The hypothesis of the study was that multisystemic therapy (MST) is “a promising approach to the treatment of serious antisocial behavior in adolescents” (Schaeffer & Borduin, 2005, 452) and a more efficient strategy for reducing the levels of recidivism among violent and serious juvenile offenders than other strategies, for example the individual therapy. The independent variable was the frequency of repeated arrests or confinements of adults who have been already taken to prison in youth. The dependent variable was the efficiency of multisystemic therapy (MST) in comparison with the individual therapy (IT). The experiment involved 176 young people with the average age of 13.7 at the moment of committing the crime and of 28.8 at the moment of participation in the experiment, conducted within the Missouri Delinquency Project. To be more specific, they were from 11.8 to 15.2 years before the experiment. The experiment took part in Missouri, so the study was confined to the citizens of this state, who were proved not to have left the state during the testing period. Among this sample there were two groups, one participating in the multisystemic therapy program and another one participating in the individual therapy program. The groups were formed randomly, but there were obligatory conditions such as having at least two arrests, having at least one parent figure and having no evidence of psychosis or dementia. In this way, the control group was made up by the youth criminals taking part in the individual treatment program, while the experimental group was made up by the youth criminals taking part in the multisystemic treatment program.
The main method applied in the study was the experiment. The investigation was complicated enough to require different techniques of collecting data. To study the long term impact of the MST on criminal activity during adulthood the research was based on pretest-posttest control group design; comparative analysis; investigation of police database (juvenile arrest records) and ongoing clinical supervision intended to see the feedback. The therapists were required to pass monthly reports to the supervisor of the project. Besides, during the programs video and audio tapes were takes, and then randomly chosen videotapes were watched, discussed and analyzed by the committees who gathered on a regular basis. Further, to describe the relative risks binary logistic regressions were conducted, followed by survival analysis to obtain the cumulative survival functions and a log-rank test with the Kaplan-Meier estimator. The operational hypothesis was that the participants of the MST program would be traced for fewer odds of being rearrested and confined at follow-up.
As a result of the study, the hypothesis of the MST efficiency in reducing the levels of recidivism among violent and serious juvenile offenders has been proved in comparison with the outcomes of the IT efficiency. It has been found out that the MST program is much more efficient in reducing recidivism of criminal activity than the IT program. In particular, it has been estimated that the MST participants were 2-4 times less likely to be arrested again for violated, drug related, or nonviolent offenses; receiving 54 percent fewer arrests and 61 percent fewer days of imprisonment in adult detention facilities. Overall conclusion was that MST can be considered as a relatively effective tool in decreasing criminal activity among serious and violent young criminals, mostly due to such advantages as its comprehensive nature and ecologically valid delivery. What is more, the interventions of the MST were found individualized and highly flexible. Finally, it directly engages intrapersonal (cognitive, for instance) and systemic (these are family relations, relations with peers, school behavior) factors which are considered to be connected with adolescent antisocial behavior.
On the whole, there were no serious flaws revealed in the study, though lack of certain data can be referred to as a factor of inaccuracy. In particular, there has been lack of comprehensive examination of MST service use depending on social status, mental abilities and health status, juvenile justice and primary care. In each treatment condition participants were not divided into subgroups, as the amount of females and minority representatives has been claimed as being too small. What is more, there were continuous moderate variables (like age, socioeconomic status and pretreatment confinements) which were considered as tentative. One more flaw is that the length of some participants’ sentences exceeded the length of the follow-up period for the current study.
Within the study, there were extraneous variables of two kinds, subject variables and experimental variables. These variables include gender (though there were not very many girls among the participants, and this variability was not taken to account by the authors); other racial, financial, cultural, language and health statuses also refer here. Nevertheless, the authors admit they did not take to account most of these variables. Further, behavior problems, parental disturbance, problematic family relations, identification with deviant peers and poor school performance have been listed as empirically detected determinants of offense too.
Thus, the research has been conducted efficiently enough to satisfy the interested parties, including not only juvenile offenders and their families, but also sociologists, psychologists and other professionals who take responsibilities for improving social safety and public security. Cost shifting could be evaluated with more details, in correlation with the level of social welfare, mental health, primary care and so on. Then, there could be equality in those who provided treatment, as in case of the MST these were graduate students aged 23-31, while the IT group was guided by therapists from 25 to 33, which means that the IT participants could have received more professional managers or coordinators.
If to evaluate the study objectively, it should be outlined that the great advantage of the current study design is that there has been a long period between pretest and posttest control. Besides, the results have been presented in comparison with another methodology to make the picture clearer and more honest. On the one hand, the design included the study of information available in databases, on the other hand, it was a direct field research of the sampled group. The findings of the test provide much information to use in further research on how to soften or to prevent recidivism among adolescent criminals and how to make them socialized by means of the MST program. Despite insignificant faults the results presented by the authors seem to be quite logical and enough to prove the hypothesis. If to be critical, it seems rational to have used experimental and control groups equal in number of participants, as it would make the outcomes more exact. The authors themselves suppose that there is a need to conduct the appropriate research in other states.
The research has been conducted to test a certain methodology on particular group, meaning juvenile offenders, tested already in the adulthood. Therefore, the findings of the study can be generalized to vast circles of population, but only those involved in violating the law to a certain extent. On the other hand, certain findings can be applied even wider, as they inform how efficient is mental treatment taken in the natural surroundings without expelling communication and with the reliable support of the family. The findings also refer to the overall problems of raising adolescents and give a kind of recommendations for empowering parents with the skills and resources to overcome those problems and to independently address the inevitable difficulties. Apart from that, the authors propose to generalize the research to the entire population of the United States, though it has been restricted to the State of Missouri. However, they have not shown the correlation between some moderating factors, marking them as insignificant for the outcomes. Still, it would be useful to compare the effectiveness of the method in different social groups.
In fact, the current research is only one example of constructive comparison of two similar treatment technologies; although the research has been thorough and careful, it would be beneficial to abstract away from this definite sample and to conduct some more independent study on the same matte, while the appropriate data are available. What is more, it has been recognized that extra research is required to estimate the mechanisms and tools of long-term change in MST. Further on, the study can be replicated and would be beneficial to replicate in other states, maybe randomly sampled, to overcome the dependence of the findings on some geographical and social factors. For replication, the data from police databases (juvenile arrest records), including fingerprints and careful observations are needed as well as availability and willingness of the potential participants.
Later research, first of all, is seen in estimating the cost effectiveness of applying the MST by policy makers and public on the whole. First of all, the public savings claimed by the authors of the current research should be approved. Besides, alternative research to study the effectiveness of MST in terms of interventions for serious juvenile offenders should be conducted.
Schaeffer, Cindy M. & Borduin, Charles M. (2005). Long-Term Follow-Up to a Randomized Clinical Trial of Multisystemic Therapy With Serious and Violent Juvenile Offenders [Violence/Victimization]. Journal of Consulting and Clinical Psychology, 73(3), 445-453.