CrimeSolutions.gov

Additional Resources:

Program Profile: Multisystemic Therapy for Youth With Problem Sexual Behaviors (MST–PSB)

Evidence Rating: Promising - One study Promising - One study

Date: This profile was posted on June 15, 2011

Program Summary

This program is an adaptation of Multisystemic Therapy, specifically designed for adolescents who have committed sexual offenses and demonstrated other problem behaviors. The program is rated Promising. Program participants had lower rates of self-reported person and property offenses as well as lower rates of arrests for sexual crimes and other crimes, compared with control group participants. These findings were statistically significant.

This program’s rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Description

Program Goals
Multisystemic Therapy for Youth with Problem Sexual Behaviors (MST–PSB) is an adaptation of MST aimed at adolescents who have committed sexual offenses and demonstrated other problem behaviors. MST–PSB is designed to reduce problem sexual behaviors, antisocial behaviors, and out-of-home placements. The program targets factors underlying problematic juvenile sexual behavior, primarily by addressing a youth’s socialization processes and interpersonal transactions. Program staff provide treatment within the adolescent’s natural environment—that is, where the youth lives. As a result, program staff members also work directly with the youth’s family and directly or indirectly with others in the youth’s community, such as peers, teachers, or probation officers. One goal of this work with the youth’s family is to empower the parents by providing them the skills and resources needed to raise their adolescent.

Program Activities/Program Theory
Most program activities and services are delivered either at home or in a community-based setting (such as school or recreation center), at times that are convenient for the family. The precise program components are selected based on the needs of the individual and family being treated. This plan is developed from a functional assessment of the youth, the family, and their social network, and is guided by nine treatment principles.

The individualized treatment components address identified risk factors. However, in general, many of the MST–PSB activities focus on working with the family to:
  • Reduce denial by both parents and child about the sexual offense and its consequences
  • Enhance parenting knowledge
  • Remove barriers to effective parenting
  • Promote affection and communication among family members
Parents are trained to play an active role, such as monitoring school performance and working with their child to encourage age-appropriate, healthy peer associations. Staff work with the family and other persons in the youth’s ecology (e.g., teachers, extended family) to help develop risk-reduction plans, strengthen relapse prevention, and promote victim safety. The youth is given the opportunity to develop social and problem-solving skills, and may receive program components that modify belief systems or attitudes that contribute to sexual offending.

The youth and family have multiple contacts each week, totaling approximately 3 hours. Therapists are available around the clock to deal with clinical issues.

Program components draw on strategies from pragmatic family therapies, behavioral parent training, and cognitive–behavioral therapy.

Key Personnel
The program is delivered by master’s-level trained therapists. Therapists generally work with between four and six families.

Evaluation Outcomes

top border
Study 1
Self-Reported Person Offenses
Borduin, Schaeffer, and Heiblum (2009) found that participants in Multisystemic Therapy for Youth with Problem Sexual Behaviors (MST–PSB) self-reported lower rates of rearrests for person offenses, compared with participants who received usual community services (UCS) following release from treatment. This difference was statistically significant.

Self-Reported Property Offenses
MST-PSB participants self-reported lower rates of rearrest for property offenses, compared with UCS participants. This difference was statistically significant.

Arrests for Sexual Crimes
MST–PSB participants had 83 percent fewer arrests for sexual crimes, compared with UCS participants. This difference was statistically significant.

Arrests for Other Crimes
MST-PSB participants had 70 percent fewer arrests for other crimes, compared with UCS participants. This difference was statistically significant.
bottom border

Evaluation Methodology

top border
Study 1
Borduin, Schaeffer, and Heiblum (2009) used a randomized control design for 48 juvenile sexual offenders to assess the effectiveness of Multisystemic Therapy for Youth with Problem Sexual Behaviors (MST–PSB) versus usual community services (UCS) to reduce sexual recidivism. The study took place in Missouri. To be included in the study, youth had to meet the following criteria:
  • The youth had been arrested for a serious sexual offense (rape/sexual assault, molestation of younger children) with an order for outpatient sexual offender counseling.
  • The youth was currently living with at least one parent figure.
  • The youth showed no evidence of psychosis or serious mental retardation.
Recruitment ran from July 1990 through November 1993; follow-up continued through October 2001. The average length of follow up was 8.9 years.

