Effectiveness Trial: MST with Juvenile Offenders

描述（由申请人提供）：青少年性犯罪者表现出严重的临床问题，导致心理健康和少年司法当局采取昂贵（且未经检验）的干预措施。在现有文献的基础上，我们认为针对青少年性犯罪者的主要（即限制性）干预措施与青少年的发展需求不匹配；因此，这些干预措施不太可能比以社区为基础的替代措施更有效。此外，我们建议有效的服务将(a)有能力解决多种风险因素；(b)个性化；(c)克服获得服务的障碍；(d)包括强有力的质量保证机制；(e)着重建立围绕青年的环境系统的能力，特别是家庭的能力；(f)促进社区安全。为了验证这些争论，本申请提出了一项比较多系统治疗（MST; Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998）与常规少年司法和心理健康服务治疗青少年的有效性研究。在随机设计中，160名少年性犯罪者将被分配到MST （N = 80）和常规服务（N = 80）的治疗条件。将使用一套多方法、多应答者评估系统来审查与临床（例如，犯罪行为、症状学）和服务（例如，服务利用、成本效益）结果有关的关键结果。通过2年的转诊后随访，每隔6个月进行一次评估，每月跟踪服务使用情况和治疗依从性。本研究的具体目的是：目的1。评估治疗对青少年犯罪活动、心理健康功能、酒精和药物使用的影响，以及对家庭关系、同伴关系和学校出勤率的影响。目标2。跟踪青少年参与少年司法、心理健康和药物滥用服务的利用、家庭外安置及其在招募后24个月的治疗条件下的相关费用。目标3。假设良好的MST治疗效果，研究可能的调节因子（如种族、性犯罪者亚型）和调节因子（如改善的家庭关系）。

DESCRIPTION (provided by applicant): Adolescent sexual offenders present serious clinical problems that have led to expensive (and untested) interventions from mental health and juvenile justice authoritics. Based on the extant literature, we argue that the predominant (i.e., restrictive) interventions for adolescent sexual offenders are not well matched with the developmental needs of these youths; and, consequently, these interventions are not likely to be more effective than community-based alternatives. Moreover, we suggest that effective services will (a) have the capacity to address multiple risk factors; (b) be individualized; (c) overcome barriers to service access; (d) include strong quality assurance mechanisms; (e) focus on building the capacities of the environmental systems, especially the family, surrounding the youth; and (f) promote community safety. To test these contentions, this application proposes an effectiveness study comparing adolescent sex offenders treated with multisystemic therapy (MST; Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998) versus adolescents treated with usual juvenile justice and mental health services, In a randomized design, 160 juvenile sex offenders will be assigned to MST (N = 80) vs. Usual Services (US; N = 80) treatment conditions. A multimethod, multirespondent assessment battery will be used to examine key outcomes pertaining to clinical (e.g., criminal behavior, symptomatology ) and service (e.g., service utilization, cost effectiveness) outcomes. Assessments will be conducted at 6-month intervals through a 2-year post referral follow-up, with monthly tracking of service utilization and treatment adherence. The specific aims of the study are:Aim 1. To evaluate treatment effects on youth criminal activity, mental health functioning, and alcohol and drug use," as well as on family relations, peer relations, and school attendance.Aim 2. To track adolescent juvenile justice involvement, mental health and substance abuse service utilization, and out-of-home placements and their associated costs across the treatment conditions for 24 months post recruitment.Aim 3. Assuming favorable MST treatment effects, to examine the possible moderators (e.g., race, sexual offender subtype) and mediators (e.g., improved family relations) of such effects.