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- Gustle, Lars-Henry, et al.
(author)
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Blueprints in Sweden. Symptom load in Swedish adolescents in studies of Functional Family Therapy (FFT), Multisystemic Therapy (MST) and Multidimensional Treatment Foster Care (MTFC).
- 2007
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In: Nordic Journal of Psychiatry. - : Informa UK Limited. - 1502-4725 .- 0803-9488. ; 61:6, s. 443-451
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Journal article (peer-reviewed)abstract
- The purpose of the present study was to compare symptom load in youth groups treated with three Swedish Blueprint programmes - Functional Family Therapy (FFT), Multisystemic Therapy (MST) and Multidimensional Treatment Foster Care (MTFC) - to see if symptom load matches the intensity of the treatment model as expected. These youth groups were also compared with in- and outpatients from child and adolescent psychiatry, and a normal comparison group. In addition, we compared the symptom load of their mothers. Symptom load was measured by the Achenbach System of Empirically Based Assessment (ASEBA) in the adolescents, and by the Symptom Checklist 90 in their mothers. The results showed that youth in the MST and MTFC studies had a higher symptom load than in the FFT study, and the same pattern of results was found in their mothers. It is concluded that there seems to be a reasonable correspondence between the offered resources and the symptom load among youth and parents; treatment methods with higher intensity have been offered to youth with higher symptom load. The correlation between internalized and externalized symptoms was high in all study groups. The MST and MTFC groups had an equally high total symptom load as the psychiatric inpatient sample.
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| 2. |
- Gustle, Lars-Henry, et al.
(author)
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Implementation of evidence-based models in social work practice: practitioners' perspectives on an MST trial in Sweden
- 2008
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In: Journal of Child & Adolescent Substance Abuse. - : Informa UK Limited. - 1067-828X .- 1547-0652. ; 17:3, s. 111-125
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Journal article (peer-reviewed)abstract
- The implementation of new treatment methods in social work practice is warranted. Moreover, little is known about professionals' attitudes toward the introduction of evidence-based practices into their communities. Therefore,this article reports on the implementation of a Swedish research project that evaluated Multisystemic Therapy (MST). All investigating social workers in a community-based social work practice and their supervisors completed a questionnaire concerning attitudes toward the research project, as well as attitudes toward MST as a treatment method. A large majority of participants were positive toward the research project, felt sufficiently informed, and thought that the implementation occurred at an appropriate pace. Likewise, participants felt positively toward the adoption of MST as a treatment method, toward evidence-based research in general, and in their affinity toward community-family-based services. On the other hand, investigating social workers differed in their practice attitudes. Potential reasons for these discrepancies, including the influence of top-down implementation, differences in experience, and differences due to the position held are discussed.
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| 3. |
- Gustle, Lars-Henry
(author)
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Implementering och korttidsuppföljning av multisystematisk terapi : En svensk randomiserad multicenterstudie angående Multisystemisk terapi
- 2007
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Doctoral thesis (other academic/artistic)abstract
- This thesis focuses on three areas: 1. the implementation of Multisystemic Therapy (MST) as a treatment method in social services in Sweden, 2. the implementation of a research project that has the aim to evaluate MST as a treatment method, 3. the evaluation of MST as a treatment method compared to traditional social services for antisocial adolescents in Sweden. The first study reports on the implementation of a Swedish research project that evaluated Multisystemic Therapy. All investigating social workers in local work practice (potential referrers to this project) and their supervisors completed a questionnaire concerning attitudes toward the research project as well as attitudes toward MST as a treatment method. A large majority of the participants were positive toward the research project, felt sufficiently informed, and thought that the implementation occurred at an appropriate pace. Likewise, participants felt positively toward the adoption of MST as a treatment method, toward evidence-based research in general, and toward community-family-based services. Study II examines some of the factors that may have affected the tendency for social workers to refer adolescents to a randomized controlled study of Multisystemic Therapy. The study concluded that the treatment ideology of the social worker was associated with referral rate. Social workers who sympathized with the ideology on which MST is based referred patients to the project to a greater extent. Also the perception of a good work climate and good social support correlated positively with the referral rate from the unit. Study III analyses symptom load in youth groups in research studies. The