Viersprong Institute for Studies on Personality Disorders (VISPD), Halsteren, The Netherlands.
Department of Psychiatry, Section Medical Psychology and Psychotherapy, Erasmus Medical Center, Rotterdam, The Netherlands.
J Abnorm Child Psychol. 2018 Jul;46(5):1037-1050. doi: 10.1007/s10802-017-0392-4.
Multisystemic Therapy (MST) and Functional Family Therapy (FFT) have overlapping target populations and treatment goals. In this study, these interventions were compared on their effectiveness using a quasi-experimental design. Between October, 2009 and June, 2014, outcome data were collected from 697 adolescents (mean age 15.3 (SD 1.48), 61.9% male) assigned to either MST or FFT (422 MST; 275 FFT). Data were gathered during Routine Outcome Monitoring. The primary outcome was externalizing problem behavior (Child Behavior Checklist and Youth Self Report). Secondary outcomes were the proportion of adolescents living at home, engaged in school or work, and who lacked police contact during treatment. Because of the non-random assignment, a propensity score method was used to control for observed pre-treatment differences. Because the risk-need-responsivity (RNR) model guided treatment assignment, effectiveness was also estimated in youth with and without a court order as an indicator of their risk level. Looking at the whole sample, no difference in effect was found with regard to externalizing problems. For adolescents without a court order, effects on externalizing problems were larger after MST. Because many more adolescents with a court order were assigned to MST compared to FFT, the propensity score method could not balance the treatment groups in this subsample. In conclusion, few differences between MST and FFT were found. In line with the RNR model, higher risk adolescents were assigned to the more intensive treatment, namely MST. In the group with lower risk adolescents, this more intensive treatment was more effective in reducing externalizing problems.
多系统治疗（MST）和功能家庭治疗（FFT）的目标人群和治疗目标重叠。在本研究中，采用准实验设计比较了这两种干预措施的效果。2009 年 10 月至 2014 年 6 月期间，从接受 MST 或 FFT 治疗的 697 名青少年（平均年龄 15.3（SD 1.48），61.9%为男性）中收集了结果数据。数据在常规结果监测期间收集。主要结果是外化问题行为（儿童行为检查表和青少年自我报告）。次要结果是生活在家里、上学或工作以及在治疗期间没有与警察接触的青少年的比例。由于非随机分组，使用倾向评分法来控制治疗前的观察差异。由于风险-需求-反应性（RNR）模型指导了治疗分配，因此还根据是否有法院命令来估计青少年的有效性，作为其风险水平的指标。对于整个样本，在外化问题方面，两种治疗方法的效果没有差异。对于没有法院命令的青少年，MST 治疗后对外化问题的影响更大。由于有法院命令的青少年中，有更多的青少年被分配到 MST 治疗组，而不是 FFT 治疗组，因此倾向评分法无法平衡该亚组中的治疗组。总之，MST 和 FFT 之间几乎没有发现差异。根据 RNR 模型，风险较高的青少年被分配到更密集的治疗方法，即 MST。在风险较低的青少年组中，这种更密集的治疗方法在减少外化问题方面更有效。
