology, 77 (2009), pp. 26-37
[Bronfenbrenner, 1979]
U. Bronfenbrenner.
The ecology of human development: Experiments by design and nature.
Cambridge, MA: Harvard University Press, (1979),
[Brunk et al., 1987]
M. Brunk, S.W. Henggeler, J.P. Whelan.
A comparison of multisystemic therapy and parent training in the brief treatment of child abuse and neglect.
Journal of Consulting and Clinical Psychology, 55 (1987), pp. 311-318
[Burns and Goldman, 1998]
Systems of care: Promising practices in children's mental health series: Volume IV. Promising practices in wraparound for children with serious emotional disturbance and their families,
[Butler et al., 2011]
S. Butler, G. Baruch, N. Hickley, P. Fonagy.
A randomized controlled trial of MST and a statutory therapeutic intervention for young offenders.
Journal of the American Academy of Child & Adolescent Psychiatry, 50 (2011), pp. 1220-1235
[Cohen et al., 2006]
J.A. Cohen, A.P. Mannarino, E. Deblinger.
Treating trauma and traumatic grief in children and adolescents.
New York: Guilford Press, (2006),
[Curtis et al., 2009]
N.M. Curtis, K.R. Ronan, N. Heiblum, K. Crellin.
Dissemination and effectiveness of multisystemic treatment in New Zealand: A benchmarking study.
Journal of Family Psychology, 23 (2009), pp. 119-129
[Daly et al., 2007]
B.P. Daly, M.S. Xanthopoulos, S.H. Stephan, C.J. Cooper, R.T. Brown.
Evidence-based interventions for childhood disorders: Summary of the report of the APA Working Group on Psychotropic Medications for Children and Adolescents.
Emotional and Behavioral Disorders in Youth, 7 (2007), pp. 31-55
[Dekovic et al., 2012]
M. Dekovic, J.J. Asscher, W.A. Manders, P. Prins, P. van der Laan.
Within-intervention change: Mediators of intervention effects during multisystemic therapy.
Journal of Consulting and Clinical Psychology, (2012),
[Ellis, 2005]
D.A. Ellis, M.A. Frey, S. Naar-King, T. Templin, P.B. Cunningham, N. Cakan.
Use of multisystemic therapy to improve regimen adherence among adolescents with type 1 diabetes in chronic poor metabo-lic control: A randomized controlled trial.
Diabetes Care, 28 (2005), pp. 1604-1610
[Ellis et al., 2006]
D.A. Ellis, S. Naar-King, P.B. Cunningham, E. Secord.
Use of multisystemic therapy to improve antiretroviral adherence and health outcomes in HIV-infected pediatric patients: Evaluation of a pilot program.
AIDS, Patient Care, and STD's, 20 (2006), pp. 112-121
[Ellis et al., 2004]
D.A. Ellis, S. Naar-King, M.A. Frey, T. Templin, M. Rowland, N. Greger.
Use of Multisystemic Therapy to improve regimen adherence among adolescents with type 1 diabetes in poor metabolic control: A pilot study.
Journal of Clinical Psychology in Medical Settings, 11 (2004), pp. 315-324
[Glisson et al., 2010]
C. Glisson, S.K. Schoenwald, A. Hemmelgarn, P. Green, D. Dukes, K.S. Armstrong, J.E. Chapman.
Randomized trial of MST and ARC in a two-level EBT implementation strategy.
Journal of Consulting and Clinical Psychology, 78 (2010), pp. 537-550
[Haley, 1987]
J. Haley.
Problem-solving therapy.
2nd ed, Jossey-Bass, (1987),
[Henggeler, 2011]
S.W. Henggeler.
Efficacy studies to large-scale transport: The development and validation of MST programs.
Annual Review of Clinical Psychology, 7 (2011), pp. 351-381
[Henggeler and Borduin, 1992]
Henggeler, S.W., & Borduin, C.M. (1992). Multisystemic Therapy Adherence Scales. Unpublished instrument. Charleston: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina
[Henggeler et al., 2002]
S.W. Henggeler, W.G. Clingempeel, M.J. Brondino, S.G. Pickrel.
Four-year follow-up of multisystemic therapy with substance abusing and dependent juvenile offenders.