Twenty-four youths were assigned to each condition. The youths included in the study were overwhelmingly (96.5 percent) boys, had a mean age of 14.0 years, and averaged 4.33 previous arrests for sexual and nonsexual felonies. Of the youths, 72.5 percent were white, 27.1 percent were African American, and 2.1 percent indicated Hispanic ethnicity; 31.3 percent lived with only one parental figure. The mean length of treatment/services was 30.8 weeks for MST youth and 30.1 weeks for UCS participants. MST youth had a greater number of behavior problems than did UCS youth; this difference was statistically significant. There were no other statistically significant differences between the groups at baseline. The researchers used an intent-to-treat approach for analysis (two boys in the UCS group were placed in out-of-home placements during the research period).

The MST–PSB participants received individualized interventions in a home-based setting. Youth and their families received multiple contacts each week, averaging 3 hours each week across family, school, peer, and individual systems. The UCS participants received their treatment through the services of the juvenile court. They received 90-minute group therapy sessions twice a week, in groups of four to six, and weekly individual treatment lasting 60 to 90 minutes. The emphases of UCS treatment included the acceptance of personal responsibility for the offense, the elimination of deviant cognitions, the development of new social skills, the development of victim awareness and empathy, and engagement in behaviors/thoughts that prevent relapse.

Outcomes included self-reported person and property offenses, and official records of arrests for sexual crimes and other crimes. Participants completed the Self-Report Delinquency Scale (Elliott et al.1983). Data about arrests came from juvenile and adult criminal records obtained within the state of Missouri. The researchers used ANOVAs to determine whether significant differences existed for the pre- and posttest assessments between the intervention and control groups. The average follow-up time for both groups was 8.9 years. The researchers did not conduct subgroup analyses.
bottom border

Cost

top border
Overall, the total cost for the first year is about $460,400 or $12,788 per participant. This includes estimated costs for start-up and ongoing support, licensing, quality assurance activities, staff salary, and travel expenses (Borduin, Schaeffer, and Heiblum 2009). More information can be found on the program website: https://www.mstpsb.com/
bottom border

Implementation Information

top border
Both a clinical volume (Henggeler and Borduin 1990) and a treatment manual (Henggeler et al. 1998) are available for Multisystemic Therapy (MST). Treatment and training manuals (Borduin et al., 2005) are available for Multisystemic Therapy for Youth With Problem Sexual Behaviors (MST–PSB). More information can be found on the program website: https://www.mstpsb.com/
bottom border

Evidence-Base (Studies Reviewed)

top border
These sources were used in the development of the program profile:

Study 1
Borduin, C.M., Cindy M. Schaeffer, and N. Heiblum. 2009. “A Randomized Clinical Trial of Multisystemic Therapy With Juvenile Sexual Offenders: Effects on Youth Social Ecology and Criminal Activity.” Journal of Consulting and Clinical Psychology 77(1):26–37.
https://www.semanticscholar.org/paper/A-randomized-clinical-trial-of-multisystemic-with-Borduin-Schaeffer/0edd5901b167829949d5bfe61f37a6af57745c6b
bottom border

Additional References

top border
These sources were used in the development of the program profile:

Borduin, Charles M., Scott W. Henggeler, David M. Blaske, and R.J. Stein. 1990. “Multisystemic Treatment of Adolescent Sexual Offenders.” International Journal of Offender Therapy and Comparative Criminology 34:105–13. (This study was reviewed but did not meet CrimeSolutions.gov criteria for inclusion in the overall program rating.)
https://pdfs.semanticscholar.org/40a7/0dcc5cebfc37ee9a910d70383bc255abd3e1.pdf

Borduin, Charles M., Elizabeth J. Letourneau, Scott W. Henggeler, and Cynthia Cupit Swenson. 2005. “Treatment Manual for Multisystemic Therapy With Problem Sexual Behavior Youths and Their Families.” Unpublished manual. Charleston, S.C.: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina.

Borduin, Charles M., David M. Blaske, Libby Cone, Barton J. Mann, and M.D. Hazelrigg. 1989. “Development and Validation of a Measure of Adolescent Peer Relations: The Missouri Peer Relations Inventory.” Unpublished manuscript. University of Missouri–Columbia.

