Effectiveness of Multisystemic Therapy for Adolescents From Families With Intellectual Disabilities

ConditionBehavioural Problems

Trial statusRecruiting

Trial phaseNot listed

Trial typeObservational

Biological sexAll

Age10-19

SponsorDe Viersprong

About this trial

The goal of this observational study is to determine the effectiveness of a specialisation of multisystemic therapy (MST) for adolescents with severe behavioural problems from families with an intellectual disability (ID; MST-ID).

To achieve this goal, a mixed method study design is used. To this end, a quantitative and a qualitatively primary research question are formulated:

* Is MST-ID superior, when compared to standard MST, in reducing rule-breaking behaviour of adolescents (quantitative)? * What are the experiences of adolescents and/or parents receiving MST-ID treatment (qualitative)?

Participants will be asked to complete two screeners (questionnaires delivered as a verbal interview) with a total duration of approximately 30 minutes. Other data will be collected through Routine Outcome Monitoring questionnaires that are part of standard MST procedures. To this end, five 'time points' have been identified: T0 (start of MST\[-ID\] treatment), T1 (end of MST\[-ID\] treatment), T2 (follow-up 6 month after MST\[-ID\] treatment), T3 (follow-up 12 month after MST\[-ID\] treatment), and T4 (follow-up 18 month after MST\[-ID\] treatment). The qualitative method used to gain insight into families' experiences is determined in consultation with the families.

To assess the effectiveness of MST-ID, its treatment outcomes will be compared to standard MST treatment outcomes of families with ID.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Known or suspected ID of the referred adolescent and/or their parent(s);

Educational level of the referred adolescent and/or highest attained diploma of their parent(s) is indicative of potential ID.

Adolescent must be 10 to 19 years old at the start of treatment;

Adolescent presents with severe behavioural problems in at least two life areas;

Disqualifiers

Adolescent lives independently;

Adolescent presents with severe problematic sexual behaviours, without presenting with other severe behavioural problems;

Adolescent presents suicidal, psychotic, or homicidal requiring specialised treatment (such as a crisis placement in a residential facility);

Adolescent has a severe Autism Spectrum Disorder (level 2-3 according to the Diagnostic and Statistical Manual of Mental Disorders [DSM-V] criteria) or a severe ID (IQ score <50);

Trial population

The target population consists of adolescents and their parent(s) with a known or suspected ID referred to MST-ID at one of three Dutch mental health care organisations (de Viersprong, Koraal, and Prisma) or to standard MST at one of two Dutch mental health care organisations (de Viersprong and Pactum).

Trial design

Design model

Case-control

Time perspective

Prospective

Treatments tested in this trial

Multisystemic therapy
Behavioral
Multisystemic Therapy (MST) is an intensive, evidence-based treatment aimed at preventing out-of-home placement of adolescents with severe behavioural problems. The intervention is home-based and focuses not only on the adolescent, but also on the various systems surrounding the adolescent, such as the family, neighbourhood, school, and friends. MST helps parents increase their parenting competencies such as parental monitoring and find (more) social support in their environment. MST also helps adolescents improve their relationship with their parents, school participation, and social activities, and promotes contact with pro-social peers. These goals are achieved by working together with key figures in the family's environment. MST treatment duration is three to five months. In MST, a family can contact a therapist 24/7.
Multisystemic therapy - intellectual disabilities
Behavioral
Multisystemic therapy - intellectual disabilities (MST-ID) is a specialisation of standard MST (see above), tailored to the needs and skill deficits of families in which the adolescent and/or parent(s) has/have a known or suspected ID. In MST-ID, among others, simplified language and visual support are used, and extra attention is paid to the generalisation of what has been learned in the treatment sessions.

