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Trials
Published in: Trials 1/2015

Open Access 01-12-2015 | Study protocol

Evaluation of multisystemic therapy pilot services in Services for Teens Engaging in Problem Sexual Behaviour (STEPS-B): study protocol for a randomized controlled trial

Authors: Peter Fonagy, Stephen Butler, Geoffrey Baruch, Sarah Byford, Michael C. Seto, James Wason, Charles Wells, Jessie Greisbach, Rachel Ellison, Elizabeth Simes

Published in: Trials | Issue 1/2015

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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/Design

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.

Discussion

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.

Trial registration

ISRCTN28441235 (registered 25 January 2012).
Literature
1.
Pereda N, Guilera G, Forns M, Gomez-Benito J. The prevalence of child sexual abuse in community and student samples: a meta-analysis. Clin Psychol Rev. 2009;29:328–38.CrossRefPubMed
2.
Stoltenborgh M, van Ijzendoorn MH, Euser EM, Bakermans-Kranenburg MJ. A global perspective on child sexual abuse: meta-analysis of prevalence around the world. Child Maltreat. 2011;16:79–101.CrossRefPubMed
3.
Snyder HN, Sickmund M. Juvenile Offenders and Victims: 2006 National Report. Pittsburgh: National Center for Juvenile Justice/Office of Juvenile Justice and Delinquency Prevention; 2006.
4.
Chapman DP, Dube SR, Anda RF. Adverse childhood events as risk factors for negative mental health outcomes. Psychiatr Ann. 2007;37:359–64.
5.
Letourneau EJ, Resnick HS, Kilpatrick DG, Saunders BE, Best CL. Comorbidity of sexual problems and posttraumatic stress disorder in female crime victims. Behav Ther. 1996;27:321–36.CrossRef
6.
Butler SM, Seto MC. Distinguishing two types of adolescent sex offenders. J Am Acad Child Adolesc Psychiatry. 2002;41:83–90.CrossRefPubMed
7.
Pullman LE, Leroux EJ, Motayne G, Seto MC. Examining the developmental trajectories of adolescent sexual offenders. Child Abuse Negl. 2014;38:1249–58.CrossRefPubMed
8.
van Wijk A, Loeber R, Vermeiren R, Pardini D, Bullens R, Doreleijers T. Violent juvenile sex offenders compared with violent juvenile nonsex offenders: explorative findings from the Pittsburgh Youth Study. Sex Abuse. 2005;17:333–52.PubMed
9.
Ronis ST, Borduin CM. Individual, family, peer, and academic characteristics of male juvenile sexual offenders. J Abnorm Child Psychol. 2007;35:153–63.CrossRefPubMed
10.
Seto MC, Lalumiere ML. What is so special about male adolescent sexual offending? A review and test of explanations through meta-analysis. Psychol Bull. 2010;136:526–75.CrossRefPubMed
11.
Nisbet IA, Wilson PH, Smallbone SW. A prospective longitudinal study of sexual recidivism among adolescent sex offenders. Sex Abuse. 2004;16:223–34.PubMed
12.
Waite D, Keller A, McGarvey EL, Wieckowski E, Pinkerton R, Brown GL. Juvenile sex offender re-arrest rates for sexual, violent nonsexual and property crimes: a 10-year follow-up. Sex Abuse. 2005;17:313–31.PubMed
13.
Worling JR, Curwen T. Estimate of Risk of Adolescent Sexual Offense Recidivism (Version 2.0: The “ERASOR”). In: Calder MC, editor. Juveniles and Children who Sexually Abuse: Frameworks for Assessment. Lyme Regis: Russell House; 2001. p. 372–97.
14.
Clift RJ, Rajlic G, Gretton HM. Discriminative and predictive validity of the penile plethysmograph in adolescent sex offenders. Sex Abuse. 2009;21:335–62.PubMed
15.
Langstrom N, Grann M. Risk for criminal recidivism among young sex offenders. J Interpers Violence. 2000;15:855–71.CrossRef
16.
Rice ME, Harris GT. Adolescent sex offenders: is phallometry developed for adult sex offenders valid for adolescents? In: Annual Conference of the Association for the Treatment of Sexual Abusers; 29 September-3 October; Dallas. 2009.
17.
Langstrom N, Enebrink P, Lauren EM, Lindblom J, Werko S, Hanson RK. Preventing sexual abusers of children from reoffending: systematic review of medical and psychological interventions. BMJ. 2013;347:f4630.CrossRefPubMedPubMedCentral
18.