Journal of the American Academy of Child & Adolescent Psychiatry, 41 (2002), pp. 868-874
[Henggeler et al., 2006]
S.W. Henggeler, C.A. Halliday-Boykins, P.B. Cunningham, J. Randall, S.B. Shapiro, J.E. Chapman.
Juvenile drug court: Enhancing outcomes by integrating evidence-based treatments.
Journal of Consulting and Clinical Psychology, 74 (2006), pp. 42-54
[Henggeler et al., 2009]
S.W. Henggeler, E.J. Letourneau, J.E. Chapman, C.M. Borduin, P.A. Schewe, M.R. McCart.
Mediators of change for multisystemic therapy with juvenile sexual offenders.
Journal of Consulting and Clinical Psychology, 77 (2009), pp. 451-462
[Henggeler et al., 1997]
S.W. Henggeler, G.B. Melton, M.J. Brondino, D.G. Scherer, J.H. Hanley.
Multisystemic therapy with violent and chronic juvenile offenders and their families: The role of treatment fidelity in successful dissemination.
Journal of Consulting and Clinical Psychology, 65 (1997), pp. 821-833
[Henggeler et al., 1992]
S.W. Henggeler, G.B. Melton, L.A. Smith.
Family preservation using multisystemic therapy: An effective alternative to incarcerating serious juvenile offenders.
Journal of Consulting and Clinical Psychology, 60 (1992), pp. 953-961
[Henggeler et al., 1993]
S.W. Henggeler, G.B. Melton, L.A. Smith, S.K. Schoenwald, J.H. Hanley.
Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders.
Journal of Child and Family Studies, 2 (1993), pp. 283-293
[Henggeler et al., 1999]
S.W. Henggeler, S.G. Pickrel, M.J. Brondino.
Multisystemic treatment of substance abusing and dependent delinquents: Outcomes, treatment fidelity, and transportability.
Mental Health Services Research, 1 (1999), pp. 171-184
[Henggeler et al., 1996]
S.W. Henggeler, S.G. Pickrel, M.J. Brondino, J.L. Crouch.
Eliminating (almost) treatment dropout of substance abusing or dependent delinquents through home-based multisystemic therapy.
American Journal of Psychiatry, 153 (1996), pp. 427-428
[Henggeler et al., 1986]
S.W. Henggeler, J.D. Rodick, C.M. Borduin, C.L. Hanson, S.M. Watson, J.R. Urey.
Multisystemic treatment of juvenile offenders: Effects on adolescent behavior and family interactions.
Developmental Psychology, 22 (1986), pp. 132-141
[Henggeler et al., 2003]
S.W. Henggeler, M.D. Rowland, C. Halliday-Boykins, A.J. Sheidow, D.M. Ward, J. Randall, J. Edwards.
One-year follow-up of multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis.
Journal of the American Academy of Child & Adolescent Psychiatry, 42 (2003), pp. 543-551
[Henggeler et al., 1999]
S.W. Henggeler, M.R. Rowland, J. Randall, D. Ward, S.G. Pickrel, P.B. Cunningham, A.B. Santos.
Home-based multisystemic therapy as an alternative to the hospitalization of youth in psychiatric crisis: Clinical outcomes.
Journal of the American Academy of Child & Adolescent Psychiatry, 38 (1999), pp. 1331-1339
[Henggeler et al., 2009]
S.W. Henggeler, S.K. Schoenwald, C.M. Borduin, M.D. Rowland, P.B. Cunningham.
Multisystemic therapy for antisocial behavior in children and adolescents.
2nd ed, Guilford Press, (2009),
[Henggeler et al., 2002]
S.W. Henggeler, S.K. Schoenwald, M.D. Rowland, P.B. Cunningham.
Serious emotional disturbance in children and adolescents: Multisystemic therapy.
New York: Guilford Press, (2002),
[Huey et al., 2000]
S.J. Huey, S.W. Henggeler, M.J. Brondino, S.G. Pickrel.
Mechanisms of change in multisystemic therapy: Reducing delinquent behavior through therapist adherence and improved family and peer functioning.
Journal of Consulting and Clinical Psychology, 68 (2000), pp. 451-467
[Huey et al., 2004]
S.J. Huey Jr., S.W. Henggeler, M.D. Rowland, C.A. Halliday- Boykins, P.B. Cunningham, S.G. Pickrel, J. Edwards.
