Effectiveness Trial: MST with Juvenile Offenders

描述(由申请人提供)：青少年性犯罪者存在严重的临床问题，导致心理健康和青少年司法当局进行昂贵(且未经测试)的干预。根据现有的文献，我们认为，针对青春期性犯罪者的主要(即限制性的)干预措施与这些青少年的发展需要不太匹配；因此，这些干预措施不太可能比基于社区的替代措施更有效。此外，我们建议，有效的服务将：(A)具备应对多种风险因素的能力；(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)侧重于建设青年周围环境系统的能力，特别是家庭的能力；(F)促进社区安全。为了验证这些论点，本申请提出了一项有效性研究，比较了接受多系统治疗(MST；Henggler，Schoenwald，Borduin，Rowland，&Cunningham，1998)的青少年性犯罪者与接受普通青少年司法和心理健康服务治疗的青少年。在随机设计中，160名青少年性犯罪者将被分配到MST(N=80)和常规服务(美国；N=80)治疗条件。将使用多方法、多应答者评估单元来检查与临床(例如，犯罪行为、症状学)和服务(例如，服务利用率、成本效益)结果有关的关键结果。将通过为期两年的转诊后跟踪，每隔6个月进行一次评估，每月跟踪服务利用情况和治疗依从性。这项研究的具体目标是：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。目的2.在招募后24个月内跟踪青少年参与司法、心理健康和药物滥用服务的利用、家庭外安置及其相关成本。目的3.假设MST治疗效果良好，检查这些影响的可能调节因素(例如种族、性犯罪者亚型)和中介(例如，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.