2. Henggeler, S. W. (1992). Delinquency. In S. B. Friedman, M. Fisher, & S. K. Schonberg (Eds.), Comprehensive adolescent health care. St. Louis: Quality Medical Publishing.
4. Henggeler, S. W., Melton, G. B., & Smith, L. A. (1992). Family preservation using Multisystemic therapy: An effective alternative to incarcerating serious juvenile offenders. Journal of Consulting and Clinical Psychology, 60, 953-961.
5. Lyon, J. M., Henggeler, S. W., & Hall, J. A. (1992). The family relations, peer relations, and criminal activities of Caucasian and Hispanic-American gang members. Journal of Abnormal Child Psychology, 20, 439-449.
12. Henggeler, S. W., Melton, G. B., Smith, L. A., Foster, S. L., Hanley, J. H., & Hutchinson, C. M. (1993). Assessing violent offending in serious juvenile offenders. Journal of Abnormal Child Psychology, 21, 233-243.
13. Henggeler, S. W., Melton, G. B., Smith, L. A., Schoenwald, S. K., & Hanley, J. H. (1993). Family preservation using Multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders. Journal of Child and Family Studies, 2, 283-293.
14. Henggeler, S. W., & Schoenwald, S. K. (1993). Multisystemic therapy with juvenile offenders: An effective family-based treatment. The Family Psychologist, 9, 24-26. (currently not available)
16. Henggeler, S. W., Cunningham, P. B., Pickrel, S. G., & Schoenwald, S. K. (1994). Multisystemic therapy: An innovative treatment approach with serious juvenile offenders and their families. In T. Jeffers & I.M. Schwartz (Eds.), Home-based services for serious and violent juvenile offenders. Philadelphia, PA: Center for the Study of Youth Policy.
17. Henggeler, S. W., Melton, G. B., & Smith, L. A. (1994). Instandhouding van het gezin met behulp van multisystemische therapie: een effectief alternatief voor hechtenis van zware jeugdige delinquenten. Gezins Therapie, 5, 80-101.
18. Henggeler, S. W., & Schoenwald, S. K. (1994). Boot camps for juvenile offenders: Just say "no." Journal of Child and Family Studies, 3, 243-248.
21. Henggeler, S. W., Smith, B. H., & Schoenwald, S. K. (1994). Key theoretical and methodological issues in conducting treatment research in the juvenile justice system. Journal of Clinical Child Psychology, 23, 143-150.
22. Scherer, D. G., Brondino, M. J., Henggeler, S. W., Melton, G. B., & Hanley, J. H. (1994). Multisystemic family preservation therapy: Preliminary findings from a study of rural and minority serious adolescent offenders. Journal of Emotional and Behavioral Disorders, 2, 198-206.
23. Sondheimer, D., Schoenwald, S. K., & Rowland, M. D. (1994). Alternatives to the hospitalization of youth with a serious emotional disturbance. Journal of Clinical Child Psychology, 23(Suppl), 7-12.
25. Borduin, C. M., Mann, B. J., Cone, L. T., Henggeler, S. W., Fucci, B. R., Blaske, D. M., & Williams, R. A. (1995). Multisystemic treatment of serious juvenile offenders: Long-term prevention of criminality and violence. Journal of Consulting and Clinical Psychology, 63, 569-578.
27. Henggeler, S. W., & Borduin, C. M. (1995). Multisystemic treatment of serious juvenile offenders and their families. In I. M. Schwartz & P. AuClaire (Eds.), Home-based services for troubled children. Lincoln: University of Nebraska Press.
28. Henggeler, S. W., Cunningham, P. B., Pickrel, S. G., & Schoenwald, S. K. (1995). Multisystemic therapy for serious juvenile offenders and their families. In R. R. Ross (Ed.), Going straight: Effective delinquency prevention and offender rehabilitation. Ottawa, Ontari Center for Cognitive Development.
37. Schoenwald, S. K., Henggeler, S. W., Pickrel, S. G., & Cunningham, P. B (1996). Treating seriously troubled youths and families in their contexts: Multisystemic therapy. In M. C. Roberts (Ed.), Model programs in child and family mental health (pp. 317-332). Mahwah, NJ: Lawrence Erlbaum Associates.
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47. Schoenwald, S. K., Henggeler, S. W., Brondino, M. J., & Donkervoet, J. C. (1997). Reconnecting schools with families of juvenile offenders. In J. L. Swartz & W. E. Martin (Eds.), Applied ecological psychology for schools within communities: Assessment and intervention, (pp. 187-205). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.
48. Schoenwald, S. K., Borduin, C. M., & Henggeler, S. W. (1998). Multisystemic therapy: Changing the natural and service ecologies of adolescents and families. In M. H. Epstein, K. Kutash, & A. Duchnowski (Eds.), Outcomes for childrenand youth with behavioral and emotional disorders and their families: Programs & evaluation best practices (pp. 485- 511). Austin, TX: PRO-ED, Inc.
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70. Brown, T. L., Swenson, C. C., Cunningham, P. B., Henggeler, S. W., Schoenwald, S. K., & Rowland, M. D. (1997). Multisystemic treatment of violent and chronic juvenile offenders: Bridging the gap between research and practice. Administration and Policy in Mental Health, 25(2), 221-238.
72. Brown, T. L., Henggeler, S. W., Brondino, M.J., & Pickrel, S.G. (1999). Trauma exposure, protective factors, and the mental health functioning of substance abusing and dependent juvenile offenders. Journal of Emotional and Behavioral Disorders, 7(2), 94-102.
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86. Randall, J., Henggeler, S.W., Pickrel, S.G., & Brondino, M.J. (1999). Psychiatric comorbidity and the 16-month trajectory of substance abusing and dependent juvenile offenders. Manuscript submitted for publication. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 1118-1124.
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203. Cunningham, P.B., & Henggeler, S.W., Limber, S.P.,Melton, G.B.,Nation, M.A. (2000).Patterns and correlates of gun ownership among nonmetropolitan and rural middle school students. Journal of Clinical Child Pscyhology, 29, 432-442.
206. Halliday-Boykins, C.A.,Graham, Sandra, (2001). At both ends of the the gun: Testing the relationship between community violence exposure and youth violent behavior. Journal of Abnormal Child Psychology, 29, (5), 383-402.
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219. Randall, J., Halliday-Boykins, C.A., Cunningham, P.B., Henggeler, S.W. (2001). Integrating evidence-based substance abuse treatment into juvenile drug courts: Implications for outcomes. National Drug Court Institute Review, Vol. III, 2, 89-115.
