Alternative to Behavior Mod Lockup

[cmack]

http://www.theglobeandmail.com/life/the ... le2241141/

Have a troubled teen? Why you need treatment, too
wency leung
Globe and Mail Blog
Posted on Friday, November 18, 2011 11:10AM EST


It takes a village to raise a child -- and to keep that child out of trouble.

Psychological sciences professor Charles Borduin of the University of Missouri developed a form of treatment for juvenile offenders more than 20 years ago that involved having therapists work with the children's entire families and communities, instead of traditional, individual counseling.

In a new study, he has quantified the long-term benefits of his approach, called Multisystemic Therapy (MST).

His latest research follows up on an original study he conducted from 1983 to 1986, which examined 176 juvenile offenders, some of whom were treated with MST and others given individual therapy.

Twenty-two years after they were treated, he found 4.3 per cent of those given MST had been arrested for violent felonies, compared with 15.5 percent who had received individual therapy.

Of the MST group, 34.8 percent had committed a felony of any kind, compared with 54.8 percent of those who had individual treatment. And those who had individual treatment were involved in family-related civil suits more than two times more often.

"This research shows that Multisystemic Therapy has long-lasting effects," Prof. Borduin said in a press release. "Nearly 22 years after the treatment, juvenile offenders treated with MST still see positive effects. This treatment has protected many potential victims, and I hope this research helps to encourage further use of the method."

In the earlier study, Prof. Borduin had found treating an offender with MST could save taxpayers and crime victims between around $75,000 to nearly $200,000 in 14 years. According to the press release, he intends to examine the savings over a 22-year period.

Should families of troubled youngsters be required to work with therapists too?

[cmack]

http://www.theglobeandmail.com/life/the ... /comments/

Comments from above article:

 spinal stenosis

12:26 PM on November 18, 2011

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Gone are the days when children should be locked up out of sight. As a community we need to support this type of approach, if it is effective. We must realise that it is a very small percentage of kids who end up with this kind of troubled and criminal background. A child needs more than anything else, compassion from their parents. If they are not in a position to provide it, they need help also, from therapists. The majority of kids who are institutionalised have stormy family lives, either because of their behaviour or because of their parent's behaviours. We need to look at programs like this. I know, I worked with troubled youth for years before this model of sending therapists into the home became known. We worked in a vacuum. the kids would go home on weekends and come back to us a mess of emotions. they would go from the structure of the group home setting to chaos at home with parents unable to cope or change. The social workers had workloads of up to 50 people. We need to look at how we structure our costs in institutional care and this one seems to save money for the social network as well.
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HeidiPG

12:36 PM on November 18, 2011

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I am a parent of a teen with mental health problems. He has been in treatment for 3 years and has made great progress in learning to control his anxiety and depression with the help of psychiatric medications, intensive counseling and a caring school structure. In addition we have participated in family counseling every two weeks for the last year and have learned a great deal about our family history and the dynamics this history brings to our relationship with our child.

We are currently completing a parenting course based on a book "Parenting from the inside out" by Dan Seibel which has been very helpful in improving our awareness of how we can affect our son's mental health, and together we are making great strides.

If we hadn't been willing to participate in the process, our son's progress would not have been as good. Now he is finishing his grade 12 year, achieving high marks and has set goals for his post-secondary plans.

The hardest part of the process was getting into the system for help at the beginning, due to the lack of funding for access to mental health services. We waited 8 months for an assessment, then another 5 months to see a Psychiatrist for a diagnosis and treatment plan. Once we were in, things progress, but while we were waiting, he had slipped so badly he lost a school year and was thinking about suicide.

I am so glad we got help and our son has survived his teen years. We couldn't have done it alone, and indeed we have repaired our relationship considerably through our participation in the process.
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cdVictoria

12:16 PM on November 18, 2011

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Another factor not mentioned in this article is the severe shortage of adolescent mental health services across the the country. Many kids are undiagnosed, misdiagnosed or diagnosed but on a wait-list for psychiatric help. Bipolar disorder and other mental illnesses are not caused by poor parenting.
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CLM1

3:17 PM on November 19, 2011

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A lot of posters are pretty unforgiving. The article isn't about blaming parents. Whether the parents did or did not contribute to the mental illness or delinquency of their child (and loving, stable families can 'produce' troubled kids) isn't the point. The family probably needs help to help their child and some strategies.
I have to wonder about those who blame permissive parenting, a school system that doesn't 'fail' kids, etc. What do you think happened in past times? Kids who failed school somehow learned their lesson, straightened up and flew right, and suddenly passed? Or dropped out and got menial jobs that no longer exist?
Whether it's nature or nurture that created the problem, we all have to live with the consequences of troubled teens. Heidi and her family deserve kudos for the support of their son, who is now on his way to being a contributing member of society, which is what every parent wants for their kid.
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cyan blue

11:52 AM on November 18, 2011

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Finally, Canada may be turning a corner here. It is about time, given the vast number of people whose lives have been harmed from, and numbers of repeated cycles of, poor parenting. Most of this harm happens by the time the kid is seven. If they have not learned the meaning and significance of a consistent "no", if they have not experienced delayed gratification, if they have not learned to take some risks and acquire some skills by themselves that boost their self-esteem - and all this in an environment of love, then sadly they are set up for failure.

