Multisystemic therapy for juvenile offenders
- 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.