Ethnic Similarity, Therapist Adherence, and Long-Term Multisystemic Therapy Outcomes

The current study investigated relations among ethnic similarity in caregiver-therapist pairs of youth participating in Multisystemic Therapy, therapist adherence, and youth long-term behavioral and criminal outcomes. Participants were 1979 youth and families treated by 429 therapists across provider organizations in 45 sites. Relations were found, independently, and in the presence of ethnic similarity, between adherence and reductions in youth Externalizing and Internalizing behavior problems 1-year post-treatment and youth criminal charges 4 years post-treatment. Relations between ethnic similarity and outcomes were found only for reductions in youth Externalizing behavior problems and not when adherence was included in the model. Adherence ratings were higher, however, in ethnically similar caregiver-therapist pairs, and evidence was found that this increased adherence predicted slightly better outcomes for youth. Implications for future research and clinical practice are considered.