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Multisystemic Therapy and Functional Family Therapy Compared on their Effectiveness Using the Propensity Score

Hester V Eeren1,2, Lucas M A Goossens3, Ron H J Scholte4,5

  • 1Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands. h.vaneeren.1@erasmusmc.nl.

Journal of Abnormal Child Psychology
|January 10, 2018
PubMed
Summary

Multisystemic Therapy (MST) and Functional Family Therapy (FFT) show similar effectiveness for adolescent externalizing behaviors. However, MST was more effective for lower-risk youth without court orders.

Keywords:
AdolescentBehavioral problemsComparative effectiveness researchPropensity scoreQuasi-experimental study

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Area of Science:

  • Psychology
  • Child and Adolescent Psychiatry
  • Behavioral Therapy

Background:

  • Multisystemic Therapy (MST) and Functional Family Therapy (FFT) are evidence-based interventions for youth with externalizing behaviors.
  • Both therapies share overlapping target populations and treatment goals, necessitating comparative effectiveness research.

Purpose of the Study:

  • To compare the effectiveness of MST and FFT in reducing externalizing problem behaviors in adolescents.
  • To investigate treatment effectiveness based on risk level, indicated by court order status, guided by the Risk-Need-Responsivity (RNR) model.

Main Methods:

  • A quasi-experimental design was employed, collecting outcome data from 697 adolescents (mean age 15.3) between 2009 and 2014.
  • Propensity score methods were used to control for pre-treatment differences due to non-random assignment.
  • Externalizing problem behavior was the primary outcome, with secondary outcomes including living situation, school/work engagement, and police contact.

Main Results:

  • Overall, no significant difference in effectiveness for externalizing problems was found between MST and FFT across the entire sample.
  • For adolescents without a court order (lower risk), MST demonstrated significantly greater reductions in externalizing problems compared to FFT.
  • Treatment assignment aligned with the RNR model, with higher-risk adolescents (court-ordered) predominantly assigned to MST.

Conclusions:

  • MST and FFT exhibit comparable overall effectiveness, but MST may be more beneficial for lower-risk adolescent populations.
  • The findings support the RNR model's principle of matching treatment intensity to client risk levels.
  • Further research is needed to explore the specific mechanisms driving MST's enhanced effectiveness in lower-risk youth.