title: One-year follow-up of multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis.
abstract: 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.
authors.affiliation: 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
authors.forename: Scott W
authors.initials: SW
authors.lastname: Henggeler
authors.forename: Melisa D
authors.initials: MD
authors.lastname: Rowland
authors.forename: Colleen
authors.initials: C
authors.lastname: Halliday-Boykins
authors.forename: Ashli J
authors.initials: AJ
authors.lastname: Sheidow
authors.forename: David M
authors.initials: DM
authors.lastname: Ward
authors.forename: Jeff
authors.initials: J
authors.lastname: Randall
authors.forename: Susan G
authors.initials: SG
authors.lastname: Pickrel
authors.forename: Phillippe B
authors.initials: PB
authors.lastname: Cunningham
authors.forename: James
authors.initials: J
authors.lastname: Edwards
mesh_terms: 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