A Quasi-experimental Design: Multisystemic Therapy As An Alternative Community-based Treatment For Youth With Severe Emotional Disturbance

This study compared multisystemic therapy to usual services in a community mental health setting for emotionally disturbed youth with externalizing disorders. Usual services included the combination of case management with a family skills training curriculum. A secondary data analysis utilizing a pretest-post-test, quasi-experimental design was used. Eighty-seven youth were in each group and were matched based on gender (53% female, 47% male) and ethnicity (34 % African American, 54% Caucasian, 10% Hispanic, and 2% other). Findings of this study suggest that youth who received MST experienced more improved treatment outcomes across the combination of areas in their social ecology than the youth who received usual services. The combined outcomes for school functioning, family functioning, youth functioning, youth mental health symptoms, substance abuse, juvenile justice involvement, risk of self harm, and severe disruptive or aggressive behavior were found to be significantly better for the MST group compared to the usual services group. In looking at individual areas separately, the MST group experienced significantly less juvenile justice involvement and a clinically significant level of improvement in mental health symptoms. However, the results of this study were mixed in that both groups experienced comparably significant improvement in youth functioning, problems in school, problems with family functioning, risk of self harm, and severe aggressive behavior.
The findings of this study support the social ecological model of MST and its use for treating seriously emotionally disturbed youth with externalizing disorders in preventing juvenile justice involvement and improving treatment outcomes across the youth's social ecology. The use of MST in community mental health with this population of youth could prevent families from relinquishing custody of their children in order to receive effective treatment for them, and avert juvenile justice involvement.