Abstract

The effect of Multisystemic Therapy (MST) treatment for serious behavior problems among adolescents has been established through multiple studies. However, variations across individuals should also be examined to better understand how MST works or for whom. In this study, we explored and identified subgroups of youth with serious problems in Norway regarding their responses to MST in terms of ultimate MST outcomes (e.g., living at home, abstaining from violence) over time. We further explored whether immigrant background, in addition to gender and age of the youth at intake, predicted belonging to the subgroups. Data came from 1674 adolescents (MeanAge = 14.55, SDAge = 1.58; 60.7% boys) and their families referred to MST treatment by the municipal Child Welfare Services for serious and persistent antisocial behavior. The outcomes were assessed at five time-points from intake to 18-months after discharge for youth and families who completed the treatment. Latent class growth analyses revealed heterogeneous trajectories regarding youths’ responses to MST. Results indicated a high and sustained degree of improvement across the ultimate outcomes for the vast majority of the youths. However, there was still variation in the groups, with improvement and deterioration trajectories for various outcomes. Most of these trajectories were predicted by gender and youth’s age at intake, but not by immigrant status. Not every youth-at-risk responds similarly to MST, and more studies examining heterogeneity will help us to identify factors to be targeted to better tailor the MST interventions for youth with serious problems.

Highlights

  • The effect of Multisystemic Therapy (MST) treatment for serious behavior problems among adolescents has been established through multiple studies carried out in various countries as well as in meta-analyses

  • As a part of continuous quality improvement, we investigated the heterogeneity in how youth with serious problems in Norway did respond to MST in terms of ultimate MST outcomes over time

  • Data came from 1674 adolescents and their families referred to MST treatment by the municipal Child Welfare Services for serious and persistent antisocial behavior

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Summary

Introduction

The effect of Multisystemic Therapy (MST) treatment for serious behavior problems among adolescents has been established through multiple studies carried out in various countries as well as in meta-analyses (Asscher et al 2014; Curtis et al 2004; Henggeler 2011, 2012; Ogden and Halliday‐Boykins 2004; Sundell et al 2008; Van der Stouwe1 3 Vol.:(0123456789)Research on Child and Adolescent Psychopathology (2021) 49:429–442(Halliday-Boykins et al 2004), on the other hand, identified five trajectories following psychiatric crisis, based on change in externalizing and internalizing symptoms as a result of either MST or psychiatric hospitalization. Multisystemic Therapy (MST) is an evidence-based, intensive family- and community-based treatment program targeted at youth aged between 12 and 18 years with serious behavior problems, which may include delinquency and substance abuse (Henggeler et al 2009; MST Services Inc. 2020). It is based on social-ecological theory (Bronfenbrenner 1979), and addresses known risk and protective factors at the youths’ various social arenas such as home, school, peers, and community. In Norway, MST has been implemented nationally, guided by the Ministry of Child and Family Welfare, and supported by a national implementation team at The Norwegian Center for Child Behavioral Development (NUBU) tasked with evaluating and maintaining the quality of the implementation

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