Multisystemic therapy effects on attempted suicide by youth presenting psychiatric emergencies.
Journal of the American Academy of Child & Adolescent Psychiatry, 43 (2004), pp. 183-190
[Kazdin, 1996]
A.E. Kazdin.
Dropping out of child therapy: Issues for research and implications for practice.
Clinical Child Psychology and Psychiatry, 1 (1996), pp. 133-156
[Leahy, 2003]
R.L. Leahy.
Cognitive therapy techniques.
New York: Guilford Press, (2003),
[Letourneau et al., 2009]
E.J. Letourneau, S.W. Henggeler, C.M. Borduin, P.A. Schewe, M.R. McCart, J.E. Chapman, L. Saldana.
Multisystemic therapy for juvenile sexual offenders: 1-year results from a randomized effectiveness trial.
Journal of Family Psychology, 23 (2009), pp. 89-102
[Liberman, 2008]
The long view of crime: A synthesis of longitudinal research,
[March and Mulle, 2008]
J.S. March, K. Mulle.
OCD in children and adolescents: a cognitive-behavioral treatment manual.
Guilford Press, (2008),
[Minuchin, 1974]
S. Minuchin.
Families & family therapy.
Harvard University Press, (1974),
[Munger, 1999]
R.L. Munger.
Rules for unruly children.
The parent discipline bible, Boys Town Press, (1999),
[Naar-King et al., 2009]
S. Naar-King, D. Ellis, K. Kolmodin, P. Cunningham, K.L.C. Jen, B. Saelens, K. Brogan.
A randomized pilot study of multisystemic therapy targeting obesity in African-American adolescents.
Journal of Adolescent Health, 45 (2009), pp. 417-419
[Lofholm et al., 2009]
A. Lofholm, T. Olsson, K. Sundell, K. Hansson.
Multisystemic therapy with conduct disordered youth: Stability of treatment outcomes two years after intake.
Evidence & Policy, 5 (2009), pp. 373-397
[Ogden and Hagen, 2006]
T. Ogden, K.A. Hagen.
Multisystemic therapy of serious behaviour problems in youth: Sustainability of therapy effectiveness two years after intake.
Journal of Child and Adolescent Mental Health, 11 (2006), pp. 142-149
[Ogden et al., 2007]
T. Ogden, K.A. Hagen, O. Andersen.
Sustainability of the effectiveness of a programme of multisystemic treatment (MST) across participant groups in the second year of operation.
Journal of Children's Services, 2 (2007), pp. 4-14
[Ogden and Halliday-Boykins, 2004]
T. Ogden, C.A. Halliday-Boykins.
Multisystemic treatment of antisocial adolescents in Norway: Replication of clinical outcomes outside of the US.
Child & Adolescent Mental Health, 9 (2004), pp. 77-83
[Olsson, 2009]
T.M. Olsson.
MST with conduct disordered youth in Sweden: Costs and benefits after 2 years.
Research on Social Work Practice, 20 (2009), pp. 561-571
[Robin and Foster, 1989]
A.L. Robin, S. Foster.
Negotiating parent-adolescent conflict: A behavioral family systems approach.
Guilford, (1989),
[Rowland et al., 2005]
M.R. Rowland, C.A. Halliday-Boykins, S.W. Henggeler, P.B. Cunningham, T.G. Lee, M.J.P. Kruesi, S.B. Shapiro.
A randomized trial of multisystemic therapy with Hawaii's Felix Class youths.
Journal of Emotional and Behavioral Disorders, 13 (2005), pp. 13-23
[Sawyer and Borduin, 2011]
A.M. Sawyer, C.M. Borduin.
Effects of MST through midlife: A 21.9-year follow up to a randomized clinical trial with serious and violent juvenile offenders.
Journal of Consulting and Clinical Psychology, 79 (2011), pp. 643-652
[Schaeffer et al., 2010]
C.M. Schaeffer, M.R. McCart, S.W. Henggeler, P.B. Cunningham.
Multisystemic therapy for conduct problems in youth.
Clinical handbook of assessing and treating conduct problems in youth, pp. 273-292
[Schoenwald, 2008]
S.K. Schoenwald.
Toward evidence-based transport of evidence-based treatments: MST as an example.