programmes were the three Blueprint programmes, Functional Family Therapy (FFT), Multisystemic Therapy (MST), and Multidimensional Treatment Foster Care (MTFC). Youth in FFT, MST, and MTFC were also compared with in- and outpatients from child and adolescent psychiatry and a normal comparison group on symptom load as measured by the Achenbach System of Empirically Based Assessment (ASEBA). Symptom load among their mothers was measured by the Symptom Checklist 90 (SCL-90). There seems to be a reasonable correspondence between the offered resources and the symptom load among youth and parents; treatment methods with higher intensity have been offered to youth with higher symptom load. Study IV assessed the short-term effectiveness of MST in the Swedish setting with a group of youths (n = 156) fulfilling the diagnostic criteria for conduct disorder. These youths were randomly assigned to MST or Traditional Services. Data were gathered from youths, parents, caseworkers, and teachers at time of randomization as well as at six months after randomization. There was no significant difference in treatment effects between the two groups of youths. In a Swedish sample MST is not more effective than traditional social services at producing short-term improvements in youth problem behaviour and mental health. The results of this thesis show the importance of successful implementation of a treatment method as Multisystemic Therapy and the importance of successful implementation of a research project. The results also address the importance of conducting transportability studies before decision to disseminate on larger scale. Key words: Adolescents, Multisystemic Therapy, Implementation, Evidence Based Practice, Randomized Trial, Evaluation, Social Research, Antisocial behaviour, Referral Rate, Symptom Load.
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| 4. |
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| 5. |
- Gustle, Lars-Henry, et al.
(author)
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Multisystemic therapy project in Sweden: what factors affect the tendency of social workers to refer subjects to the research project?
- 2007
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In: International Journal of Social Welfare. - : Wiley. - 1369-6866 .- 1468-2397. ; 16:4, s. 358-366
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Journal article (peer-reviewed)abstract
- This article examines some of the factors that may have affected the tendency for social workers to refer adolescents to a randomised controlled study of multisystemic therapy (MST). If we are to improve integration between researchers and the clinical setting in the future, it is important to consider those factors that affect implementation of research projects and evidence-based treatment methods. Evidence-based methods that lack the support of clinicians will have problems surviving in clinical practice. In the present study, we found that social workers' treatment ideology was associated with referral rate. Social workers who sympathised with the ideology on which MST is based referred patients to the project to a greater extent. Moreover, we found that the perception of a good work climate and good social support correlated positively with the referral rate from the unit. The results suggest that when implementing evidence-based methods, or research projects on treatment methods, researchers should consider whether the method is consistent with the current treatment ideology within the unit. Working conditions in the unit should also be considered.
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| 6. |
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| 7. |
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| 8. |
- Sundell, Knut, et al.
(author)
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The transportability of multisystemic therapy to Sweden: Short-term results from a randomized trial of conduct-disordered youths
- 2008
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In: Journal of Family Psychology. - : American Psychological Association (APA). - 0893-3200 .- 1939-1293. ; 22:4, s. 550-560
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Journal article (peer-reviewed)abstract
- This randomized clinical trial assessed the effectiveness of multisystemic therapy (MST) for 156 youths who met the diagnostic criteria for conduct disorder. Sweden's 3 largest cities and I small town served as the recruiting area for the study. A mixed factorial design was used, with random allocation between MST and treatment as usual groups. Assessments were conducted at intake and 7 months after referral. With an intention-to-treat approach, results from multiagent and multimethod assessment batteries showed a general decrease in psychiatric problems and antisocial behaviors among participants across treatments. There were.no significant differences in treatment effects between the 2 groups. The lack of treatment effect did not appear to be caused by site differences or variations in program maturity. MST treatment fidelity was lower than that of other studies, although not clearly related to treatment outcomes in this study. The results are discussed in terms of differences between Sweden and the United States. One difference is the way in which young offenders are processed (a child welfare approach vs. a juvenile justice system approach). Sociodemographic differences (e.g., rates of poverty, crime, and substance abuse) between the 2 countries may also have moderating effects on the rates of rehabilitation among young offenders.
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