Juvenile Delinquency 87Box 7.3Elements of Multisystemic Therapy (MST)
1 Family therapy which focuses on effective communication, systematic reward
and punishment systems, and taking a problem-solving approach to day-to-day
conflicts.
2 Encouragement to spend more time with peers who do not have problems,
and to stop seeing other delinquents.
3 Liaison with school to improve learning and homework performance, and
restructure after-school hours.
4 Individual development, including assertiveness training against negative peer
influences.
5 Empowerment of youths and their parents to cope with family, school, peer
and neighbourhood problems. The emphasis is on promoting the family’s own
problem-solving abilities, not providing ready-made answers.
6 Coordination with other agencies, for example, juvenile justice, social work,
mental health, education.Sweden failed to find any superiority of MST over management as usual,
though one in England did.
3 Multidimensional Treatment Foster Care (MTFC)was developed by Patricia
Chamberlain. It is the most intensive of the three approaches and is
also rooted in sound research on the causes of delinquency. Here, the
young person is put into a foster home for around six months and
taught life skills and kept away from antisocial peers. A tight regime
gives immediate rewards for all positive behaviour and sanctions for rule
breaking. This is delivered through a points system carefully tailored to
the individual’s needs and interests. During this time the birth family are
taught skills in managing and supervising the young person. Offending
rates one year after return home are again reduced by a third to a half.
Parent training has also been shown to reduce offending rates, but at
considerable emotional cost to staff involved.
Preventative programmes are theoretically attractive as they operate
before antisocial behaviour is thoroughly ingrained. These programmes
are aimed at early or middle childhood and can be at one of three levels:
(1) universal interventions for all children; (2) targeted interventions for
children at high risk of becoming offenders; and (3) indicated interventions
aiming for the secondary prevention of offending behaviour in referred
populations who already have established conduct problems. Few univer-
sal programmes have yet been evaluated, but there are promising targeted
programmes for primary school-aged children that involve the following
three components: (1) parent-management training; (2) reading reme-
diation; and (3) teacher-training in classroom management techniques.
Secondary prevention may well be feasible since parent-management
training has been shown to reduce conduct problems in middle childhood,
though it has yet to be established that this does reduce subsequent