221. Letourneau, E. J., Cunningham, P. B., & Henggeler, S. W. (2002). Multisystemic treatment of antisocial behavior in adolescents. In S. G. Hofmann & M. C. Tompson (Eds.), Treating chronic and severe mental disorders: A handbook of empirically supported interventions (pp. 364-381). New York: Guilford Press.
223. Henggeler, S.W., Clingempeel, W.G., Brondino, M.J., Pickrel, S.G. (2002). Four-year follow-up of Multisystemic therapy with substance-abusing and substance-dependent juvenile offenders. Journal of the American Academy of Child and Adolescent Psychiatry, 41(7), 868-874.
227. Clingempeel, W.G., & Henggeler, S.W. (2003). Aggressive juvenile offenders transitioning into emerging adulthood: Factors discriminating persistors and desistors. American Journal of Orthopsychiatry, 73, 310-323.
229. Henggeler, S.W., & Sheidow, A.J. (2002). Conduct disorder and delinquency. In D.H. Sprenkle (Ed.), Effectiveness research in marriage and family therapy (pp. 57-51) . Alexandria , VA : American Association for Marriage and Family Therapy.
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249. Henggeler, S.W. (2003). Advantages and disadvantages of multisystemic therapy and other evidence-based practices for treating juvenile offender. Journal of Forensic Psychology Practice, 3, 53-59.
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262. Rowland, M.D., Halliday-Boykins, C.A., Henggeler, S.W., Cunningham, P.B., Lee, T.G., Kruesi, M.J.P., & Shapiro, S.B. (2005). A randomized trial of multisystemic therapy with Hawaii 's Felix Class youths . Journal of Emotional and Behavioral Disorders, 13(1).13-23.
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Delinquency refers to illegal activities committed by a minor. Such acts can be divers on their seriousness and their effects on others. At the low end of seriousness continuum are status offenses, which are behaviors that are not illegal if performed by an adult (e.g., truancy, running away). At the upper end of the continuum are serious criminal offenses, such as robbery, rape, and aggravated assault. In the middle range are illegal activities such as burglary, disorderly conduct, and petty larceny. This chapter focuses on the criminal activities found in the middle to the upper range of the seriousness continuum. A detailed explication of the conclusions reached in this chapter can be obtained in two recent reviews of the literature on delinquency.
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4. Family preservation using multisystemic therapy: An effective alternative to incarcerating serious juvenile offenders
Multisystemic therapy (MST) delivered through a community mental health center was compared with usual services delivered by Department of Youth Services in the treatment of 84 serious juvenile offenders and their multiproblem families. Offenders were assigned randomly to treatment conditions. Pretreatment and posttreatment assessment batteries evaluating family relations, peer relations, symptomatology, social competence, and self-reported delinquency were completed by the youth and a
parent, and archival records were searched at 59 weeks postreferral to obtain data on rearrest and incarceration. In comparison with youths who received usual services, youths who received MST had fewer arrests and self-reported offenses and spent an average of 10 fewer weeks incarcerated. In addition, families in the MST condition reported increased family cohesion and decreased youth aggression in peer relations. The relative effectiveness of MST was neither moderated by demographic
characteristics nor mediated by psychosocial variables.
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5. The family relations, peer relations, and criminal activities of Caucasian and Hispanic-American gang members
Juvenile gang members present serious problems to society, yet few empirical studies have examined their criminal activity, family relations, and peer relations in comparison with other highly antisocial youths. In a 2 (Gang Membership) X 2 (Ethnicity: Hispanic-American vs. Caucasian) design, 131 incarcerated male juvenile offenders were administered a battery assessing criminal activity, family relations, and peer relations. Results demonstrated (a) higher rates of criminal behavior (i.e., general delinquency, index offenses, school delinquency) among gang members than among offenders who did not belong to gangs, (b) higher rates of general delinquency and home delinquency among Caucasian offenders than among Hispanic-American offenders, and (c) greater aggression and less social maturity in the peer relations of gang members than in the peer relations of offenders who did not belong to gangs. In addition, gang membership mediated sociocultural differences in hard drug use. Findings are integrated with the extant literature.
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12. Assessing violent offending in serious juvenile offenders
The convergent validity of the two most frequently used methods for assessing violent offending in juveniles (i.e., self-reports and arrests) was evaluated. Participants were 87 serious juveniles and their maternal figures, primarily from disadvantaged families. Validation measures tapped established behavioral, family, and peer correlates of delinquency. Results failed to support the ability of either arrests for violent crimes or self-reported violent offenses to index violent criminal behavior accurately. Several methodological features of the study support our hypothesis that the findings were not spurious. Procedural and conceptual implications of the findings are discussed.
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13. Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders
In a randomized clinical trial, multisystemic family preservation was shown to significantly reduce rates of criminal activity and incarceration in a sample of 84 serious juvenile offenders and their multi-need families. In the current study, archival records were searched for re-arrest an average of 2.4 years post-referral. Survival analysis showed that youths who received multisystemic family preservation were less
likely to be re-arrested than were youths who had received usual services. Such results represent the first controlled demonstration that family preservation, when delivered via a clearly specified treatment model, has lasting effects with serious juvenile offenders. Implications for family preservation and juvenile justice research are discussed.
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17. Instandhouding van het gezin met behulp van multisystemische therapie: een effectief alternatief voor hechtenis van zware jeugdige delinquenten
Multisystemische therapie (MST), gegeven vanuit een geestelijk gezondheidscentrum, werd vergeleken met de gebruikelijke hulpverlening door een Department of Youth Services bij de behandeling van 84 zware jeugdige delinquenten en hun gezinnen die met vele problemen te kampen hebben. Delinquenten werden at random ingedeeld in de behandelingsgroepen. Met behulp van testbatterijen, die bij aanvang en beëindiging van de behandeling werden afgenomen bij de jongere en een van de ouders, weden evaluaties verricht van gezinarelaties, relaties met leeftaijdegenoten, symptomatologie, sociale vaardigheden, en zelfvermelde delinquentie. Verder werden er 59 weken na verwijzing archiefgegvens verzameld over nieuwe arrestaties en inhechtenisnemigen. In vergelijking met jongeren die de gebruikelijke hulpverlening ontvingen, werden jongeren in de MST-groep minder vaak gearresteerd, rapporteerden ze minder misdrijven te plegen, en hadden ze gemiddeld tien weken minder in de gevangenis gezeten. Bovendien vertoonden gezinnen in de MST-groep een toename van de gezinscohessie en een afname van de agressivizeit van MST werd niet beinvloed door demografishe kenmerken of psychosociale variabelen.