Treatment groups

470 Participants

are divided into 2 treatment groups

Group A: Families receiving standard MST1 intervention

Group B: Families receiving MST-ID1 intervention

Trial outcomes

Primary outcomes

Rule-breaking behaviour of adolescents - parents

Rule-breaking behaviour of adolescents according to parents will be assessed using the Child Behavior Check List (CBCL). The CBCL consists of 118 questions rated on a 3-point scale from 0 (absent) to 2 (occurs often). Higher scores indicate that adolescents experience more problems.

Time frame

Start of MST(-ID) treatment (T0) until 18-month follow up (T4)

Rule-breaking behaviour of adolescents - adolescents

Rule-breaking behaviour of adolescents according to parents will be assessed using the Youth Self Report (YSR). The YSR consists of 112 questions rated on a 3-point scale from 0 (absent) to 2 (occurs often). Higher scores indicate that adolescents experience more problems.

Time frame

Start (T0) and end (T1) of MST(-ID) treatment, an average of 4 months in between

Secondary outcomes

Externalising and internalising behavioural problems of adolescents - parents

Externalising and internalising behavioural problems of adolescents will be assessed using the Child Behavior Check List (CBCL). The CBCL consists of 118 questions rated on a 3-point scale from 0 (absent) to 2 (occurs often). Higher scores indicate that adolescents experience more problems.

Time frame

Start of MST(-ID) treatment (T0) until 18-month follow up (T4)

Externalising and internalising behavioural problems of adolescents - adolescents

Externalising and internalising behavioural problems of adolescents according to adolescents will be assessed using the Youth Self Report (YSR). The YSR consists of 112 questions rated on a 3-point scale from 0 (absent) to 2 (occurs often). Higher scores indicate that adolescents experience more problems.

Time frame

Start (T0) and end (T1) of MST(-ID) treatment, an average of 4 months in between

Parenting stress

Parenting stress will be assessed using the Parenting Stress Questionnaire (PSQ), which is the English version of the Dutch Opvoedingsbelasting Vragenlijst (OBVL). The PSQ consists of 34 questions rated on a 4-point scale from 1 (not true) to 4 (very true). Higher scores indicate more parenting stress.

Time frame

Start of MST(-ID) treatment (T0) until 18-month follow up (T4)

Out-of-home placement

Out-of-home placement of adolescents will be assessed using the Social Demographic Information 3.0 questionnaire (SDI 3.0).

Time frame

Start of MST(-ID) treatment (T0) until 18-month follow up (T4)

Other outcomes

Family and treatment characteristics

Characteristics of families that are gathered are previous treatment, referral stream and the following: Adolescent: age, gender identity, cultural background, prior residential placement, living situation, level of education Primary caregiver: level of education, employment status, partner, experienced financial stress, experienced living situation stress

Time frame

Start of MST(-ID) treatment (T0)

Intellectual functioning

Intellectual functioning will be assessed using the Dutch Screener for Intelligence and Learning Disabilities (SCIL). The SCIL consists of 14 questions that result in a total SCIL score that can range from 0 to 28. A total SCIL score of 19 and below indicates the presence of intellectual disabilities.

Time frame

Start of MST(-ID) treatment (T0)

Adaptive functioning

Adaptive functioning will be assessed using the Dutch Screener for Adaptive Functioning and Learning Disabilities (SCAF). The SCAF consists of 12 questions that result in a total SCAF score that can range from 0 to 13. A higher score indicates a higher level of adaptive functioning.

Time frame

Start of MST(-ID) treatment (T0)

Treatment fidelity

Treatment fidelity is measured and checked through administration of a validated questionnaire to the primary caregiver of each family (TAM-R).

Time frame

Monthly throughout MST(-ID) treatment, an average of 4 months

Sponsors and contacts

Click on the lead sponsor to view all of their trials.

De Viersprong

Lead sponsor

Stichting tot Steun

Collaborator

Koraal

Collaborator

Prisma

Collaborator

MST-Netherlands/Belgium

Collaborator

Radboud University Medical Center

Collaborator

Pactum

Collaborator

Source ClinicalTrials.gov

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