Abstract
BackgroundSubstance use and delinquency are considered to be mutual risk factors. Previous studies have shown that multidimensional family therapy (MDFT) is effective in tackling both conditions on the short term. The current study examines the long-term effects of MDFT on criminal offending.Methods109 adolescents with cannabis use disorder and comorbid problem behavior were randomly assigned to either MDFT or cognitive behavioral therapy (CBT). Police arrest data were collected for 6 years: 3 years prior to and 3 years after treatment entry. Using survival analysis and repeated measure General Linear Models (rmGLM), the two treatment groups were compared on number of arrests, type of offence, and severity of offence. Moderator analyses looking at age, disruptive behavior disorders, history of crimes, family functioning, and (severe) cannabis use were conducted (rmGLM).ResultsWhile police arrest rates increased in the 3 years before treatment, the rates decreased substantially after the start of both treatments. No differences were found between the treatment groups with respect to either time to first offence from the start of the treatment or changes in frequency or severity of offending over time. A treatment effect trend favoring MDFT was found for property offending in the subgroup of adolescents with high baseline-severity of cannabis use.ConclusionsAcross a follow-up period of 3 years, MDFT and CBT were similarly effective in reducing delinquency in adolescents with a cannabis use disorder.Trial registration ISRCTN51014277, Registered 17 March 2010—Retrospectively registered, http://www.isrctn.com/ISRCTN51014277
Highlights
Substance use and delinquency are considered to be mutual risk factors
The present study extends a previous randomized controlled trial conducted by Hendriks et al [18] on the potential of multidimensional family therapy (MDFT) and cognitive behavioral therapy (CBT) to decrease the rate of cannabis use disorder (CUD) in adolescents
With trials conducted at American and European sites, using self-report and registry data, it is safe to conclude that both MDFT and CBT are evidence-based treatments for substance abusing and for delinquent adolescents
Summary
Previous studies have shown that multidimensional family therapy (MDFT) is effective in tackling both conditions on the short term. Substance use disorder (SUD) is often part of multi-problem behavior, characterized by comorbid delinquency, truancy, and (other) psychopathology [1, 2]. While substance use (disorder) is a risk factor for criminal offending [7]. Because of the interrelatedness between the two conditions, clinicians and researchers have investigated treatments which aim to target both substance use disorders and delinquency. The meta-analysis of Baldwin [14] reports a slightly larger effect for family therapies like multidimensional family therapy (MDFT) compared to other therapies (including CBT) on delinquency and substance use reduction. Looking at the literature, both CBT and MDFT seem to be able to address multiple-problem behaviors, like SUD and delinquency [11]
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