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One‐Year Follow‐up of Multisystemic Therapy as an Alternative to the Hospitalization of Youths in Psychiatric Crisis
Open accessAbstract
Objective This study presents findings from a 1-year follow-up to a randomized clinical trial comparing multisystemic therapy (MST), modified for use with youths presenting psychiatric emergencies, with inpatient psychiatric hospitalization.Method One hundred fifty-six children and adolescents approved for emergency psychiatric hospitalization were randomly assigned to home-based MST or inpatient hospitalization followed by usual services. Assessments examining mental health symptoms, out-of-home placement, school attendance, and family relations were conducted at five times: within 24 hours of recruitment, shortly after the hospitalized youth was released from the hospital (1-2 weeks after recruitment), at the completion of MST (average of 4 months postrecruitment), and 10 and 16 months postrecruitment.Results Based on placement and youth-report measures, MST was initially more effective than emergency hospitalization and usual services at decreasing youths' symptoms and out-of-home placements and increasing school attendance and family structure, but these differences generally dissipated by 12 to 16 months postrecruitment. Hospitalization produced a rapid, but short-lived, decrease in externalizing symptoms based on caregiver reports.Conclusion Findings suggest that youths with serious emotional disturbance might benefit from continuous access to a continuum of evidence-based practices titrated to clinical need.
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“However, most of the recently published brief interventions are aimed at specific psychiatric emergencies, such as suicidality [8, 24] and trauma exposure [25, 26]. Others focus exclusively on youth in acute crisis and are not for younger children [27].”
From Bridging the gap between the emergency department and outpatient care: feasibility of a short-term psychiatric crisis intervention for children and adolescents (2023) · cites this paper as [27]
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Metadata
- Authors
- HENGGELER, S. W., ROWLAND, M. D., HALLIDAY‐BOYKINS, C., SHEIDOW, A. J., WARD, D. M., RANDALL, J., PICKREL, S. G., CUNNINGHAM, P. B., & EDWARDS, J.
- Affiliations
- Medical University of South Carolina (US)
- Corresponding author
- HENGGELER, SCOTT W.
- Venue
- Journal of the American Academy of Child & Adolescent Psychiatry
- Publisher
- Elsevier BV
- Published
- 2003-05
- Volume
- 42
- Issue
- 5
- Pages
- 543-551
- ISSN
- 0890-8567 (ISSN-L)
- OpenAlex
- W1978563741
- Cited by
- 144
- References
- 32
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 11 · 2023: 5 · 2021: 8 · 2020: 3 · 2019: 4 · 2018: 1 · 2017: 3 · 2016: 2 · 2015: 8 · 2014: 6 · 2013: 7 · 2012: 8
- FWCI
- 15.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- NIMH (grant R01MH51852)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Sociology and Political Science › Child Welfare and Adoption
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- multisystemic therapy, inpatient psychiatric hospitalization, children and adolescents, serious emotional disturbance, home-based therapy, out-of-home placement, school attendance, family relationships, externalizing problems, long-term follow-up, continuum of care
- MeSH terms
- Adolescent, Mental Disorders, Child, Combined Modality Therapy, Crisis Intervention, Ethnicity, Female, Follow-Up Studies, Home Care Services, Hospitalization, Humans, Length of Stay, Male, Self Concept, Adolescent Health Services, Treatment Outcome
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