Multisystemic treatment of criminality and violence in adolescents.

OBJECTIVE

To discuss the emergent success of multisystemic therapy (MST), a family-based therapeutic approach that has been viewed as a promising treatment for violence and other serious antisocial behaviors in adolescents.

METHOD

The empirical underpinnings, theoretical foundation, and clinical features of MST are described, followed by a brief review of studies of MST effectiveness with serious juvenile offenders.

RESULTS

The theoretical foundation and clinical features of MST draw upon empirical findings regarding the multidetermined nature of serious antisocial behavior as well as upon social-ecological models of behavior in which the youth and family's school, work, peers, and neighborhood are viewed as interconnected systems with dynamic and reciprocal influences on the behavior of family members. In controlled studies with serious juvenile offenders, MST has demonstrated long-term reductions in criminal activity, violent offenses, drug-related arrests, and incarceration.

CONCLUSIONS

The success of MST can be attributed primarily to (1) the match between MST intervention foci and empirically identified correlates/causes of criminality and violence in adolescents (e.g., parental discipline, family affective relations, peer associations, school performance) and (2) the flexible use of well-validated intervention strategies in the natural environment.