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Multisystemic Therapy for Child Non-Externalizing Psychological and Health Problems: A Preliminary Review

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Abstract

Multisystemic therapy (MST) is effective for decreasing or preventing delinquency and other externalizing behaviors and increasing prosocial or adaptive behaviors. The purpose of this project was to review the literature examining the efficacy of MST for other child psychological and health problems reflecting non-externalizing behaviors, specifically difficulties related to child maltreatment, serious psychiatric illness [Serious psychiatric illness was defined throughout the current review paper as the “presence of symptoms of suicidal ideation, homicidal ideation, psychosis, or threat of harm to self or others due to mental illness severe enough to warrant psychiatric hospitalization based on the American Academy of Child and Adolescent Psychiatry (Level of care placement criteria for psychiatric illness. American Academy of Child and Adolescent Psychiatry, Washington, DC, 1996) level of care placement criteria for psychiatric illness” (Henggeler et al. in J Am Acad Child Psy 38:1331–1345, p. 1332, 1999b). Additionally, youth with “serious emotional disturbance (SED)” defined as internalizing and/or externalizing problems severe enough to qualify for mental health services in public school who were “currently in or at imminent risk of a costly out-of-home placement” (Rowland et al. in J Emot Behav Disord 13:13–23, pp. 13–14, 2005) were also included in the serious psychiatric illness category.], and health problems (i.e., obesity and treatment adherence for diabetes). PubMed, Web of Science, MEDLINE, and PsycINFO databases; Clinicaltrials.gov; DARE; Web of Knowledge; and Cochrane Central Register of Controlled Trials were searched; and MST developers were queried to ensure identification of all relevant articles. Of 242 studies identified, 18 met inclusion criteria for review. These were combined in a narrative synthesis and critiqued in the context of review questions. Study quality ratings were all above mean scores reported in prior reviews. Mixed support was found for the efficacy of MST versus other treatments. In many cases, treatment effects for MST or comparison groups were not sustained over time. MST was efficacious for youth with diverse backgrounds. No studies discussed efficacy of MST provided in different treatment settings. Four studies found MST more cost-effective than a comparison treatment, leading to fewer out-of-home placements for youth with serious psychiatric illness or lower treatment costs for youth with poorly controlled diabetes.

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Notes

  1. Serious psychiatric illness was defined throughout the current review paper as the “presence of symptoms of suicidal ideation, homicidal ideation, psychosis, or threat of harm to self or others due to mental illness severe enough to warrant psychiatric hospitalization based on the American Academy of Child and Adolescent Psychiatry (1996) level of care placement criteria for psychiatric illness” (Henggeler et al. 1999b, p. 1332). Additionally, youth with “serious emotional disturbance (SED)” defined as internalizing and/or externalizing problems severe enough to qualify for mental health services in public school who were “currently in or at imminent risk of a costly out-of-home placement” (Rowland et al. 2005, pp. 13–14) were also included in the serious psychiatric illness category.

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Acknowledgments

This work was partly supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, and the Houston VA Health Services Research and Development Center of Excellence (HFP90-020). The views expressed are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs, the United States government or Baylor College of Medicine.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX, 77030, USA

    Heather T. Pane, Rachel S. White, Michael R. Nadorff & Melinda A. Stanley

  2. DePelchin Children’s Center, 4950 Memorial Drive, Houston, TX, 77007, USA

    Heather T. Pane

  3. Department of Pediatrics, Adolescent Medicine, Baylor College of Medicine, 6701 Fannin St., Houston, TX, 77030, USA

    Rachel S. White

  4. Department of Psychology, Mississippi State University, 110 Magruder Hall, 255 Lee Blvd, Starkville, MS, 39762, USA

    Michael R. Nadorff

  5. Boston University, School of Education, Two Silber Way, Boston, MA, 02215, USA

    Amie Grills-Taquechel

  6. Houston VA HSR&D Center of Excellence (152), Michael E. DeBakey VA Medical Center (MEDVAMC), 2002 Holcombe Blvd., Houston, TX, 77030, USA

    Melinda A. Stanley

  7. VA South Central Mental Illness Research, Education and Clinical Center, Houston, TX, USA

    Melinda A. Stanley

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  1. Heather T. Pane
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Correspondence to Heather T. Pane.

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Pane, H.T., White, R.S., Nadorff, M.R. et al. Multisystemic Therapy for Child Non-Externalizing Psychological and Health Problems: A Preliminary Review. Clin Child Fam Psychol Rev 16, 81–99 (2013). https://doi.org/10.1007/s10567-012-0127-6

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