Borduin CM, Schaeffer CM, Heiblum N. A randomized clinical trial of multisystemic therapy with juvenile sexual offenders: effects on youth social ecology and criminal activity. J Consult Clin Psychol. 2009;77:26–37.CrossRefPubMed
19.
Hanson RK, Bourgon G, Helmus L, Hodgson S. The principles of effective correctional treatment also apply to sexual offenders: a meta-analysis. Crim Justice Behav. 2009;36:865–91.CrossRef
20.
Andrews DA, Bonta J. The Psychology of Criminal Conduct. 5th ed. New York: Elsevier; 2010.
21.
Hanson RK, Bussière MT. Predicting relapse: a meta-analysis of sexual offender recidivism studies. J Consult Clin Psychol. 1998;66:348–62.CrossRefPubMed
22.
Henggeler SW, Sheidow AJ, Lee T. Multisystemic treatment of serious clinical problems in youths and their families. In: Roberts AR, Springer DW, editors. Handbook of Forensic Mental Health with Victims and Offenders: Assessment, Treatment, and Research. New York: Springer; 2007. p. 315–45.
23.
Ogden T, Halliday-Boykins CA. Multisystemic treatment of antisocial adolescents in Norway: replication of clinical outcomes outside of the US. Child Adolesc Ment Health. 2004;9:77–83.CrossRef
24.
Ogden T, Amlund HK. What works for whom? Gender differences in intake characteristics and treatment outcomes following Multisystemic Therapy. J Adolesc. 2009;32:1425–35.CrossRefPubMed
25.
Butler S, Baruch G, Hickey N, Fonagy P. A randomized controlled trial of multisystemic therapy and a statutory therapeutic intervention for young offenders. J Am Acad Child Adolesc Psychiatry. 2011;50:1220–35. e1222.CrossRefPubMed
26.
Sundell K, Hansson K, Lofholm CA, Olsson T, Gustle LH, Kadesjo C. The transportability of multisystemic therapy to Sweden: short-term results from a randomized trial of conduct-disordered youths. J Fam Psychol. 2008;22:550–60.CrossRefPubMed
27.
Leschied AW, Cunningham A. Seeking effective interventions for serious young offenders: Interim results of a four-year randomized study of multisystemic therapy in Ontario, Canada. London, Ontario: Centre for Children and Families in the Justice System; 2002.
28.
Fonagy P, Butler S, Goodyer I, Cottrell D, Scott S, Pilling S, et al. Evaluation of multisystemic therapy pilot services in the Systemic Therapy for At Risk Teens (START) trial: study protocol for a randomised controlled trial. Trials. 2013;14:265.CrossRefPubMedPubMedCentral
29.
Tarren-Sweeney M. Predictors of problematic sexual behavior among children with complex maltreatment histories. Child Maltreat. 2008;13:182–98.CrossRefPubMed
30.
Hanson RK, Gordon A, Harris AJR, Marques JK, Murphy W, Quinsey VL, et al. First report of the collaborative outcome data project on the effectiveness of psychological treatment for sex offenders. Sex Abuse. 2002;14:169–94.PubMed
31.
Reitzel LR, Carbonell JL. The effectiveness of sexual offender treatment for juveniles as measured by recidivism: a meta-analysis. Sex Abuse. 2006;18:401–21.PubMed
32.
Letourneau EJ, Henggeler SW, Borduin CM, Schewe PA, McCart MR, Chapman JE, et al. Multisystemic therapy for juvenile sexual offenders: 1-year results from a randomized effectiveness trial. J Fam Psychol. 2009;23:89–102.CrossRefPubMedPubMedCentral
33.
Curtis NM, Ronan KR, Borduin CM. Multisystemic treatment: A meta-analysis of outcome studies. J Fam Psychol. 2004;18:411–9.CrossRefPubMed
34.
Littell JH. The case for Multisystemic Therapy: evidence or orthodoxy? Child Youth Serv Rev. 2006;28:458–72.CrossRef
35.
Littell JH, Popa M, Forsythe B. Multisystemic Therapy for social, emotional, and behavioral problems in youth aged 10–17. Cochrane Database Syst Rev 2005:CD004797.
36.
Kendall PC, Flannery-Schroeder E, Panichelli-Mindel SM, Southam-Gerow M, Henin A, Warman M. Therapy for youths with anxiety disorders: A second randomized clinical trial. J Consult Clin Psychol. 1997;65:366–80.CrossRefPubMed
37.
Walkup JT, Albano AM, Piacentini J, Birmaher B, Compton SN, Sherrill JT, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. N Engl J Med. 2008;359:2753–66.CrossRefPubMedPubMedCentral
38.
Cohen JA, Scheeringa MS. Post-traumatic stress disorder diagnosis in children: challenges and promises. Dialogues Clin Neurosci. 2009;11:91–9.PubMedPubMedCentral
39.