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18. Boot camps for juvenile offenders: Just say no
The apparent increase in the violence of juvenile crime and the media’s sensationalistic portrayals of juvenile violence have fueled public outrage and spawned numerous political strategies to "get tough". Among the most popular of these is for shapers of policy to vocally advocate the development and proliferation of boot camps. As this editorial is being written, governors and legislators in several states are advocating the use of boot camps for juvenile offenders, and the Crime Bill currently being debated in Congress, and supported by President Clinton, contains a provision for boot camps for juvenile offenders. While the boot camp solution may be politically expedient (in that is assuages public anger and fear and casts the impression that lawmakers are taking action) there is little reason to believe or suggest that such camps are effective in treating chronic, serious, or violent juvenile offenders.
Two types of evidence bear upon the question of whether boot camps are effective. The first type consists of findings from studies of boot camps themselves. Most of the studies are quasi-experimental, at best, and many reports are based entirely upon anecdotal evidence (Office of Technology Assessment, 1991). The second type consists of findings on the correlates and causes of juvenile delinquency.
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21. Key theoretical and methodological issues in conducting treatment research in the juvenile justice system
Addressed are critical conceptual and methodological problems that have hampered the development and implementation of effective treatment for juvenile offenders. Theoretical formulations underlying extant treatments are considered, and the nature and scope of theoretical models better suited to the development of effective intervention programs are described. Discussed methodological issues focus on the validity of comparisons between groups and the construct validity of treatment. Suggestions for addressing key issues are informed by conclusions of leading methodologists and our experience in conducting several clinical trials with serious juvenile offenders.
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22. Multisystemic family preservation therapy: Preliminary findings from a study of rural and minority serious adolescent offenders
The increase in the number of serious offenses by adolescents, particularly among minority populations, has drawn attention to these difficult-to-treat youths. This article provides preliminary findings from the Diffusion of Multisystemic Family Preservation (MFP) Services Project, which conducted work with rural African-American and White families who have a chronic or violent adolescent offender at imminent risk for incarceration. Analyses assessed the impact of multisystemic therapy on family functioning (parental monitoring, family communications, family structure, etc.) and on the problem behavior of the delinquent adolescent (conduct problems, aggression, and criminal activity). In general, the MFP group demonstrated improvements in amount of problem behavior and mother psychological distress, and in
aspects of family functioning following treatment. These results generally replicate the previous successes that MFP has shown in the treatment of serious juvenile offenders in urban areas.
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23. Alternatives to the hospitalization of youth with a serious emotional disturbance
Examined the evidence regarding efficacy, necessity, and outcomes of psychiatric hospitalization for children and adolescents and described recently developed alternatives that are likely to be more ethical and clinically and cost effective.
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25. Multisystemic treatment of serious juvenile offenders: Long-term prevention of criminality and violence
This article examined the long-term effects of multisystemic therapy (MST) vs. individual therapy (IT) on the prevention of criminal behavior and violent offending among 176 juvenile offenders at high risk for committing additional serious crimes. Results from multiagent, multimethod assessment batteries conducted before and after treatment showed that MST was more effective than IT in improving key family correlates of antisocial behavior and in ameliorating adjustment problems in individual family members. Moreover, results from a 4-year follow-up of rearrest data showed that MST was more effective than IT in preventing future criminal behavior, including violent offending. The implications of such findings for the design of violence prevention programs are discussed.
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27. Multisystemic treatment of serious juvenile offenders and their families
Multisystemic therapy (Henggeler & Borduin, 1990) is a family-based therapeutic approach that has been viewed as a highly promising treatment for complex psychosocial problems in children and adolescents (see Culbertson, 1990; Miller & Prinz, 1990). This chapter discusses the application of multisystemic therapy to the treatment of serious juvenile offenders and their multiproblem families. In our discussion, we address the empirical rationale for the application of this particular therapy as well as the clinical features of multisystemic therapy that make it especially well suited for treating anti-social behavior in adolescents. More specifically, we address the following issues: 1) we show that serious juvenile offenders experience numerous psychosocial difficulties and present significant problems to their communities and that there are is a dire need to develop effective interventions for such offenders and their families; (2) we show that there are multiple correlates and causes of delinquency and that the key correlates pertain to characteristics of the social systems (i.e., family, peers, school) in which these offenders are involved; (3) we argue that the identified correlates of delinquency are consistent with a social –ecological model of behavior, which represents the theoretical foundation of multisystemic therapy; (4) we summarize findings from controlled evaluations of multisystemic therapy and argue that the efficacy of multisystemic therapy is largely due to its considerations of the multiple factors associated with delinquency ; and (5) we provide a brief description of the clinical features of multisystemic therapy and delineate nine principles for designing multisystemic interventions.
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38. Treatment of serious antisocial behavior
Research findings regarding the causes and treatment of delinquency, youth violence, and adolescent substance abuse provide important information for public policy decisions and community planning. These contributions come at a critical time, as the continued increase of these problems and rising public concern have prompted renewed debate over how to respond. This paper examines the individual and societal costs of serious antisocial behavior in adolescents, the correlates and causes of such behavior, recent advances in the treatment of serious antisocial behavior, and the implications of this research for public policy and health care reform.
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39. Effective community-based treatments for serious juvenile offenders
(from the chapter) This chapter focuses on treatment and service-system innovations that have demonstrated clinical and cost effectiveness with serious juvenile offenders. Emphasis is placed on treatments that have been subjected to controlled clinical trials. Models of service delivery that appear to hold promise for this population are also described, and issues related to their evaluation are discussed. Innovative treatments discussed include multisystemic treatment, adventure programming with families, and therapeutic foster care. Three models of community-based service delivery are examined: family preservation, individualized care, and intensive case management.
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42. Multisystemic therapy: an effective violence prevention approach for serious juvenile offenders
This article provides an overview of a treatment approach, Multisystemic Therapy (MST), that has demonstrated long-term reductions in criminal activity and violence among youth at high-risk for perpetrating violence. Importantly, central prevention in the United States. Moreover, as demonstrated from the findings of controlled clinical trials evaluating MST with serious juvenile offenders, the viability of the public health approach is supported.
