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Multisystemic Therapy - Building Stronger Families (MST-BSF): Substance misuse, child neglect, and parenting outcomes
Cindy M Schaeffer1, Cynthia Cupit Swenson2, Jennifer Smith Powell2
1Division of Child and Adolescent Psychiatry, University of Maryland Baltimore, 737 W. Lombard St. 4th Floor, Baltimore, MD 21201, United States of America.
Insights
Multisystemic Therapy - Building Stronger Families (MST-BSF) significantly reduced parental alcohol and opiate misuse and child neglect. This family-based treatment shows promise for families involved with child protective services.
Area of Science:
- Child Welfare
- Addiction Medicine
- Family Therapy
Background:
- Parental substance misuse is a significant risk factor for child maltreatment and out-of-home placement.
- Limited research exists on comprehensive family-based treatment models addressing both parental substance misuse and child maltreatment concurrently.
Purpose of the Study:
- To evaluate the effectiveness of the Multisystemic Therapy - Building Stronger Families (MST-BSF) treatment model.
- To assess MST-BSF's impact on families involved with Child Protective Services due to physical abuse/neglect and parental substance misuse.
Main Methods:
- A randomized clinical trial involving 98 families with open Child Protective Services cases.
- Families were randomly assigned to either MST-BSF or Comprehensive Community Treatment (CCT).
- Outcomes were assessed over 18 months post-baseline.
Main Results:
- MST-BSF significantly reduced parent-reported alcohol and opiate use compared to CCT.
- MST-BSF improved child-reported neglectful parenting.
- No significant difference in new abuse incidents between groups over 18 months.
Conclusions:
- MST-BSF is an effective intensive, family- and ecologically-based treatment for reducing parental substance misuse and child neglect.
- Findings contribute to understanding interventions for child neglect, particularly in families with co-occurring parental substance misuse.
Background:
Parental substance misuse impacts millions of children globally and is a major determinant of repeat maltreatment and out-of-home placement. There is little published research on family-based, comprehensive treatment models that simultaneously address parental substance misuse and child maltreatment.
Objective:
This study reports outcomes from a randomized clinical trial examining the effectiveness of the Multisystemic Therapy - Building Stronger Families (MST-BSF) treatment model with families involved with Child Protective Services due to physical abuse and/or neglect plus parental substance misuse.
Participants And Setting:
Ninety-eight families who had an open case with Child Protective Services in two areas of the state of Connecticut participated.
Method:
Families referred by the Connecticut Department of Children and Families were randomly assigned to MST-BSF or Comprehensive Community Treatment (CCT). Both interventions were delivered by community-based therapists. Outcomes were measured across 5 assessments extending 18 months post-baseline.
Results:
Intent-to-treat analyses showed that MST-BSF was significantly more effective than CCT in reducing parent self-reported alcohol and opiate use and in improving child-reported neglectful parenting. Although means were in predicted directions, new incidents of abuse across 18 months did not differ between groups. The study features high recruitment and engagement rates for a population experiencing multiple involvements with child protection.
Conclusion:
The outcomes of this study support the effectiveness of MST-BSF, an intensive family- and ecologically- based treatment, for significantly reducing parental alcohol and opiate misuse and child neglect. These findings help in our understanding of how best to address the understudied issue of interventions for child neglect.
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