Multisystemic therapy for juvenile offenders
Local governments can invest in this strategy using State and Local Fiscal Recovery Funds (SLFRF) from the American Rescue Plan Act (ARPA).
- This strategy can help prevent violence. The U.S. Department of Treasury has indicated that strategies that help achieve this outcome are eligible for the use of Fiscal Recovery Funds.
Investments in this strategy are SLFRF-eligible as long as they are made in qualified census tracts or are designed to assist populations or communities disproportionately impacted by COVID-19.
- Intensive intervention for serious juvenile offenders in which a small team of therapists work with youth offenders and their families regularly at home, school, or community-based organization for three to five months
- Prioritizes engaging with systems and addressing risk factors surrounding the participant, especially schools, peer groups, family, and communities
- Focuses on building a participant's strengths and altering problematic interactions with family and peers
Strength of evidence
Evidence level: Proven (highest tier)
Proven (highest tier)
Ranked as having the highest level of evidence by County Health Rankings and Roadmaps, the California Evidence-Based Clearinghouse for Child Welfare, the Substance Abuse and Mental Health Services Administration, the National Institute of Justice
$8,000-$10,000 per participant
Outcomes and impact
- Reduced rates of incarceration and rearrest of youth in program
- Reduced antisocial and delinquent behavior and alcohol and drug use
- Improved family functioning, mental health, and broader health outcomes
- Long-term follow-up studies twenty or more years after initial treatment have confirmed effects on lower recidivism and offense rates compared to offenders exposed to individual therapy
- Improved mental health outcomes and reduced instances of caregiver neglect and assault of children
- Lower rates of arrest and incarceration for siblings and caregivers
- Up to a $23.59 return on investment for every dollar spent, up to $200,000 net benefit per youth
Keys to successful implementation
- Partner with each participant’s key networks, such as family, peers, schools, and neighborhood/community groups to identify opportunities for the participant to engage in socially positive behavior.
- Deliver services in the location where the participant and family are seeking a behavioral change, such as a home or school, to reduce barriers to treatment (such as transportation or timeliness).
- Assign each therapist a small caseload (4-6 patients), ensuring them enough capacity to conduct regular home visits at a clinical intensity matching the needs of participating families.
- Dedicate enough resources to the program to ensure a high level of model fidelity, especially in terms of staffing: typically, a team includes 3-4 fulltime, master's-level therapists who are supervised by a seasoned therapist.
- Ensure participants have access to a therapist or supervisor at all times to address emergencies and unexpected situations.
- Consider the program to be a high intensity, high volume intervention that requires significant upfront investment to ensure a strong return: it must be adequately staffed to allow for each participant to receive an average of 60 hours of treatment over the course of the program.