Treat the family, treat the child: Multisystemic therapy
as a treatment for social, emotional and behavior problems
Littell JH, Popa M, Forsythe B
The Bottom Line:
Children and teenagers who have behavioural, emotional, or social problems are at high risk of becoming involved in crime and being sent to juvenile detention centres or to jail. It has been claimed that Multisystemic Therapy (MST), an intensive program that treats the whole family and also involves school and community, produces better results than programs focused on the child alone. This review found no evidence that MST is better than other treatments or no treatment at all. However, it does not cause harm, and it may be useful for very high-risk children and adolescents, for whom traditional therapies are not as effective. |
What problem is being addressed?
Children and adolescents who act out or who regularly engage in criminal acts often experience multiple family and social problems that contribute to their behaviour. Traditional therapy has focused on changing the child or teen, but there is increasing support for treatments aimed at altering the environment that is believed to promote the negative behaviour.
What intervention is being tested?
Multisystemic Therapy (MST), an intensive therapy designed to change the psychological and behavioural problems of children and teens aged 10 to 17, as well as family and social circumstances that may contribute to their aggressive and antisocial behaviour. The goal of MST is to keep families together. Treatment is home-based and focused on identifying and changing individual, family, and environmental factors thought to contribute to problem behavior. Strategies are tailored to each family and may include efforts to improve parenting and communication skills, family and peer relations, and academic performance.
What is the real scientific evidence?
Studies comparing MST to other treatments (juvenile detention centre, individual therapy, foster care, hospitalization) found no good evidence that MST is more effective than other interventions in reducing criminal activity by, or incarceration of, young people with social, emotional, and behavioral problems. However, there was no evidence that MST causes harm.
MST may have advantages in that it looks at the child in his/her environment, viewing peer and other social interactions as important to how behaviour develops. It also offers crisis intervention, which may help to address the needs of very high risk populations.
The preceding is a summary of:
Littell JH, Popa M, Forsythe B. Multisystemic Therapy for social, emotional, and behavioral problems in youth aged 10-17. The Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD004797.pub4. DOI: 10.1002/14651858.CD004797.pub4.
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