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47. Reconnecting schools with families of juvenile offenders
(from the chapter) This chapter describes Multisystemic Therapy (MST), a treatment model that has a well-documented capacity to address the difficulties in providing effective mental health services for juvenile offenders. MST is an intensive, time-limited, family- and community-based treatment approach that has demonstrated effectiveness in randomized trials with chronic and violent juvenile offenders and their families. In addition to describing the theoretical, clinical, and research-related features of MST, a second goal of this chapter is to discuss the implications of the emergent success of MST for the development of effective community-based mental health programming for youths and families.
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48. Mulitsystemic therapy: Changing the natural and service ecologies of adolescent and families
(from the chapter) Recent research findings suggest the causes and treatment of such serious antisocial behavior as delinquency and adolescent substance abuse clearly point to the need for ecologically based interventions. Therefore, this chapter examines the implications of this research for the development of effective ecological treatments for serious antisocial behavior. More specifically, the authors examine Multisystemic Therapy (MST), an ecological approach that has proven effective with chronic and violent juveniles in several clinical trials, and highlight the MST approach to reconnecting families of juvenile offenders with schools, and vice versa. Research regarding casual models and treatments of delinquency are also discussed.
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Delinquency refers to illegal activities committed by a minor. Such acts can be diverse in their seriousness and their effects on others. At the low end of seriousness continuum are status offenses, which are behaviors that are not illegal if performed by an adult (e.g., truancy, running away). At the upper end of the continuum are serious criminal offenses such as robbery, rape and aggravated assault. In the middle range are illegal activities such as burglary, disorderly conduct, and petty larceny. This chapter focuses on the criminal activities found in the middle to upper range of seriousness continuum.
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51. Treatment of violent juvenile offenders – We have the knowledge: Comment on Gorman-Smith et al. (1996)
On the basis of research by D. Gorman-Smith, P.H. Tolan, A. Zelli, and L.R. Huesmann (1996) and many others, a reasonable consensus has been achieved regarding the concurrent correlates of criminal behavior in adolescents. Moreover, it is known that when these correlates are addressed through a well-specified, ecological treatment model that emphasizes the delivery of flexible, individualized, and comprehensive empirically based services to youths and their families, rates of serious juvenile offending are decreased. Yet, prevailing mental health and juvenile justice services rarely attend to the known determinants of serious antisocial behavior and, in fact provide interventions that are expensive and likely exacerbate the problem. The challenge is both to develop and validate ecologically based treatment models to advocate for the myriad needs of serious juvenile offenders and their families.
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55. Multisystemic therapy with violent and chronic juvenile offenders and their families: The role of treatment fidelity in successful dissemination
The effects of multisystemic therapy (MST) in treating violent and chronic juvenile offenders and their families in the absence of ongoing treatment fidelity checks were examined. Across 2 public sector mental health sites, 155 youths and their families were randomly assigned to MST versus usual juvenile justice services. Although MST improved adolescent symptomology at posttreatment and decreased incarceration by 47% at a 1.7-year follow-up, findings for decreased criminal activity were not as favorable as observed on other recent trials of MST. Analyses of parent, adolescent, and therapist reports of MST treatment adherence ratings were high. These results highlight the importance of maintaining treatment fidelity when disseminating complex family-based services to community settings.
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62. Watching the bottom line: Cost-effective interventions for reducing crime in Washington
The Washington State Legislature directed the Washington State Institute for Public Policy to evaluate the costs and benefits of certain criminal justice policies, violence prevention programs, and other efforts to decrease criminal recidivism and at-risk behaviors of youth. This progress report contains information on several interventions that have been shown to work, some that have not, and some that are promising but not yet fully evaluated.
Similar to the home insulation example, this analysis focuses on the "bottom-line" economics of different programs that try to reduce criminal behavior, by comparing up-from program costs paid by taxpayers to any further benefits that a program produces.
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65. Female juvenile delinquency: Misunderstood by the juvenile justice system, neglected by social science
The study of juvenile delinquency has focused primarily on conduct disorder and aggression in males, while relatively little attention has been paid to females who commit delinquent acts. This article offers a critical review of the existing theories of and research on female delinquency and the juvenile justice system’s response to female delinquency. The inadequacies and persistence of historical theories and the conceptual and methodological strengths and weaknesses of contemporary perspectives in female delinquency are reviewed. Understanding and treatment of female and male delinquency could be enhanced through the adoption of a gender-integrated theory of delinquency that is informed by the comprehensive study of developmental, psychological, and social-ecological determinants.
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67. Changing the social ecologies of adolescent sexual offenders: Implications of the success of multisystemic therapy in treating serious antisocial behavior in adolescents
Current treatment models for adolescent sexual offenders are individually oriented and have limited empirical support. These models may not be effective in reducing recidivism because they do not address the multiple factors (i.e., individual, family, peer, school) related to sexual offending. Multisystemic therapy (MST), an ecologically based treatment model that addresses multiple determinants of behavior, has proven effective with chronic, violent nonsexual offenders in several randomized trials. Preliminary research also indicates promise for MST with sexual offenders. This article: (a) presents empirical support for use of an ecological approach with adolescent sexual offenders based on a multidetermined etiology, (b) provides a theoretical and clinical description of MST, and (c) describes a recent adaptation of MST that maintains the ecological emphasis of MST and integrates important conceptualizations from the literature on adolescent sexual offending.
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68. Treating juvenile offenders in community settings
(from the chapter) The purpose of this chapter is to describe community-based treatment approaches that have demonstrated some promise with juvenile offenders at high risk for mental health problems. Topics include: review of treatments and treatment outcomes (adventure-based programs, behavioral parent training, teaching-family model, individualized/wraparound care, family ties); intensive supervision programs (interventions, specific aims, overall evaluation); and multisystemic therapy.
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70. Multisystemic treatment of violent and chronic juvenile offenders: Bridging the gap between research and practice
The lack of communication between researchers and practitioners has hindered the development of effective interventions for children and adolescents. Recently, however, significant headway in bridging this researcher-practitioner gap has been made due to the emergence of multisystemic therapy (MST) as a treatment approach that combines the rigor of science of and the "real world" aspects of clinical practice in treating violent and chronic juvenile offenders and their families in community-based settings. MST addresses the multiple known determinates of delinquency and delivers services in the family’s natural environment, with considerable emphasis on treatment fidelity. This article describes MST and provides a case example of how MST treatment principles are applied.