Hackett S, Masson H, Phillips S. Services for Young People Who Sexually Abuse. A report on mapping and exploring services for young people who have sexually abused others. London: Youth Justice Board for England and Wales; 2005.
40.
Borduin CM, Letourneau EJ, Henggeler SW, Saldana L, Swenson CC. Treatment manual for multisystemic therapy with juvenile sexual offenders and their families. Charleston, SC: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina; 2005.
41.
Gerardin P, Thibaut F. Epidemiology and treatment of juvenile sexual offending. Paediatr Drugs. 2004;6:79–91.CrossRefPubMed
42.
Zimring FE. An American Travesty: Legal Responses to Adolescent Sexual Offending. Chicago: University of Chicago Press; 2009.
43.
HM Inspectorate of Probation. Annual Report 2013–14. Manchester: HM Inspectorate of Probation; 2013.
44.
James AC, Neil P. Juvenile sexual offending: one-year period prevalence study within Oxfordshire. Child Abuse Negl. 1996;20:477–85.CrossRefPubMed
45.
Kjellgren C, Wassberg A, Carlberg M, Langstrom N, Svedin CG. Adolescent sexual offenders: a total survey of referrals to Social Services in Sweden and subgroup characteristics. Sex Abuse. 2006;18:357–72.PubMed
46.
Henggeler SW, Letourneau EJ, Chapman JE, Borduin CM, Schewe PA, McCart MR. Mediators of change for multisystemic therapy with juvenile sexual offenders. J Consult Clin Psychol. 2009;77:451–62.CrossRefPubMedPubMedCentral
47.
Hanson RK, Morton-Bourgon KE. The characteristics of persistent sexual offenders: a meta-analysis of recidivism studies. J Consult Clin Psychol. 2005;73:1154–63.CrossRefPubMed
48.
Leroux EJ, Pullman LE, Motayne G, Seto MC: Victim age and the generalist versus specialist distinction in adolescent sexual offending. Sex Abuse 2014.
49.
Huey Jr SJ, Henggeler SW, Brondino MJ, Pickrel SG. Mechanisms of change in multisystemic therapy: reducing delinquent behavior through therapist adherence and improved family and peer functioning. J Consult Clin Psychol. 2000;68:451–67.CrossRefPubMed
50.
Schoenwald SK. From policy pinball to purposeful partnership: The policy contexts of multisystemic therapy transport and dissemination. In: Kazdin AE, Weisz JR, editors. Evidence-Based Psychotherapies for Children and Adolescents. New York: Guilford Press; 2010. p. 538–53.
51.
Mann BJ, Borduin CM, Henggeler SW, Blaske DM. An investigation of systemic conceptualizations of parent–child coalitions and symptom change. J Consult Clin Psychol. 1990;58:336–44.CrossRefPubMed
52.
Henggeler SW, Rodick J, Borduin CM, Hanson C, Watson S, Urey J. Multisystemic treatment of juvenile offenders: Effects on adolescent behavior and family interaction. Dev Psychol. 1986;22:132–41.CrossRef
53.
Goodman R. Comparing the Strengths and Difficulties Questionnaire and the Child Behavior Checklist: Is small beautiful? J Abnorm Child Psychol. 1999;27:17–24.CrossRefPubMed
54.
Messer SC, Angold A, Costello EJ, Loeber R, van Kammen W, Stouthamer-Loeber M. Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents: Factor composition and structure across development. Int J Methods Psychiatr Res. 1995;5:251–62.
55.
Conners CK. Conners’ Rating Scales-Revised: Technical Manual. Toronto: Multi-Health Systems; 1995.
56.
Grabell AS, Knight RA. Examining childhood abuse patterns and sensitive periods in juvenile sexual offenders. Sex Abuse. 2009;21:208–22.PubMed
57.
Friedrich WN, Lysne M, Sim L, Shamos S. Assessing sexual behavior in high-risk adolescents with the adolescent clinical sexual behavior inventory (ACSBI). Child Maltreat. 2004;9:239–50.CrossRefPubMed
58.
Smith DJ, McVie S. Theory and method in the Edinburgh study of youth transitions and crime. Br J Criminol. 2003;43:169–95.CrossRef
59.
Butler SM, Leschied AW, Fearon P. Antisocial beliefs and attitudes in pre-adolescent and adolescent youth: the development of the antisocial beliefs and attitudes scales (ABAS). J Youth Adolesc. 2007;36:1058–71.CrossRef
60.
Essau CA, Sasagawa S, Frick PJ. Callous-unemotional traits in a community sample of adolescents. Assessment. 2006;13:454–69.CrossRefPubMed
61.
Olson D. FACES IV, and the Circumplex Model: Validation study. J Marital Fam Ther. 2011;37:64–80.CrossRefPubMed
62.