For the sake of kids we need to view parenting as a responsibility, not just a "right". Kids don't fail grade two, kids don't fail BMI assessments, kids don't fail behavioral tests - parents do. Except for the one-in-a-million child-variant, it really is not rocket science.
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starla8383

11:30 AM on November 18, 2011

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Children are a product of their upbringing and environment. A teenager doesn't become troubled in a vacuum. Blaming the trouble on the child alone won't get the heart of the issues, and will likely breed resentment. Parents can't mess up their kids and then bring them to someone else to be fixed.

 I'm Not an Alberta Redneck

12:31 PM on November 18, 2011

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It is primarily the environment, specifically peer pressure. By creating a school system where everyone "succeeds" those who learn this the soonest and act on it, become the leaders and soon are enticing others into this disruptive and ultimately dysfunctional lifestyle choice. (to often put it mildly)

We need schools where such troublemakers are not allowed to prowl the halls, recruiting new members of their gangs.
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johnnynorth

1:57 PM on November 18, 2011

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"Parents can't mess up their kids and then bring them to someone else to be fixed."

If they have messed up their kids, then they do need outside assistance. The assistance should not just be for the kids, but also guide the parents.
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toronto2vancouver

3:01 PM on November 18, 2011

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I'm not sure why this comment has a negative score, you are actually on target for a lot of it. Some therapies focus exclusively on parent training for teens and are very successful. It's typically a combination of genes and environment that leads to psychopathology
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BH1

3:55 PM on November 18, 2011

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I think part of the negative response is due to the implied idea that all children's problems are a direct result of bad things their parents did. I don't think that's what this article or therapeutic approach is intending to say. It's just that families must be part of the solution -- _regardless_ of whether or not they literally 'messed up their kids'. To rephrase what you said, people can't heal in a vacuum.

Of course, troubled kids very often do come from troubled families, that's fair enough. But sometimes there's more to it than that. We're born with individual personalities and have a lot of influences and experiences besides our parents, parents may mean well and have the skills to handle one child but not a different or more difficult one, and that doesn't even start to address the issues of kids who've moved from home to home.

I think part of the point is that the best results come when everyone who is spending a lot of time with the 'patient' knows what to do to help them best.

[cmack]

Study referenced in above article:

http://www.eurekalert.org/pub_releases/ ... 111711.php

Public release date: 17-Nov-2011
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Contact: Steven Adams
[email protected]
573-882-8353
University of Missouri-Columbia
Treatment for juvenile offenders shows shows positive results 22 years later
            
      

IMAGE: Charles Borduin, MU professor of psychological sciences in the College of Arts & Science
Click here for more information.

      
            

COLUMBIA, Mo. – More than 20 years ago, Charles Borduin, a University of Missouri researcher, developed a treatment for juvenile offenders that has become one of the most widely used evidence-based treatments in the world. Now, he has found that the treatment continues to have positive effects on former participants more than 20 years after treatment.

Throughout the course of his career, Borduin, professor of psychological sciences in the College of Arts & Science, has pioneered the treatment called Multisystemic Therapy (MST) as a way to prevent serious mental health problems in children and adolescents. MST interventions involve the offender's entire family and community, as opposed to the more common individual therapy, where the offender visits a therapist who offers feedback, support and encouragement for behavior change.

Borduin followed up with clinical trial participants that completed treatment nearly 22 years earlier, on average. He found the following differences between participants who received MST and those who received individualized therapy:

    * Violent felonies: Since completing treatment, 4.3 percent of juveniles treated with MST were arrested for a violent felony, compared to 15.5 percent of individual therapy participants.
    * All felonies: Overall, 34.8 percent of MST participants committed a felony, compared to 54.8 percent of individual therapy participants.
    * Misdemeanors: MST participants committed five times fewer misdemeanors than individual therapy participants.
    * Family problems: Individual therapy participants were involved in family-related civil suits two times more often than MST participants.

"This research shows that Multisystemic Therapy has long-lasting effects," said Borduin. "Nearly 22 years after treatment, juvenile offenders treated with MST still see positive effects. This treatment has protected many potential victims, and I hope this research helps to encourage further use of the method."

MST is used in 12 countries around the world, as well as in 34 states. In Norway, it is the national model for juvenile offender treatment. Borduin said MST is the most widely used evidence-based treatment for juvenile offenders in the U.S.; however, only 1 to 2 percent of juvenile offenders receive the treatment.

The study follows an original clinical trial that took place between 1983 and 1986. In the original trial, the 176 children who participated in the study were randomly selected for treatment with MST or individual therapy. For this study, Borduin located records for more than 80 percent of participants. On average, the follow-up occurred 21.9 years following the conclusion of treatment. Borduin said this is one of the longest post-treatment period follow-ups ever done for a psychological evidence-based treatment of any disorder.

In a previous study, Borduin found that the net cumulative benefit of providing MST to a single juvenile offender resulted in a savings to taxpayers and crime victims of $75,110 to $199,374 over nearly 14 years. Borduin now plans to study savings over the course of almost 22 years following treatment.

Borduin's findings were recently published in the Journal of Consulting and Clinical Psychology. He collaborated with Aaron Sawyer, a graduate student in the Department of Psychological Sciences.