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Adm Policy Ment Health. 2017 Nov;44(6):853-866. doi: 10.1007/s10488-017-0797-y.

Placement and Delinquency Outcomes Among System-Involved Youth Referred to Multisystemic Therapy: A Propensity Score Matching Analysis.

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Justice and Child Welfare Division, Westat, 1600 Research Blvd, Rockville, MD, 20850, USA.
Social Development Research Group, School of Social Work, University of Washington, 9725 3rd Avenue NE, Seattle, WA, 98115, USA.
Rhode Island Department of Children, Youth, and Families, 101 Friendship St., Providence, RI, 02903, USA.
Division of Prevention and Community Research, Yale University School of Medicine, 389 Whitney Avenue, New Haven, CT, 06511, USA.


Multisystemic therapy (MST) was developed to help youth with serious social, emotional, and behavioral problems. Research on the efficacy and effectiveness of MST has shown positive outcomes in different domains of development and functioning among various populations of youth. Nonetheless, even with a large body of literature investigating the treatment effects of MST, few studies have focused on the effectiveness of MST through large-scale dissemination efforts. Utilizing a large sample of youth involved in a statewide dissemination of MST (n = 740; 43% females; 14% Black; 29% Hispanic; 49% White; Mage = 14.9 years), propensity score matching was employed to account for baseline differences between the treatment (n = 577) and comparison (n = 163) groups. Treatment effects were examined based on three outcomes: out-of-home placement, adjudication, and placement in a juvenile training school over a 6-year period. Significant group differences remained after adjusting for baseline differences, with youth who received MST experiencing better outcomes in offending rates than youth who did not have an opportunity to complete MST due to non-clinical or administrative reasons. Survival analyses revealed rates of all three outcomes were approximately 40% lower among the treatment group. Overall, this study adds to the body of literature supporting the long-term effectiveness of MST in reducing offending among high-risk youth. The findings underscore the potential benefits of taking evidence-based programs such as MST to scale to improve the well-being and functioning of high-risk youth. However, strategies to effectively deliver the program in mental health service settings, and to address the specific needs of high-risk youth are necessary.


Adjudication; Delinquency; Incarceration; Multisystemic therapy; Out-of-home placement

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