Henggeler, Scott W., and Charles M. Borduin. 1990. Family Therapy and Beyond: A Multisystemic Approach to Treating the Behavior Problems of Children and Adolescents. Pacific Grove, Calif.: Brooks/Cole.

Henggeler, Scott W., Sonja K. Schoenwald, Charles M. Borduin, M.D. Rowlad, and Phillipe B. Cunningham. 1998. Multisystemic Treatment of Antisocial Behavior in Children and Adolescents. New York, N.Y.: Guilford Press.

Letourneau, Elizabeth J., Scott W. Henggeler, Charles M. Borduin, Paul A. Schewe, Michael R. McCart, Jason E. Chapman, and L. Saldana. 2009. “Multisystemic Therapy for Juvenile Sexual Offenders: 1-Year Results from a Randomized Effectiveness Trial.” Journal of Family Psychology 23(1):89–102. (This study was reviewed but did not meet CrimeSolutions.gov criteria for inclusion in the overall program rating.)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2710607/

Olson, D.H., J. Portner, and R. Bell. 1982. “FACES-II.” In D.H. Olson, H.I. McCubbin, H.L. Barnes, A. Larsen, M. Muxen, and M. Wilson (eds.). Family Inventories. St. Paul, Minn.: University of Minnesota, Family Social Science, 5–24.

Quay, H.C., and D.R. Peterson. 1987. Manual for the Revised Behavior Problem Checklist. Coral Gables, Fla.: University of Miami.
bottom border

Related Practices

top border
Following are CrimeSolutions.gov-rated practices that are related to this program:

Therapeutic Treatment for Juvenile Sex Offenders
This practice includes a variety of treatment modalities (including cognitive-behavioral therapy, relapse prevention, and multisystemic therapy), which are designed to reduce the risks and harms associated with juveniles at risk of committing sexual offenses. The practice is rated Promising for reducing juveniles’ rates of general recidivism but rated No Effects for reducing sexual recidivism and violent recidivism.

Evidence Ratings for Outcomes:
Promising - More than one Meta-Analysis Crime & Delinquency - Multiple crime/offense types
No Effects - More than one Meta-Analysis Crime & Delinquency - Sex-related offenses
No Effects - One Meta-Analysis Crime & Delinquency - Violent offenses



Family-based Treatment for Adolescent Delinquency and Problem Behaviors
In general family-based treatment practices consist of a wide range of interventions that are designed to change dysfunctional family patterns that contribute to the onset and maintenance of adolescent delinquency and other problem behaviors. This practice is rated Effective for reducing recidivism, and Promising for reducing antisocial behavior and substance use, and improving psychological functioning and school performance.

Evidence Ratings for Outcomes:
Effective - One Meta-Analysis Crime & Delinquency - Multiple crime/offense types
Promising - One Meta-Analysis Mental Health & Behavioral Health - Externalizing behavior
Promising - One Meta-Analysis Drugs & Substance Abuse - Multiple substances
Promising - One Meta-Analysis Mental Health & Behavioral Health - Psychological functioning
Promising - One Meta-Analysis Education - Academic achievement/school performance
bottom border


Program Snapshot

Age: 13 - 17

Gender: Both

Race/Ethnicity: Black, Hispanic, White

Geography: Rural, Suburban, Urban

Setting (Delivery): Home, Other Community Setting

Program Type: Cognitive Behavioral Treatment, Family Therapy, Individual Therapy, Parent Training, Children Exposed to Violence

Targeted Population: Sex Offenders, Young Offenders, Children Exposed to Violence, Families

Current Program Status: Active

Listed by Other Directories: Child Exposure to Violence Evidence Based Guide, Campbell Collaboration, National Registry of Evidence-based Programs and Practices

Program Developer:
Richard Munschy
Director of Clinical Training
MST Associates
10 Lexington Street
New Britain CT 06052
Phone: 616.523.9130
Fax: 860.225.4776
Website
Email

Program Developer:
Charles Borduin
Professor
Department of Psychological Sciences, University of Missouri
108A McAlester Hall, S. 6th Street
Columbia MO 65211-2500
Phone: 573.882.4578
Fax: 573.882.7710
Website
Email

Training and TA Provider:
Richard Munschy
Director of Clinical Training
MST Associates
10 Lexington Street
New Britain CT 06052
Phone: 616.523.9130
Fax: 860.225.4776
Website
Email