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一项针对有严重行为问题的非法院转介青少年的多系统治疗的独立随机临床试验。

An independent randomized clinical trial of multisystemic therapy with non-court-referred adolescents with serious conduct problems.

作者信息

Weiss Bahr, Han Susan, Harris Vicki, Catron Thomas, Ngo Victoria K, Caron Annalise, Gallop Robert, Guth Carol

机构信息

Department of Psychology and Human Development, Vanderbilt University.

出版信息

J Consult Clin Psychol. 2013 Dec;81(6):1027-39. doi: 10.1037/a0033928. Epub 2013 Aug 12.

Abstract

OBJECTIVE

Adolescent conduct problems exact serious social as well as personal costs, and effective treatments are essential. One of the most widely disseminated and effective programs for the treatment of serious conduct problems in adolescents is Multisystemic Therapy (MST). However, most evaluations of MST have involved the developers of MST. The purpose of the present study was to conduct an independent evaluation of MST, with non-court-referred adolescents with conduct problems.

METHOD

Participants were 164 adolescents ages 11-18 years who were recruited from self-contained behavior intervention classrooms in public schools. Adolescents and their families were randomly assigned to receive MST or services as usual. Outcome measures assessed conduct problems, school functioning, and court records of criminal behavior. Participants were followed for 18 months after baseline using parent, adolescent, and teacher reports; arrest data were collected for 2.5 years postbaseline.

RESULTS

Two of 4 primary outcome measures focused on externalizing problems showed significant treatment effects favoring MST. Several secondary and intervention targets pertaining to family functioning and parent psychopathology showed positive effects of MST, and no negative effects were identified.

CONCLUSIONS

Results provide some further support for the effectiveness of MST, although smaller effect sizes than previous studies also suggest the complexity of successful dissemination, particularly to non-court-referred populations.

摘要

目的

青少年行为问题会带来严重的社会和个人代价,因此有效的治疗至关重要。多系统治疗(MST)是治疗青少年严重行为问题最广泛传播且有效的项目之一。然而,大多数对MST的评估都涉及MST的开发者。本研究的目的是对MST进行独立评估,评估对象为有行为问题但未被法庭转介的青少年。

方法

参与者为164名年龄在11至18岁之间的青少年,他们是从公立学校独立的行为干预教室招募而来的。青少年及其家庭被随机分配接受MST或常规服务。结果测量评估行为问题、学校功能以及犯罪行为的法庭记录。在基线后对参与者进行了18个月的跟踪,采用家长、青少年和教师报告;在基线后2.5年收集逮捕数据。

结果

4项主要关注外化问题的结果测量中有2项显示出有利于MST的显著治疗效果。与家庭功能和父母精神病理学相关的几个次要和干预目标显示出MST的积极效果,且未发现负面影响。

结论

研究结果为MST的有效性提供了进一步的支持,尽管效应量比之前的研究小,这也表明成功推广MST的复杂性,尤其是在未被法庭转介的人群中。

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