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72. Trauma exposure, protective factors, and mental health functioning of substance-abusing and dependent juvenile offenders
This study examined the linkages of trauma exposure and protective factors with important aspects of mental health and behavioral functioning in a sample of youth presenting serious clinical difficulties. In general, results suggest that the effects of trauma vary considerably with the nature of the trauma. Specifically, findings indicated that, after controlling for important third variable explanations, violence exposure was linked with adolescent criminal offending, whereas sexual abuse was linked with psychiatric comorbidity. Additionally, several of the demographic and protective factors showed significant associations with measures of criminal activity and mental health. Implications of these findings are discussed and directions for future research are suggested.
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85. Multisystemic treatment of substance-abusing and–dependent delinquents: Outcomes, treatment fidelity, and transportability
The effectiveness and transportability of multisystemic therapy (MST) were examined in a study that included 118 juvenile offenders meeting DSM-III-R criteria for substance abuse or dependence and their families. Participants were randomly assigned to receive MST versus usual community services. Outcome measures assessed drug use, criminal activity, and days in out-of-home placement at posttreatment (T2) and at a 6-month posttreatment follow-up (T3); also treatment adherence was examined from multiple perspectives (i.e., caregiver, youth, and therapist). MST reduced alcohol, marijuana, and other drug use at T2 and total days in out-of-home placement by 50% at T3. Reductions in criminal activity, however, were not as large as have been obtained previously for MST. Examinations of treatment adherence measures suggests that the modest results of MST were due, at least in part, to difficulty in transporting this complex treatment model from the direct control of its developers. Increased emphasis on quality assurance mechanisms to enhance treatment fidelity may help overcome barriers to transportability.
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86. Psychiatric comorbidity and the 16-month trajectory of substance-abusing and substance-dependent juvenile offenders
Objectives: To examine the concurrent correlates of internalizing and externalizing disorders among substance- abusing and substance-dependent juvenile offenders and to determine the association between psychiatric comorbidity and psychosocial functioning of the youths 16 months later. Method: Participants were 118 juvenile offenders meeting DSM-111-R criteria for substance abuse or dependence and their families. A multisource measurement battery was used to assess drug use, criminal activity, family relations, peer relations, school functioning, and out-of-home placements. Results: Comorbidity for externalizing disorders was associated with high rates of antisocial behavior and predicted worse 16-month outcomes than substance abuse alone or substance abuse with comorbid internalizing disorders. For criminal activity and drug use, the presence of internalizing disorders buffered the deleterious effect of externalizing disorders on substance-abusing and substance-dependent juvenile offenders. Conclusion: Even in substance-abusing delinquents, a population already extreme in antisocial behavior, the presence of externalizing disorders indicates high risk for deterioration.
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89. Neighborhood solutions for neighborhood problems: An empirically based violence prevention collaboration
Youth antisocial behavior is influenced, in part, by neighborhood context. Yet, rather than attempting to ameliorate factors contributing to youth antisocial behavior, service dollars are primarily devoted to expensive and often ineffective out-of-home placements. This article describes the development and implementation of a collaborative partnership designed to empower an economically disadvantaged neighborhood to address violent criminal behavior, substance abuse, and other serious antisocial problems of its youth while maintaining youth in the neighborhood. Through a collaboration between a university research center and neighborhood stakeholders, services are being provided to address the key priorities identified by neighborhood residents, and extensive efforts are being made to develop family and neighborhood contexts that are conducive to prosocial youth behavior.
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91. Mechanisms of change in multisystemic therapy: Reducing delinquent behavior through therapist adherence and improved family and peer functioning
The mechanisms through which multisystemic therapy (MST) decreased delinquent behavior were assessed in 2 samples of juvenile offenders. Sample 1 included serious offenders who were predominately rural, male, and African American. Sample 2 included substance-abusing offenders who were predominately urban, male, and Caucasian. Therapist adherence to the MST protocol (based on multiple respondents) was associated with improved family relations (family cohesion, family functioning, and parent monitoring) and decreased delinquent peer affiliation, which, in turn, were associated with decreased delinquent behavior. Furthermore, changes in family relations and delinquent peer affiliation mediated the relationship between caregiver-rated adherence and reductions in delinquent behavior. The findings highlight the importance of identifying central change mechanisms in determining how complex treatment such as MST contribute to ultimate outcomes.
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101. Effects of multisystemic therapy on drug use and abuse in serious juvenileoffenders: A progress report from two outcome studies
Although treatment approaches for adolescent substance abuse have proliferated,treatment efficacy has been rarely evaluated. This study presents a progress report,focusing on reductions in substance use and abuse, from two independent evaluationsof the efficacy of multisystemic therapy (MST) in treating the antisocial behavior ofserious juvenile offender, were assigned randomly either to MST or individual counseling conditions. Analyses of arrests data, which were collected for an average of 4 years posttreatment, indicated that youths who participated in MST had significantly lower rate of substance-related arrests than did youths who participated in individual counseling. In the Family and Neighborhood Solutions project, conducted in South Carolina, serious juvenile offenders were assigned randomly either to MST or usual juvenile justice services. Based on self-report measures of substance use collected pretreatment and posttreatment, youths in the MST condition reported a significant reduction in soft drug use relative to youths who received usual services. Together, these finding support the value of conducting a rigorous and more comprehensive evaluation of the efficacy of MST in treating substance-abusing delinquents and their families.
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102. Multisystemic treatment of adolescent sexual offenders
This study compared the efficacy of multisystemic therapy (MST) and individual therapy (IT) in the outpatient treatment of adolescent sexual offenders. Sixteen adolescent sexual offenders were randomly assigned to either MST or IT conditions. Youths in the MST and IT conditions received an average of 37 hours and 45 hours of treatment, respectively. Recidivism data were collected on all subjects at an approximately 3-year follow up. Between groups comparisons showed that significantly fewer subjects in the MST condition had been rearrested for sexual crimes and that the frequency of sexual rearrests was significantly lower in the MST condition than in the IT condition. The relative efficacy of MST was attributed to its emphasis on changing behavior and interpersonal relations within the offender natural environment.
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104. Multisystemic treatment of juvenile offenders: Effects on adolescent behavior and family interaction
The efficacy of a multisystemic approach to treatment was evaluated for juvenile offenders and their families. Subjects included 57 delinquent adolescents who received family-ecological treatment, 23 delinquent adolescents who received an alternative treatment, and 44 normal adolescents who served as developmental controls. Pretreatment and posttreatment assessments were conducted with the adolescent and his or her parent(s). Personality inventories, behavior ratings, and self-report and observational measures of family relations were included to evaluate changes at several systemic levels. Statistical analysis revealed that the adolescents who received family-ecological treatment evidenced significant decreases in conduct problems, anxious-withdrawn behaviors, immaturity, and association with delinquent peers. The mother-adolescent and marital relations in these families were significantly warmer, and the adolescent was significantly more involved in family interaction. In contrast, the families who received the alternative treatment evidenced no positive change and showed deterioration in affective relations. The normal families manifested relationship changes that are consistent with those identified by investigators of normal adolescent development. The findings support a multisystemic model of behavior disorders and treatment.
