Division of Child and Adolescent Psychiatry, University of Maryland Baltimore, 737 W. Lombard St. 4th Floor, Baltimore, MD 21201, United States of America.
Division of Global and Community Health, 176 Croghan Spur, Suite 104, Charleston, SC, 29407, United States of America.
Child Abuse Negl. 2021 Dec;122:105379. doi: 10.1016/j.chiabu.2021.105379. Epub 2021 Nov 3.
Parental substance misuse impacts millions of children globally and is a major determinant of repeat maltreatment and out-of-home placement. There is little published research on family-based, comprehensive treatment models that simultaneously address parental substance misuse and child maltreatment.
This study reports outcomes from a randomized clinical trial examining the effectiveness of the Multisystemic Therapy - Building Stronger Families (MST-BSF) treatment model with families involved with Child Protective Services due to physical abuse and/or neglect plus parental substance misuse.
Ninety-eight families who had an open case with Child Protective Services in two areas of the state of Connecticut participated.
Families referred by the Connecticut Department of Children and Families were randomly assigned to MST-BSF or Comprehensive Community Treatment (CCT). Both interventions were delivered by community-based therapists. Outcomes were measured across 5 assessments extending 18 months post-baseline.
Intent-to-treat analyses showed that MST-BSF was significantly more effective than CCT in reducing parent self-reported alcohol and opiate use and in improving child-reported neglectful parenting. Although means were in predicted directions, new incidents of abuse across 18 months did not differ between groups. The study features high recruitment and engagement rates for a population experiencing multiple involvements with child protection.
The outcomes of this study support the effectiveness of MST-BSF, an intensive family- and ecologically- based treatment, for significantly reducing parental alcohol and opiate misuse and child neglect. These findings help in our understanding of how best to address the understudied issue of interventions for child neglect.
父母滥用药物影响着全球数以百万计的儿童，是重复虐待和家庭外安置的主要决定因素。很少有关于同时解决父母药物滥用和儿童虐待问题的基于家庭的综合治疗模式的研究。
本研究报告了一项随机临床试验的结果，该试验考察了多系统治疗-加强家庭（MST-BSF）治疗模式在因身体虐待和/或忽视以及父母药物滥用而与儿童保护服务部门有关联的家庭中的有效性。
康涅狄格州两个地区有开放的儿童保护服务案件的 98 个家庭参与了该研究。
由康涅狄格州儿童和家庭部转介的家庭被随机分配到 MST-BSF 或综合社区治疗（CCT）组。这两种干预措施都是由社区为基础的治疗师提供的。结果在基线后 18 个月内进行了 5 次评估。
意向治疗分析表明，MST-BSF 在减少父母自我报告的酒精和鸦片类药物使用以及改善儿童报告的忽视性养育方面明显比 CCT 更有效。尽管均值符合预测方向，但两组在 18 个月内新发生的虐待事件并无差异。该研究具有很高的招募率和参与率，研究对象是经历了多次儿童保护介入的人群。
本研究的结果支持了 MST-BSF 的有效性，MST-BSF 是一种强化家庭和生态为基础的治疗方法，可显著减少父母的酒精和鸦片类药物滥用以及儿童的忽视。这些发现有助于我们了解如何最好地解决干预儿童忽视这一研究不足的问题。
