Within-intervention change: mediators of intervention effects during multisystemic therapy.

Area of Science:

• Child and adolescent psychology
• Family therapy research
• Behavioral interventions

Background:

• Adolescent externalizing problems are a significant concern.
• Parenting factors play a crucial role in adolescent behavior.
• Multisystemic therapy (MST) is an evidence-based intervention for serious juvenile offenses.

Purpose of the Study:

• To test if improvements in parental sense of competence during MST lead to better parenting.
• To examine if these parenting changes reduce adolescent externalizing problems.
• To investigate the sequential mediation pathways involving parental competence and parenting dimensions.

Main Methods:

• Randomized controlled trial with 256 adolescents and families.
• Comparison between MST and treatment as usual (TAU).
• Monthly assessments during intervention and pre/post intervention evaluations.

Main Results:

• MST significantly enhanced parental sense of competence and positive discipline.
• A sequential mediation was found: increased parental competence predicted improved positive discipline, which then predicted decreased adolescent externalizing problems.
• No significant mediation was found for inept discipline or relationship quality.

Conclusions:

• Parental sense of competence and positive discipline are key targets for interventions.
• MST's effectiveness in reducing adolescent externalizing problems is partly mediated by improvements in parenting.
• Future interventions should focus on enhancing parental self-efficacy and positive parenting strategies.