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106. Multidimensional casual models of delinquent behavior and their implications for treatment
In this chapter, the social ecology of delinquent behavior is examined, and three central themes are developed. First, adolescent criminal activity is embedded within several systemic contents (e.g., family, peers, school, and neighborhood) that influence such behavior and are influenced by the behavior. Second, the consideration of variables within adolescents’ broader social environments increases the explanatory power of models of delinquency. And third, the social ecology of delinquency has important implications for the development of effective treatment strategies. In contrast, to most existing treatments of delinquency, which focus on the individual adolescent or one pertinent system, the social-ecological perspective suggests that broad-based treatments are more appropriate. Before turning to these issues, the significance of delinquency as an area of research and the correlates of delinquency are briefly reviewed.
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202. "If I get locked up, I get locked up": Secondary control and adjustment among juvenile offenders
This study examined relations between two types of control (primary and secondary) and the psychological and community adjustment of adolescent offenders. Prior to release from confinement, 279 male adolescent offenders were interviewed about their control beliefs and a number of adjustment variables, including emotional /behavior problems, feelings of despair, expectations to avoid recontact with the law, and recognition of cost for reoffending. In addition, probation officers were searched interviewed regarding the participants’ adjustment to the community 8 weeks following their release and official records were searched for a 6-month period to determine the nature and timing of any reincarcerations. Secondary control was significantly associated with maladjustment for all psychological and behavioral outcomes. When predicting reincarceration, this relationship was qualified by a significant interaction with primary control, such that those who recidivated the soonest had high levels of both primary and secondary control. These data suggest that secondary control beliefs may be maladaptive among adolescent offenders, particularly when perceived primary control is high.
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203. Patterns and correlates of gun ownership among nonmetropolitan and rural middle school students
Examined prevalence of gun ownership and the links among gun ownership, reasons for gun ownership, and antisocial behavior in a sample of nonmetropolitan and rural middle school students. Participants completed the Questionnaire for Students (Olweus, 1995) and included 6,263 students from elementary and middle schools, of whom most were African American (range = 46%-95% per school). Reasons for gun ownership were strongly associated with rates of antisocial behavior. Youths who owned guns for sporting reasons reported rates of antisocial behavior that were only slightly higher than those reported by youths who did not own guns. Youths who owned guns to gain respect or to frighten others reported extremely high rates of antisocial behavior. These high-risk adolescent gun owners were likely to come from families of high-risk gun owners, associate with friends who were high-risk gun owners, and engage in high rates of bullying behavior. Findings suggest that effective violence prevention programs must target high-risk youths, address risk factors that go beyond individual settings, and address a comprehensive array of factors.
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206. At both ends of the gun: Testing the relationship between community violence exposure and youth violent behavior
Much psychological inquiry has focused on understanding the contribution that exposure to urban violence makes to violent behavior among youth. However, other ways in which these variables may be related have been largely overlooked. This study compared four alternative social-ecological models of the link between community violence exposure and violent behavior to determine the degree to which: (1) community violence exposure contributes to violent behavior, (2) violent behavior contributes to community violence exposure, (3) both are consequences of common antecedents, and (4) both are manifestations of the same higher-order construct. Two hundred and seventy-seven adolescent offenders were interviewed about family, neighborhood, cognitive, and peer characteristics, in addition to violent behavior and community violence exposure and youth violent behavior is to consider both as representatives of a general involvement in violence.
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207. Multisystemic therapy with serious juvenile offenders and their families
Multisystemic therapy (MST; Henggeler & Borduin, 1990; Henggeler, Schoenwald, Borduin, Rowland, & Cunningham , 1998) is a family-and community-based treatment that has reduced long-term rates of recidivism and out-of-home placement for violent and chronic juvenile offenders and improved adolescent and family functioning. Such outcomes are significant in light of the myriad personal and social problems presented and experienced by serious juvenile offenders (Sampson & Laub, 1990, 1993). This chapter will describe the bases of the success of MST, the specific outcomes that can be expected when MST is delivered with integrity, and the principles that guide the design of MST interventions.
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208. Implementation of an empirically based drug and violence prevention and intervention program in public school settings
Describes the implementation of a collaborative preventive intervention project (Healthy Schools) designed to reduce levels of bullying and related antisocial behaviors in children attending two urban middle schools serving primarily African American students. These schools have high rates of juvenile violence, as reflected by suspensions and expulsions for behavioral problems. Using a quasi-experimental design, empirically based drug and violence prevention programs, Bullying Prevention and Project ALERT, are being implemented at each middle school. In addition, an intensive evidence-based intervention, multisystemic therapy, is being used to target students at high risk of expulsion and court referral. Hence, the proposed project integrates both universal approaches to prevention and a model that focuses on indicated cases. Targeted outcomes, by which the effectiveness of this comprehensive school-based program will be measured, are reduced youth violence, reduced drug use, and improved psychosocial functioning of participating youth.
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219. Integrating evidence-based substance abuse treatment into juvenile drug courts: Implications for outcomes
This article describes the importance of integrating evidence-based substance abuse treatments into juvenile drug courts. Guidelines from the National Institute on Drug Abuse (NIDA) are offered as a template to enable drug courts to select substance abuse treatments based on available evidence of effectiveness. Multisystemic therapy (MST) is presented as an example of an evidence-based model of treatment that meets NIDA guidelines and has been integrated into several juvenile drug courts. Substance abuse outcomes from published MST trials are summarized, and a current study that examines the relative effectiveness of drug court with MST versus drug court with traditional substance abuse treatment is described.
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227. Aggressive juvenile offenders transitioning into emerging adulthood: factors discriminating persistors and desistors
Aggressive juvenile offenders (mean age = 15.6 years) were classified as persistors (n = 55) or desistors (n = 25) with aggressive crimes 5 years later (mean age = 20.6 years). At adolescence, desistors engaged in fewer aggressive acts, committed fewer property crimes, and behaved less aggressively and more positively toward peers. At emerging adulthood, desistors reported greater emotional support, higher job satisfaction, closer peer relationships, and fewer psychiatric problems. Findings largely remained significant after initial group differences were controlled.
