The effectiveness of Multisystemic Therapy (MST): a meta-analysis.

Multisystemic Therapy (MST) is a well-established intervention for juvenile delinquents and/or adolescents showing social, emotional and behavioral problems. A multilevel meta-analysis of k=22 studies, containing 332 effect sizes, consisting of N=4066 juveniles, was conducted to examine the effectiveness of MST. Small but significant treatment effects were found on delinquency (primary outcome) and psychopathology, substance use, family factors, out-of-home placement and peer factors, whereas no significant treatment effect was found for skills and cognitions. Moderator analyses showed that study characteristics (country where the research was conducted, efficacy versus effectiveness, and study quality), treatment characteristics (single versus multiple control treatments and duration of MST treatment), sample characteristics (target population, age, gender and ethnicity) and outcome characteristics (non-specific versus violent/non-violent offending, correction for pretreatment differences, and informant type) moderated the effectiveness of MST. MST seems most effective with juveniles under the age of 15, with severe starting conditions. Furthermore, the effectiveness of MST may be improved when treatment for older juveniles is focused more on peer relationships and risks and protective factors in the school domain.