title: Evaluation of multisystemic therapy pilot services in Services for Teens Engaging in Problem Sexual Behaviour (STEPS-B): study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Clinically effective and cost-effective methods for managing problematic sexual behaviour in adolescents are urgently needed. Adolescents who show problematic sexual behaviour have a range of negative psychosocial outcomes, and they and their parents can experience stigma, hostility and rejection from their community. Multisystemic therapy (MST) shows some evidence for helping to reduce adolescent sexual reoffending and is one of the few promising interventions available to young people who show problematic sexual behaviour. This paper describes the protocol for Services for Teens Engaging in Problem Sexual Behaviour (STEPS-B), a feasibility trial of MST for problem sexual behaviour (MST-PSB) in antisocial adolescents at high risk of out-of-home placement due to problematic sexual behaviour.
  
  
  METHODS
  Eighty participants and their families recruited from five London boroughs will be randomized to MST-PSB or management as usual with follow-up to 20 months post-randomization. The primary outcome is out-of-home placement at 20 months. Secondary outcomes include sexual and non-sexual offending rates and antisocial behaviours, participant well-being, educational outcomes and total service and criminal justice sector costs. Feasibility outcomes include mapping the clinical service pathways needed to recruit adolescents displaying problematic sexual behaviour, acceptability of a randomized controlled trial to the key systems involved in managing these adolescents, and acceptability of the research protocol to young people and their families. Data will be gathered from police computer records, the National Pupil Database and interviews and self-report measures administered to adolescents and parents and will be analysed on an intention-to-treat basis.
  
  
  CONCLUSIONS
  The STEPS-B feasibility trial aims to inform policymakers, commissioners of services and professionals about the potential for implementing MST-PSB as an intervention for adolescents showing problem sexual behaviour. Should MST-PSB show potential, STEPS-B will determine what would be necessary to implement the programme more fully and at a scale that would warrant a full trial.
  
  
  BACKGROUND
  ISRCTN28441235 (registered 25 January 2012).
authors.affiliation: Research Department of Clinical, Educational and Health Psychology, University College London, London, UK. p.fonagy@ucl.ac.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: Fonagy
authors.affiliation: Research Department of Clinical, Educational and Health Psychology, University College London, London, UK. stephen.butler@ucl.ac.uk.
authors.forename: Stephen
authors.initials: S
authors.lastname: Butler
authors.affiliation: Brandon Centre, London, UK. geoffreybaruch@brandoncentre.org.uk.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Baruch
authors.affiliation: Centre for the Economics of Mental Health, Institute of Psychiatry, King's College London, London, UK. s.byford@kcl.ac.uk.
authors.forename: Sarah
authors.initials: S
authors.lastname: Byford
authors.affiliation: Royal Ottawa Health Care Group, Ottawa, Ontario, Canada. michael.seto@theroyal.ca.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Seto
authors.affiliation: MRC Biostatistics Unit, University of Cambridge, Cambridge, UK. james.wason@mrc-bsu.cam.ac.uk.
authors.forename: James
authors.initials: J
authors.lastname: Wason
authors.affiliation: Brandon Centre, London, UK. charleswells@brandoncentre.org.uk.
authors.forename: Charles
authors.initials: C
authors.lastname: Wells
authors.affiliation: Research Department of Clinical, Educational and Health Psychology, University College London, London, UK. j.greisbach@ucl.ac.uk.
authors.forename: Jessie
authors.initials: J
authors.lastname: Greisbach
authors.affiliation: Research Department of Clinical, Educational and Health Psychology, University College London, London, UK. r.ellison@ucl.ac.uk.
authors.forename: Rachel
authors.initials: R
authors.lastname: Ellison
authors.affiliation: Research Department of Clinical, Educational and Health Psychology, University College London, London, UK. e.simes@ucl.ac.uk.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Simes
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D001521:Behavior Therapy / Q000379:methods*; D002648:Child; D002652:Child Behavior; D002985:Clinical Protocols; D005196:Family Therapy / Q000379:methods*; D005240:Feasibility Studies; D006792:House Calls; D006801:Humans; D057194:Intention to Treat Analysis; D008131:London; D010865:Pilot Projects; D000066553:Problem Behavior / Q000523:psychology*; D015397:Program Evaluation; D011569:Psychiatric Status Rating Scales; D012107:Research Design; D012742:Sex Offenses / Q000517:prevention & control / Q000523:psychology*; D012725:Sexual Behavior; D013997:Time Factors; D016896:Treatment Outcome