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229. Conduct disorder and delinquency
The purpose of this chapter is to review those family-based treatments of conduct disorder and delinquency in adolescents that have been identified by federal entities and leading reviewers as efficacious, and to suggest implications for clinical practice and future research. Treatment research regarding adolescent substance abuse and conduct disorder in children is examined in other chapters in this volume (chapteers 3 and 4 respectively).
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233. Panoramica da investigacao em terapia multissistemica
A Terapia Multissistémica (TMS) (Henggeler & Borduin, 1990; Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998) é um tratamento baseado na família e na comunidade, que tem produzido resultados clinicos a longo termo, bem como uma redução dos custos na terapia em jovens com comportamentos anti-sociais e suas famílias. Este trabalho apresent: (1) uma visão geral da história da TMS; (2) uma descição dos obectivos da TMS; (3) uma revisão dos fundamentos teóricos e empíricos do modelo; e, (4) um resumo da investigação relativa aos efeitos desta terapia.
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243. Conduct disorder and delinquency
Overview evidence-based family treatments for adolescent conduct problems. Three treatments succeed in meeting recommendations for treatment development set forth in recent evaluations by reviewers and federal entities. These treatments (Functional Family Therapy, Multisystemic Therapy, and Oregon Treatment Foster Care) have achieved their success by using the science base of known risk factors, providing an effective alternative to restrictive placements, and using scientific methods to evaluate effectiveness. Major features of these three treatments are presented, including clinical and quality assurance procedures, controlled outcome research support, cost analyses, and process research. Bases of treatment success and parallels among settings. Finally, suggestions for future research and clinical implications are discussed.
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248. Multisystemic treatment of antisocial adolescents in Norway: Replication of clinical outcomes outside of the US
Background: MST is an intensive home- and community-based intervention for youths with serious antisocial behavior and other serious clinical problems that has been effective at reducing out-of-home placements and producing favorable long-term clinical outcomes in the U.S. The aims of the study were to determine the degree to which these outcomes would be replicated in Norway for youths with serious behavior problems and to conduct a randomized trial of MST by an independent team of investigators. Method: Participants were 100 seriously antisocial youths in Norway who were randomly assigned to Multisystemic Therapy (MST) or usual Child Welfare Services (CS) treatment conditions. Data were gathered from youths, parents, and teachers pre- and post-treatment. Results: MST was more effective than CS at reducing youth internalizing and externalizing behaviors and out-of-home placements, as well as increasing youth social competence and family satisfaction with treatment. Discussion: This is the first study of MST outside of the US and one of the first not conducted by the developers of MST. The findings replicate those obtained by MST's developers and demonstrate the generalisability of short-term MST effects beyond the US.
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261. Long-term follow-up to a randomized clinical trial of multisystemic therapy with serious and violent juvenile offenders
In this study, the authors examined the long-term criminal activity of 176 youths who had participated in either multisystemic therapy (MST) or individual therapy (IT) in a randomized clinical trial (C.M. Borduin et al. 1995). Arrest and incarceration data were obtained on average 13.7 (range = 10.2-15.9) years later when participants were on average 28.8 years old. Results show that MST participants had significantly lower recidivism rates at follow-up than did their counterparts who participated in IT (50% vs. 81%, respectively). Moreover, MST participants had 54% fewer arrests and 57% fewer days of confinement in adult detention facilities. This investigation represents the longest follow-up to date of a MST clinical trial and suggests that MST is relatively effective in reducing criminal activity among serious and violent juvenile offenders.
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262. A randomized trial of multisystemic therapy with Hawaii 's Felix Class youths
Examined 6-month post-recruitment clinical and placement outcomes for 31 youths with serious emotional disturbance (SED) at imminent risk of out-of-home placement in the Hawaii Continuum of Care (COC). Youths were randomly assigned to multisystemic therapy (MST) adapted for SED populations or to Hawaii’s existing COC services. Assessments were conducted at intake and 6 months after referral. In comparison with counterparts in the comparison condition, youths in the MST condition reported significant reductions in externalizing symptoms, internalizing symptoms, and minor criminal activity; their caregivers reported near significant increases in social support; and archival records showed that MST youths experienced significantly fewer days in out-of-home placement. The findings generally replicate the favorable short-term outcomes observed previously for MST with youths experiencing SED.
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270. Juvenile drug court: Enhancing outcomes by integrating evidence-based treatments
Evaluated the effectiveness of juvenile drug court for 161 juvenile offenders meeting diagnostic criteria for substance abuse or dependence and determined whether integration of evidence-based practices enhanced the outcomes of juvenile drug court. Over a 1-yeard period, a four-condition randomized design evaluated outcomes for family court with usual community services, drug court with usual community services, drug court with multisystemic therapy, and drug court with multisystemic therapy enhanced with contingency management for adolescent substance use, criminal behavior, symptomalogy, and days in out-of-home placement. In general, findings supported the view that drug court was more effective than family court services in decreasing rates of adolescent substance use and criminal behavior. Possibly due to the greatly increased surveillance of youths in drug court, however, these relative reductions in antisocial behavior did not translate to corresponding decreases rearrest or incarceration. In addition, findings supported the view that the use of evidence-based treatments within the drug court context improved youth substance-related outcomes. Clinical and policy implication of these findings are discussed.
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291. An independent effectiveness trial of multisystemic therapy with juvenile justice youth
This study examines the effectiveness of an evidence-based practice, multisystemic therapy (MST), conducted in a real-world mental health setting with juvenile justice involved youth and their families. Importantly, this is the first randomized clinical trial of MST with juvenile offenders in the United States conducted without direct oversight by the model developers. This study reports outcomes achieved for 93 youth randomly assigned to MST or treatment as usual (TAU) services through 18-month follow-up posttreatment for offense data and 6-month follow-up posttreatment for ratings of the Child and Adolescent Functional Assessment Scale (CAFAS). Outcomes include significant reduction in rearrest and improvement in 4 areas of functioning measured by the CAFAS for youth who received MST. Implications for delivery of empirically supported treatments in real-world settings are discussed.
