Adaptation of Multisystemic Therapy for Transition Age Youth

描述（由申请人提供）：本R34申请的总体目标是开发一种适应性的最强证据为基础的计划，以减少青少年犯罪，多系统治疗（MST），以减少犯罪和增加接受强化公共精神卫生服务的过渡年龄青年（18-25岁）的角色功能。避免消极的公民功能，即刑事犯罪是成年人功能的基石。最近的调查结果表明，大多数有严重精神健康状况的过渡年龄青年将在25岁之前被捕，大多数人多次被捕，并受到严重指控。由于这种犯罪对青少年、他们的家庭和社会造成严重影响，因此，在限制这一群体成员犯罪方面证明有效的干预措施将大大有助于公共利益。为了制定这样的干预措施，适应MST是从文学的可塑性的原因，在青少年和成年人的犯罪和停止，有和没有心理健康状况。拟议的项目将详细说明和完善临床方法，协议和保真度过程，并通过4个阶段的课程确定治疗和研究协议的可行性，其中第一阶段（1-2个月）获得国家专家的书面意见，并通过提供者，青年和家庭成员的焦点小组对拟议的临床适应。第二阶段（3至7个月）将包括MST-TAY计划的开发周期。在每个周期中，我们将起草一个版本的干预措施，用5-10个临床病例进行测试，从客户和MST临床医生那里获得反馈，然后生成一个新版本的干预措施。在第三阶段（8至30个月），我们将进行一个更大的试点，以确定研究方法的可行性，使用稳定的干预措施的最终版本。该试点将招募30名18-25奥尔兹，他们是通过他们的案件经理确定的。一半的参与者将被随机分配接受干预，另一半则照常接受服务。4期数据分析将检查研究和治疗损耗率，完成的研究和治疗会话的平均数量，平均治疗满意度评级，并估计干预的效果大小。

DESCRIPTION (provided by applicant): The overall aim of this R34 application is to develop an adaptation of the strongest evidence based program to reduce juvenile offending, Multisystemic Therapy (MST), for offending reduction and increased role functioning in transition age youth (ages 18-25) receiving intensive public mental health services. Avoiding negative civic functioning, namely criminal offending is a cornerstone of adult functioning. Recent findings suggest that the majority of transition age youth with serious mental health conditions will be arrested by age 25, most with multiple arrests, and for serious charges. Because of the serious implications such offending poses for youths, their families, and society, an intervention that proved effective in limiting offending among members of this population would contribute substantially to the public good. To develop such an intervention, adaptations to MST are drawn from the literature of malleable causes of offending and desistance in adolescents and adults, with and without mental health conditions. The proposed project will specify and refine the clinical approach, protocols, and fidelity process, and determine the feasibility of the treatment and research protocols through a 4 stage course in which the first stage (months 1-2) obtains written input from national experts, and through focus groups of providers, youth, and family members on the proposed clinical adaptations. The second phase (months 3 to 7) will consist of development cycles of the MST-TAY program. In each cycle, we will draft a version of the intervention, test it with 5-10 clinical cases, obtain feedback from clients and MST clinicians, then generate a new version of the intervention. In the third phase (months 8 to 30), we will conduct a larger pilot for the purpose of determining feasibility of the research approach, using the stable, final version of the intervention. The pilot will enroll 30 18-25 year olds who are identified through their case manager. Half of the participants will be randomized to receive the intervention and half to services as usual. Phase 4 data analyses will examine rates of research and treatment attrition, mean number of research and treatment sessions completed, mean treatment satisfaction ratings, and estimate the effect size of the intervention.