One-year follow-up of multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis.
OBJECTIVE
This study presents findings from a 1-year follow-up to a randomized clinical trial comparing multisystemic therapy (MST), modified for use with youths presenting psychiatric emergencies, with inpatient psychiatric hospitalization.


METHODS
One hundred fifty-six children and adolescents approved for emergency psychiatric hospitalization were randomly assigned to home-based MST or inpatient hospitalization followed by usual services. Assessments examining mental health symptoms, out-of-home placement, school attendance, and family relations were conducted at five times: within 24 hours of recruitment, shortly after the hospitalized youth was released from the hospital (1-2 weeks after recruitment), at the completion of MST (average of 4 months postrecruitment), and 10 and 16 months postrecruitment.


RESULTS
Based on placement and youth-report measures, MST was initially more effective than emergency hospitalization and usual services at decreasing youths' symptoms and out-of-home placements and increasing school attendance and family structure, but these differences generally dissipated by 12 to 16 months postrecruitment. Hospitalization produced a rapid, but short-lived, decrease in externalizing symptoms based on caregiver reports.


CONCLUSIONS
Findings suggest that youths with serious emotional disturbance might benefit from continuous access to a continuum of evidence-based practices titrated to clinical need.
Henggeler
Scott W
SW
Department of Psychiatry and Behavioral Sciences, Family Services Research Center, Medical University of South Carolina, 67 President Street, Suite CPP, Box 250861, Charleston, SC 29425, USA. henggesw@musc.edu
Rowland
Melisa D
MD
Halliday-Boykins
Colleen
C
Sheidow
Ashli J
AJ
Ward
David M
DM
Randall
Jeff
J
Pickrel
Susan G
SG
Cunningham
Phillippe B
PB
Edwards
James
J
D000293:Adolescent; D016497:Adolescent Health Services; D002648:Child; D003131:Combined Modality Therapy; D003419:Crisis Intervention; D005006:Ethnicity; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D012649:Self Concept; D016896:Treatment Outcome