Intensive behavior therapy no better than conventional support in treating teenagers with antisocial behavior

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Research led by UCL has found that intensive and costly multisystemic therapy is no better than conventional therapy in treating teenagers with moderate to severe antisocial behaviour.

The researchers also found that multisystemic (MST) might also have led to an increased risk of criminal behaviour by children who were low-risk in terms of the factors assessed in the study.

The study, which was published in The Lancet Psychiatry, was led by Professor Peter Fonagy (UCL Psychology & Language Sciences).

Multisystemic therapy (MST) is used to tackle in children aged 11 to 17. The treatment uses a team of professionals working with the young person, their family, friends, neighbours and teachers for three to five months to help them manage their behaviour and reduce criminal offending.

MST was developed in the United States for tackling youth offending and was introduced to Britain following a trial in 2011.

The trial, which was funded by the Department for Education and the Department for Health, tracked 684 families with a troubled child, half of whom were assigned MST and half who were given conventional support.

The researchers found that after 18 months, 43 young people from the group given MST (13 %) were taken into care or custody, compared with 36 (11%) in the control group.

"The medium-term gain from multisystemic therapy relative to management as usual was limited in terms of effect on antisocial , with some suggestion that multisystemic therapy led to an increased risk of in individuals who were fairly low risk in terms of factors assessed in this study," the paper said.

"The findings also reflect the effectiveness of mental health, youth offending, and social care services in England – which were active in both groups of the trial – in reducing the risk of crime and protecting and society."


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More information: Peter Fonagy et al. Multisystemic therapy versus management as usual in the treatment of adolescent antisocial behaviour (START): a pragmatic, randomised controlled, superiority trial, The Lancet Psychiatry (2018). DOI: 10.1016/S2215-0366(18)30001-4
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Jan 19, 2018
People have to work side by side in order to effect change. There has to be some type of reward system. It has to be something meaningful. It is true love that makes the difference. One cannot steer a ship that isn't moving. It has to be encouraging environment. The words have to be short and concise. Then one can help someone grow-up. There is no easy way to do this. Medical and Nutritional issues must also be addressed.

Jan 19, 2018
Last year, there was an article on Victorian Period juvenile care system And how they had produced a lower percentage of repeat offenders.

I pointed out that the difference is explainable, not by different methods of social child care. But the real difference is, that almost every variety of adolescent behavior, that was tolerated or ignored by Victorian society?

Is today treated as a criminal offense! Even expressing frustration with authoritarian demands is a crime these days. Children have no freedom and certainly no civil rights.

Jan 21, 2018
Last year, there was an article on Victorian Period juvenile care system And how they had produced a lower percentage of repeat offenders.

I pointed out that the difference is explainable, not by different methods of social child care. But the real difference is, that almost every variety of adolescent behavior, that was tolerated or ignored by Victorian society?

Is today treated as a criminal offense! Even expressing frustration with authoritarian demands is a crime these days. Children have no freedom and certainly no civil rights.

Good point.

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