Gullone E, Robinson K. The Inventory of Parent and Peer Attachment–Revised (IPPA-R) for children: a psychometric investigation. Clin Psychol Psychother. 2005;12:67–79.CrossRef
63.
Loeber R, Stouthamer-Loeber M, Van Kammen W, Farrington DP. Initiation, escalation and desistance in juvenile offending and their correlates. J Crim Law Criminol. 1991;82:36–82.CrossRef
64.
Straus MA, Douglas EM. A short form of the Revised Conflict Tactics Scales, and typologies for severity and mutuality. Violence Vict. 2004;19:507–20.CrossRefPubMed
65.
Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997;27:191–7.CrossRefPubMed
66.
Wechsler D. Weschler Abbreviated Scale of Intelligence Manual. San Antonio: Psychological Corporation; 1999.
67.
Goodman R, Ford T, Richards H, Gatward R, Meltzer H. The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. J Child Psychol Psychiatry. 2000;41:645–55.CrossRefPubMed
68.
Shmueli-Goetz Y, Target M, Fonagy P, Datta A. The Child Attachment Interview: a psychometric study of reliability and discriminant validity. Dev Psychol. 2008;44:939–56.CrossRefPubMed
69.
Tighe A, Pistrang N, Casdagli L, Baruch G, Butler S. Multisystemic therapy for young offenders: families’ experiences of therapeutic processes and outcomes. J Fam Psychol. 2012;26:187–97.CrossRefPubMed
70.
Barrett B, Byford S, Chitsabesan P, Kenning C. Mental health provision for young offenders: service use and cost. Br J Psychiatry. 2006;188:541–6.CrossRefPubMed
71.
Byford S, Barrett B, Roberts C, Wilkinson P, Dubicka B, Kelvin RG, et al. Cost-effectiveness of selective serotonin reuptake inhibitors and routine specialist care with and without cognitive behavioural therapy in adolescents with major depression. Br J Psychiatry. 2007;191:521–7.CrossRefPubMed
72.
Clark A, O’Malley A, Woodham A, Barrett B, Byford S. Children with complex mental health problems: needs, costs and predictors over one year. Child Adolesc Ment Health. 2005;10:170–8.CrossRef
73.
Harrington R, Peters S, Green J, Byford S, Woods J, McGowan R. Randomised comparison of the effectiveness and costs of community and hospital based mental health services for children with behavioural disorders. BMJ. 2000;321:1047–50.CrossRefPubMedPubMedCentral
74.
Beecham JK, Knapp MRJ. Costing psychiatric options. In: Thornicroft G, Brewin C, Wing J, editors. Measuring Mental Health Needs. Oxford: Oxford University Press; 1992.
75.
Drummond MF, O’Brien B, Stoddart GL. Methods for the Evaluation of Health Care Programmes. Oxford: Oxford University Press; 1997.
76.
Schoenwald SK, Chapman JE, Henry DB, Sheidow AJ. Taking effective treatments to scale: organizational effects on outcomes of multisystemic therapy for youth with co-occurring substance use. J Child Adolesc Subst Abuse. 2012;21:1–31.CrossRefPubMed
77.
Killaspy H, Bebbington P, Blizard R, Johnson S, Nolan F, Pilling S, et al. The REACT study: randomised evaluation of assertive community treatment in north London. BMJ. 2006;332:815–20.CrossRefPubMedPubMedCentral
78.
Pietkiewicz I, Smith JA. Praktyczny przewodnik interpretacyjnej analizy fenomenologicznej w badaniach jakościowych w psychologii. [A practical guide to using Interpretative Phenomenological Analysis in qualitative research psychology]. Czasop Psychol. 2012;18:361–9.
79.
Smith C, Allardyce S, Hackett S, Bradbury-Jones C, Lazenbatt A, Taylor J. Practice and policy in the UK with children and young people who display harmful sexual behaviours: an analysis and critical review. J Sex Aggress. 2014;20:267–80.CrossRef
80.
Children and Young People’s Mental Health and Wellbeing Taskforce. Future in mind: Promoting, protecting and improving our children and young people’s mental health and wellbeing. London: Deparment of Health/NHS England; 2015.
Metadata
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
Authors
Peter Fonagy
Stephen Butler
Geoffrey Baruch
Sarah Byford
Michael C. Seto
James Wason
Charles Wells
Jessie Greisbach
Rachel Ellison
Elizabeth Simes
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Trials / Issue 1/2015
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-015-1017-2

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