# Presentation: 788615

## MST  OUTCOMES

- 8 Randomized Trials Published (more than 850 families participating)
- 3 with violent and chronic juvenile offenders
- 1 with substance abusing or dependent juvenile offenders
- 1 with youths presenting psychiatric emergencies
- 1 with maltreating families
- 1 with inner-city delinquents
- 1 with juvenile sexual offenders

## Randomized and Controlled Trials in Progress, Funded, or Unpublished

- Canada (Leschied) - serious juvenile offenders
- Vanderbilt University (Weiss) - antisocial middle school children
- Delaware (Miller) - serious juvenile offenders
- Texas (Thomas) - juvenile offenders, gang members
- Charleston, SC (Henggeler) - substance abusing juvenile offenders (drug court)
- New York City (Office of Children and Family Services) - serious juvenile offenders
- Philadelphia and Hawaii (Henggeler) - MST continua of care
- Norway (Ogden) - juvenile offenders
- Washington State - serious juvenile offenders
- Stark County, Ohio (Timmons-Mitchell) - juvenile offenders
- Cuyahoga County, Ohio (Timmons-Mitchell) - domestically violent juveniles
- Charleston, SC (Swenson) - physically abused children

## CONSISTENT MST CLINICAL OUTCOMES

- In Comparison with Control Groups, MST:
- Improved family relations and functioning
- Increased school attendance
- Decreased adolescent psychiatric symptoms
- Decreased adolescent substance use
- Decreased long-term rates of rearrest 25% to 70%

##   CONSISTENT MST SERVICE OUTCOMES

- In Comparison with Control Groups, MST achieved:
- 97% and 98% rates of treatment completion in recent studies
- 47% to 64% decreases in long-term rates of days in out-of-home placements
- Higher consumer satisfaction
- Considerable cost savings (Washington State Institute on Public Policy)
- 		1. 	MST		 $64,000/youth
- 		15.	Bootcamps	($  7,910)/youth

## MST Substance-Related Outcomes

- Serious juvenile offenders: two trials
- pre-post self-report substance use
- substance-related arrests at 4-year follow-up
- Diagnosed substance abusing/dependent juvenile offenders
- pre-post self-reported substance use
- Youths with serious emotional disturbance
- self-reported alcohol use at 6-month follow-up
- marijuana use (urine screens) at 12-month follow-up

## Substance Abusing/Dependent Offenders: MST Service Findings

- Engagement and Retention in Treatment
- 98% (57 of 58 families) treatment completion (4 months)
- Cost Savings
- Incremental costs of MST offset by savings incurred from reductions in days of out-of-home placement at 12 months
- School Attendance
- Significant increase in regular classrooms

## Current MST Substance-Related Trials

- Drug Court Study (NIDA, NIAAA)
- Does integration of evidence-based practices enhance drug court outcomes?
- Neighborhood Solutions (SC DHHS)
- Evidence-based practices provided in high risk neighborhood with neighborhood collaboration
- MST Continua of Care (Annie E. Casey)
- Hawaii and Philadelphia; aimed at the most costly mental health, substance abuse, and juvenile justice youths

## Long-Term Substance-Related Outcomes at 5-6 Year Follow-up

- Stable Cocaine Use in Young Adulthood Predicted by the Interaction of:
- multiple internalizing disorders with high mother-child conflict in middle adolescence
- multiple internalizing disorders with high sibling negativity
- Low Cocaine Use in Young Adulthood
- Females who received MST in middle adolescence

## BASES OF MST SUCCESS

- Addresses multidetermined nature of serious clinical problems
- High ecological validity of intensive services
- Intensive quality assurance system
- Integration of evidence-based intervention models
- Caregiver viewed as key to long term outcomes
- Program accountability for family engagement and outcomes