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328. The relation of antisocial behavior patterns and changes in internalizing symptoms for a sample of inner-city youth: Comorbidity within a developmental framework
Research examining the relationship between internalizing symptoms and antisocial behaviors has generally been cross-sectional in design. Thus, although extant data have substantiated a strong correlation between internalizing symptoms and antisocial behaviors, few studies have focused on describing the nature of the co-occurrence over time. This study examined the relation between growth in internalizing symptoms and longitudinal patterns of antisocial behavior in a sample of 283 inner-city males and their caregivers assessed as part of a longitudinal developmental risk study. Participants were assessed annually in four waves. Non-offenders and escalating offenders had lower levels of internalizing problems at wave 1 than did chronic minor and serious-chronic-violent offenders. Results revealed a developmental trend of decreasing internalizing problems across study years for most participants , as would be expected, with adolescents participating in serious, chronic, and violent patterns of antisocial behavior displaying greater internalizing problems than those participating in stable patterns of less serious or no antisocial behavior. Further, when there was escalation of seriousness and frequency of antisocial behavior, there also was increased internalizing problems relative to non-escalating juveniles. Results are discussed in the context of developmental psychopathology.
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331. Beyond treatment effects: Comorbid psychopathologies and long-term outcomes among substance-abusing delinquents
Secondary analyses of a randomized clinical trial controlled for treatment condition effects and examined the impact of comorbid psychopathologies on the mental health, physical health, and criminal behavior of 80 substance abusing delinquents approximately 5 years later in emerging adulthood. Overall, emerging adults with comorbid disorder during adolescence scored higher on psychopathology, criminal behavior, and health problems. Participants with both internalizing and externalizing disorders exhibited more negative outcomes than those with a comorbid externalizing disorder. For the entire sample, more internalizing diagnoses forecasted higher internalizing and aggression scores, more criminality, and poorer physical health. More externalizing disorders predicted higher internalizing, delinquency, and criminality scores, but was unrelated to physical health. More internalizing diagnoses for females but not males preficted greater criminality, and especially more aggressive crimes in emerging adulthood.
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334. Recidivism rates for registered and nonregistered juvenile offenders
The primary purpose of this study is to examine the effects of South Carolina's comprehensive registration policy on recidivism of juveniles who sexually offend. Registered and nonregistered male youth are matched on year of index offense, age at index offense, race, prior person offenses, prior nonperson offenses, and type of index sexual offense, for a total of 111 matched pairs. Recidivism is assessed across a mean 3.4 -year follow-up (SD=2.5). The sexual offense reconviction rate is too low (2 events) to support between-group analyses. Cox regression results indicate no significant between-group differences with respect to new nonsexual person offense convictions but significant between-group differences with respect to new nonperson offense convictions. Specifically, registered youth are more likely than nonregistered youth to have new nonperson offense convictions across follow-up. Public policy implications of these findings are discussed.
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335. A randomized clinical trial of multisystemic therapy with juvenile sexual offenders: Effects on youth social ecology and criminal activity
A randomized clinical trial evaluated the efficacy of multisystemic therapy (MST) versus usual community services (UCS) for 48 juvenile sexual offenders at high risk of committing additional serious crimes. Results from multiagent assessment batteries conducted before and after treatment showed that MST was more effective than UCS in improving key family, peer, and academic correlates of juvenile sexual offending and in ameliorating adjustment problems in individual family members. Moreover, results from an 8.9-year follow-up of rearest and incarceration data (obtained when participants were on average 22.9 years of age) showed that MST participants had lower recidivism rates than did UCS participants for sexual (8% vs. 46%, respectively) and nonsexual (29% vs. 58%, respectively) crimes. In addition, MST participants had 70% fewer arrests for all crimes and spent 80% fewer days confined in detention facilities than did their counterparts who received UCS. The clinical and policy implications of these findings are discussed.
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336. Multisystemic therapy for juvenile sexual offenders: 1-year results from a randomized effectiveness trial
Despite the serious and costly problems presented by juvenile sexual offenders, rigorous tests of promising interventions have rarely been conducted. This study presents a community-based effectiveness trial comparing multisystemic therapy (MST) adapted for juvenile sexual offenders with services that are typical of those provided to juvenile sexual offenders in the United States. Youth were randomized to MST (n = 67) or treatment as usual for juvenile sexual offenders (TAU-JSO; n = 60). Outcomes through 12 months postrecruitment were assessed for problem sexual behavior, delinquency, substance use, mental health functioning, and out-of-home placements. Relative to youth who received TAU-JSO, youth in the MST condition evidenced significant reductions in sexual behavior problems, delinquency, substance use, externalizing symptoms, and out-of-home placements. the findings suggest that family- and community-based interventions, especially those with an established evidence-base in treating adolescent antisocial behavior, hold considerable promise in meeting the clinical needs of juvenile sexual offenders.
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339. Estimating the differential costs of criminal activity for juvenile drug court participants: Challenges and recommendations
Juvenile drug court (JDC) programs have expanded rapidly over the past 20 years and are an increasingly popular option for rehabilitating juvenile offenders with substance use problems. Given the hgih cost of crime to society, an important economic question is whether and to what extent JDC programs reduce criminal activity among juvenile offenders. To address this question, the present study added an economic cost analysis to an ongoing randomized trial of JDC conducted in Charleston, South Carolina. Four treatment conditions were included in the parent study: Family court with usual community-based treatment (FC, the comparison group), Drug Court with usual community-based treatment (DC), DC with Multisystemic Therapy (DC/MST), and DC/MST enhanced with Contingency Management (DC/MST/CM). The economic study estimated the cost of criminal activity for nine specific crimes at baseline (pretreatment) and 4 and 12 months thereafter. A number of methodological challenges were encountered, suggesting that it may be more difficult to economically quantify frequency and type of criminal activity for adolescents than for adults. The present paper addresses methodological approaches and challenges, and proposes guidelines for future economic evaluations of adolescents substance abuse and crime prevention programs.
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345. Mediators of change for multisystemic therapy with juvenile sexual offenders
The mediators of favorable multisystemic therapy (MST) outcomes achieved at 12 months postrecruitment were examined within the context of a randomized effectiveness trial with 127 juvenile sexual offenders and their caregivers. Outcome measures assessed youth delinquency, substance use, externalizing symptoms, and deviant sexual interest/risk behaviors; hypothesized mediators included measures of parenting and peer relations. Data were collected at pretreatment, 6 months postrecruitment, and 12 months postrecruitment. Consistent with the MST theory of change and the small extant literature in this area of research, analyses showed that favorable MST effects on youth antisocial behavior and deviant sexual interest/risk behaviors were mediated by increased caregiver follow-through on discipline practices as well as decreased caregiver disapproval of and concern about the youth’s bad friends during the follow-up. These findings have important implications for the community-based treatment of juvenile sexual offenders.
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