Henggeler S W, Pickrel S G, Brondino M J
Family Services Research Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston 29425, USA.
Ment Health Serv Res. 1999 Sep;1(3):171-84. doi: 10.1023/a:1022373813261.
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. Examination 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.
在一项研究中，对多系统治疗（MST）的有效性和可推广性进行了检验，该研究纳入了118名符合《精神疾病诊断与统计手册》第三版修订本（DSM-III-R）中药物滥用或药物依赖标准的青少年罪犯及其家庭。参与者被随机分配接受多系统治疗或常规社区服务。结果测量指标评估了治疗后（T2）以及治疗后6个月随访时（T3）的药物使用情况、犯罪活动以及离家安置天数；此外，还从多个角度（即照顾者、青少年和治疗师）对治疗依从性进行了检查。多系统治疗在T2时减少了酒精、大麻和其他药物的使用，并在T3时使离家安置的总天数减少了50%。然而，犯罪活动的减少幅度不如之前多系统治疗所取得的那样大。对治疗依从性测量指标的检查表明，多系统治疗取得的适度效果至少部分是由于难以将这种复杂的治疗模式从其开发者的直接控制中推广开来。加强对质量保证机制的重视以提高治疗的保真度，可能有助于克服可推广性方面的障碍。
