MST OUTCOMES 8 Randomized Trials Published (more than 850 families participating) u3 with violent and chronic juvenile offenders u1 with substance abusing or dependent juvenile offenders u1 with youths presenting psychiatric emergencies u1 with maltreating families u1 with inner-city delinquents u1 with juvenile sexual offenders

Randomized and Controlled Trials in Progress, Funded, or Unpublished Canada (Leschied) - serious juvenile offenders Vanderbilt University (Weiss) - antisocial middle school children Delaware (Miller) - serious juvenile offenders Texas (Thomas) - juvenile offenders, gang members Charleston, SC (Henggeler) - substance abusing juvenile offenders (drug court) New York City (Office of Children and Family Services) - serious juvenile offenders Philadelphia and Hawaii (Henggeler) - MST continua of care Norway (Ogden) - juvenile offenders Washington State - serious juvenile offenders Stark County, Ohio (Timmons-Mitchell) - juvenile offenders Cuyahoga County, Ohio (Timmons-Mitchell) - domestically violent juveniles Charleston, SC (Swenson) - physically abused children

CONSISTENT MST CLINICAL OUTCOMES In Comparison with Control Groups, MST: uImproved family relations and functioning uIncreased school attendance uDecreased adolescent psychiatric symptoms uDecreased adolescent substance use uDecreased long-term rates of rearrest 25% to 70%

CONSISTENT MST SERVICE OUTCOMES In Comparison with Control Groups, MST achieved: u97% and 98% rates of treatment completion in recent studies u47% to 64% decreases in long-term rates of days in out-of-home placements uHigher consumer satisfaction uConsiderable cost savings (Washington State Institute on Public Policy) 1. MST $64,000/youth 15.Bootcamps($ 7,910)/youth

MST Substance-Related Outcomes Serious juvenile offenders: two trials –pre-post self-report substance use –substance-related arrests at 4-year follow-up Diagnosed substance abusing/dependent juvenile offenders –pre-post self-reported substance use Youths with serious emotional disturbance –self-reported alcohol use at 6-month follow-up –marijuana use (urine screens) at 12-month follow-up

Substance Abusing/Dependent Offenders: MST Service Findings Engagement and Retention in Treatment –98% (57 of 58 families) treatment completion (4 months) Cost Savings –Incremental costs of MST offset by savings incurred from reductions in days of out-of- home placement at 12 months School Attendance –Significant increase in regular classrooms

Current MST Substance- Related Trials Drug Court Study (NIDA, NIAAA) –Does integration of evidence-based practices enhance drug court outcomes? Neighborhood Solutions (SC DHHS) –Evidence-based practices provided in high risk neighborhood with neighborhood collaboration MST Continua of Care (Annie E. Casey) –Hawaii and Philadelphia; aimed at the most costly mental health, substance abuse, and juvenile justice youths

Long-Term Substance-Related Outcomes at 5-6 Year Follow-up Stable Cocaine Use in Young Adulthood Predicted by the Interaction of: –multiple internalizing disorders with high mother-child conflict in middle adolescence –multiple internalizing disorders with high sibling negativity Low Cocaine Use in Young Adulthood –Females who received MST in middle adolescence

BASES OF MST SUCCESS ¬Addresses multidetermined nature of serious clinical problems ­High ecological validity of intensive services ®Intensive quality assurance system ¯Integration of evidence-based intervention models °Caregiver viewed as key to long term outcomes ±Program accountability for family engagement and outcomes