Abstract
Multisystemic Therapy (MST) and Functional Family Therapy (FFT) have overlapping target populations and treatment goals. In this study, these interventions were compared on their effectiveness using a quasi-experimental design. Between October, 2009 and June, 2014, outcome data were collected from 697 adolescents (mean age 15.3 (SD 1.48), 61.9% male) assigned to either MST or FFT (422 MST; 275 FFT). Data were gathered during Routine Outcome Monitoring. The primary outcome was externalizing problem behavior (Child Behavior Checklist and Youth Self Report). Secondary outcomes were the proportion of adolescents living at home, engaged in school or work, and who lacked police contact during treatment. Because of the non-random assignment, a propensity score method was used to control for observed pre-treatment differences. Because the risk-need-responsivity (RNR) model guided treatment assignment, effectiveness was also estimated in youth with and without a court order as an indicator of their risk level. Looking at the whole sample, no difference in effect was found with regard to externalizing problems. For adolescents without a court order, effects on externalizing problems were larger after MST. Because many more adolescents with a court order were assigned to MST compared to FFT, the propensity score method could not balance the treatment groups in this subsample. In conclusion, few differences between MST and FFT were found. In line with the RNR model, higher risk adolescents were assigned to the more intensive treatment, namely MST. In the group with lower risk adolescents, this more intensive treatment was more effective in reducing externalizing problems.
Highlights
Multisystemic Therapy (MST) and Functional Family Therapy (FFT) have overlapping target populations and treatment goals
Using the propensity score (PS) method to control for the non-random assignment of adolescents to either MST or FFT, this study compared these two interventions on their effectiveness in the Netherlands
Target populations were balanced and no differences between the interventions were found regarding externalizing problem behavior
Summary
Multisystemic Therapy (MST) and Functional Family Therapy (FFT) have overlapping target populations and treatment goals. Multisystemic Therapy (MST) and Functional Family Therapy (FFT) both originated from the United States (US) Their proven effectiveness in reducing adolescents’ antisocial behavior and delinquency has led to the worldwide dissemination of these interventions. Research has shown that MST effectively reduces behavioral problems and delinquency, recidivism, substance abuse, out-of-home placement, family problems, and involvement with deviant peers (Henggeler 2011; van der Stouwe et al 2014) The effectiveness of both MST and FFT is well-established compared to regular treatment, such as individual treatment, family-based interventions, or parenting counseling (Asscher et al 2013; Sundell et al 2008). Little is known about their relative effectiveness (i.e., whether one intervention outperforms the other)
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