Journal of Child and Adolescent Substance Abuse, 17 (2008), pp. 69-91
[Schoenwald, 2012]
S.K. Schoenwald.
The transport and diffusion of multisystemic therapy.
Dissemination and implementation of evidencebased psychological interventions, pp. 227-246
[Schoenwald et al., 2009]
S.K. Schoenwald, J.E. Chapman, A.J. Sheidow, R.E. Carter.
Long-term youth criminal outcomes in MST transport: The impact of therapist adherence and organizational climate and structure.
Journal of Clinical Child and Adolescent Psychology, 38 (2009), pp. 91-105
[Schoenwald et al., 2000]
S.K. Schoenwald, S.W. Henggeler, M.J. Brondino, M.D. Rowland.
Multisystemic therapy: Monitoring treatment fidelity.
Family Process, 39 (2000), pp. 83-103
[Schoenwald et al., 2009]
S.K. Schoenwald, A.J. Sheidow, J.E. Chapman.
Clinical supervision in treatment transport: Effects on adherence and outcomes.
Journal of Consulting and Clinical Psychology, 77 (2009), pp. 410-421
[Schoenwald et al., 2004]
S.K. Schoenwald, A.J. Sheidow, E.J. Letourneau.
Toward effective quality assurance in evidencebased practice: Links between expert consultation, therapist fidelity, and child outcomes.
Journal of Child and Adolescent Clinical Psychology, 33 (2004), pp. 94-104
[Schoenwald et al., 2003]
S.K. Schoenwald, A.J. Sheidow, E.J. Letourneau, J.G. Liao.
Transportability of Multisystemic Therapy: Evidence for multi-level influences.
Mental Health Services Research, 5 (2003), pp. 223-239
[Stambaugh et al., 2007]
L.F. Stambaugh, S.A. Mustillo, B.J. Burns, R.L. Stephens, B. Baxter, D. Edwards, M. DeKraai.
Outcomes from wraparound and multisystemic therapy in a center for mental health services system-of-care demonstration site.
Journal of Emotional and Behavioral Disorders, 15 (2007), pp. 143-155
[Sundell, 2012]
Sundell, K. (2012, May). MST research in Europe. Invited plenary at the First European MST Conference, Olso, Norway
[Sundell et al., 2008]
K. Sundell, K. Hansson, C.A. Lofholm, T. Olsson, L.H. Gustle, C. Kadesjo, The transportability of MST to Swed.
Short-term results from a randomized trial of conduct disordered youth.
Journal of Family Psychology, 22 (2008), pp. 550-560
[Swenson et al., 2010]
C.C. Swenson, J. Penman, S.W. Henggeler, M.D. Rowland.
Multisystemic therapy for child abuse and neglect.
Family Services Research Center, Medical University of South Carolina, (2010),
[Swenson et al., 2010]
C.C. Swenson, C. Schaeffer, S.W. Henggeler, R. Faldowski, A.M. Mayhew.
Multisystemic therapy for child abuse and neglect: A randomized effectiveness trial.
Journal of Family Psychology, 24 (2010), pp. 497-507
[Tighe et al., 2012]
A. Tighe, N. Pistrang, L. Casdagli, G. Baruch, S. Butler.
Multisystemic therapy for young offenders: Families’ experiences of therapeutic processes and outcomes.
Journal of Family Psychology, 26 (2012), pp. 187-197
[Timmons-Mitchell et al., 2006]
J. Timmons-Mitchell, M.B. Bender, M.A. Kishna, C.C. Mitchell.
An independent effectiveness trial of multisystemic therapy with juvenile justice youth. Journal of Clinical Child and.
Adolescent Psychology, 35 (2006), pp. 227-236
[Tuerk et al., 2012]
E.H. Tuerk, M.R. McCart, S.W. Henggeler.
Collaboration in family therapy.
Journal of Clinical Psychology: In Session, 68 (2012), pp. 168-178
[Weersing and Weisz, 2002]
V.R. Weersing, J.R. Weisz.
Community clinic treatment of depressed youth: Benchmarking usual care against CBT clinical trials.
Journal of Consulting and Clinical Psychology, 70 (2002), pp. 299-310
[Weisz and Kazdin, 2010]
Evidence-based psychotherapies for children and adolescents, 2nd,
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