Effectiveness of Multisystemic Therapy for Minority Youth: Outcomes Over 8 Years in Los Angeles County
Jan 1, 2014
Criminal justice agencies are increasingly seeking to use evidence-based practices to reduce delinquent and antisocial behaviors among youth in the juvenile justice system. One of the more prominent programs is Multisystemic Therapy (MST), an intensive family- and community-based treatment program for serious, violent, and chronic juvenile offenders 12 to 17 years of age.
MST targets specific factors in each youth's environment (family, peers, school, neighborhood) that are contributing to antisocial behavior. MST interventions are pragmatic and goal-oriented: MST aims to give parents and other caregivers the skills and resources needed to deal with their youth's behavior problems and aims to empower youth to cope with family, peer, school, and neighborhood issues. MST is typically provided in home, school, or other community location, and the MST therapist uses a youth's family, peer, school, neighborhood, and support networks to facilitate positive changes in behavior.
Several studies have found that MST programs are effective in reducing delinquent behaviors among youth in the juvenile justice system. However, most evaluations of MST have been based on small sample sizes. Further, previous evaluations of MST have included very few Hispanic youth. This is an important gap: Hispanic youth are disproportionally involved in the juvenile justice system compared with white youth and have generally not fared well in traditional psychological treatment.
To address these gaps, RAND Corporation researchers recently led an evaluation of MST in Los Angeles County's juvenile justice system. The study used a large sample size, comparing outcomes for 757 juvenile probationers in Los Angeles County who participated in MST from 2003 to 2010 with outcomes for 380 juvenile probationers who were eligible for but did not receive MST services. To improve the study's statistical power, the researchers pooled eight years of data on MST and comparison-group youth. The study also included a large proportion of Hispanic youth (77 percent of MST participants and 69 percent of the comparison group). Treatment and comparison-group youth were well matched on a variety of demographic and criminal history variables.
In Los Angeles County, MST is provided using a home-based model of service delivery. MST treatment usually lasts four months, including approximately 60 hours of contact with the therapist. The results suggest that MST reduces recidivism and increases positive outcomes for youth in Los Angeles County's probation system (see the figure). MST youth had significantly lower incarceration rates than comparison-group youth (11.2 percent, compared with 20.3 percent) and significantly higher rates of completion of community service (8.5 percent, compared with 2.6 percent for comparison-group youth).
Comparison-group youth had significantly lower rates of probation violation than MST participants (7.9 percent, compared with 12.2 percent of MST participants). However, researchers believe that this result may be due to the fact that MST is an intensive intervention requiring frequent contact between youth and their probation officers. This could mean that violations by MST participants were more likely to be observed than those of comparison-group youth.
Therapists also rated MST youth to have improved functioning within family, peer, school, and community settings. MST participants showed significant improvement in all five areas evaluated (parenting skills, family relations, network of social supports, educational and vocational success, and involvement with prosocial — i.e., beneficial or helpful — peers). For example, at program entry, only 21.2 percent of MST youth had satisfactory family relations, compared with 77.8 percent at program exit. Improvement in the other areas was even greater, with parenting skills going from a 4.3-percent satisfactory rating at program entry to a 72.7-percent rating at program exit.
The findings suggest that MST is an effective form of treatment for Hispanic youth. Hispanic youth in the MST program had significantly lower rates of arrest and incarceration, as well as significantly higher rates of completion of probation, than those of Hispanic youth not in MST programs.
Black MST participants did not perform significantly better than their comparison-group counterparts on any of the juvenile justice outcomes. In fact, black youth in the MST program had significantly higher rates of arrest than black comparison-group youth. This outcome may be due to the disproportionate number of black youth detained in Los Angeles County's juvenile justice system compared with white or Hispanic youth.