title: The cost-effectiveness of family/family-based therapy for treatment of externalizing disorders, substance use disorders and delinquency: a systematic review.
abstract: Family therapy and family-based treatment has been commonly applied in children and adolescents in mental health care and has been proven to be effective. There is an increased interest in economic evaluations of these, often expensive, interventions. The aim of this systematic review is to summarize and evaluate the evidence on cost-effectiveness of family/family-based therapy for externalizing disorders, substance use disorders and delinquency.
  
  
  
  A systematic literature search was performed in PubMed, Education Resource information Centre (ERIC), Psycinfo and Cochrane reviews including studies conducted after 1990 and before the first of August of 2013. Full economic evaluations investigating family/family-based interventions for adolescents between 10 and 20 years treated for substance use disorders, delinquency or externalizing disorders were included.
  
  
  
  Seven hundred thirty-one articles met the search criteria and 51 studies were initially selected. The final selection resulted in the inclusion of 11 studies. The quality of these studies was assessed. Within the identified studies, there was great variation in the specific type of family/family-based interventions and disorders. According to the outcomes of the checklists, the overall quality of the economic evaluations was low. Results varied by study. Due to the variations in setting, design and outcome it was not feasible to pool results using a meta-analysis.
  
  
  
  The quality of the identified economic evaluations of family/family-based therapy for treatment of externalizing disorders, adolescent substance use disorders and delinquency was insufficient to determine the cost-effectiveness. Although commonly applied, family/family-based therapy is costly and more research of higher quality is needed.
authors.affiliation: Institute for Medical Technology Assessment & Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands. Goorden@bmg.eur.nl.
authors.forename: Maartje
authors.initials: M
authors.lastname: Goorden
authors.affiliation: Institute for Medical Technology Assessment & Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
authors.forename: Saskia J
authors.initials: SJ
authors.lastname: Schawo
authors.affiliation: Institute for Medical Technology Assessment & Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
authors.forename: Clazien A M
authors.initials: CA
authors.lastname: Bouwmans-Frijters
authors.affiliation: Brijder Addiction Treatment, Parnassia Group, Parnassia Addiction Research Centre (PARC), P.O. Box 53002, 2505 AA, The Hague, The Netherlands.
authors.forename: Evelien
authors.initials: E
authors.lastname: van der Schee
authors.affiliation: Brijder Addiction Treatment, Parnassia Group, Parnassia Addiction Research Centre (PARC), P.O. Box 53002, 2505 AA, The Hague, The Netherlands.|Department of Child and Adolescent Psychiatry, Curium, Leiden University Medical Center, Leiden University, P.O. Box 37, 2300 AA, Leiden, The Netherlands.
authors.forename: Vincent M
authors.initials: VM
authors.lastname: Hendriks
authors.affiliation: Institute for Medical Technology Assessment & Institute of Health Policy & Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
authors.forename: Leona
authors.initials: L
authors.lastname: Hakkaart-van Roijen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000191:economics* / Q000628:therapy; D003362:Cost-Benefit Analysis; D005196:Family Therapy / Q000191:economics*; D006801:Humans; D007604:Juvenile Delinquency / Q000191:economics / Q000523:psychology*; D019966:Substance-Related Disorders / Q000191:economics* / Q000628:therapy
keywords: Cost-effectiveness; Delinquency; Family/family-based therapy; Substance use disorders; Systematic review