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27 February
NO 1270
Restrictive placements
The lack of research findings that establish the effectiveness of restrictive placements is not surprising for several reasons:
Institutional programs typically fail to address the multiple determinants of adolescents' antisocial behavior (Henggeler, 1989, 1997). Research shows that antisocial behavior is simultaneously influenced either directly or indirectly by a number of factors:
Individual characteristics of the adolescent (e.g., low social conformity, psychopathology)
Family characteristics (e.g., parental psychopathology, poor affective relations, ineffective management and discipline, parental substance abuse)
Peer characteristics (e.g., associations with deviant peers, lack of prosocial peer relations)
School characteristics (e.g., low academic achievement and performance, lack of teacher support, and low commitment to school)
Neighborhood characteristics (e.g., poverty, crime rate, exposure to violence, exposure to substance use/abuse, lack of social support in the community).
Nevertheless, prevailing treatment interventions generally focus on only one set of risk factors, while largely ignoring the others.
Restrictive approaches fail to deliver treatment in an ecologically valid way (Henggeler, Schoenwald & Pickrel,1995). For example, services are typically delivered in artificial settings (e.g., offices, boot camps) that bear little similarity to the conditions and contingencies youth experience in their homes, schools, and neighborhood settings.
Virtually no resources are devoted to remedying problems that exist in youths' natural environments. For example, simply teaching social skills to an incarcerated youth who has a history of stealing, fighting, and gang involvement will have little effect on his or her behavior upon returning to an environment that continues to include antisocial friends, drug-using parents, a crime-ridden neighborhood, or an inadequate school. Yet research clearly and consistently shows that each of these environmental factors, either individually or in tandem, is a powerful determinant of youths' antisocial behavior.
Service providers are not held accountable for outcomes. Historically, mental health care providers (Henggeler, 1994) and juvenile justice authorities (Henggeler, 1996) have not been required to provide consumers, the public, or funders with data on the outcomes for the youth and families they serve. Funding for mental health and juvenile justice services is typically based on providing services rather than on obtaining outcomes (Henggeler et al., 1998).
TAMARA L. BROWN AND
SCOTT W. HENGGELER
Brown, Tamara L. and Henggeler, Scott W.
(1998). Preventing restrictive placements through MST. Reaching
Today's Youth, 2, 4. p. 53.
REFERENCES
Henggeler, S. W. (1989). Delinquency in adolescence. Newbury Park, CA. Sage.
Henggeler, S. W. (1994). A consensus: Conclusions of the APA Task Force report on innovative models of mental health services for children, adolescents, and their families. Journal of Clinical Child Psychology, 23 (Suppl.), pp.3-6.
Henggeler, S. W. (1996). Treatment of violent juvenile offenders-we have the knowledge: Comment on Gorman-Smith et al. (1996). Journal of Family Psychology, 10, pp. 137-141
Henggeler, S. W., Schoenwald, S. K., Borduin, C. M., Rowland, M. D., & Cunningham, P. B. (1998). Multisystemic treatment of antisocial behavior in children and adolescents. New York, NY. Guilford Press.
Henggeler, S. W., Schoenwald, S. K., & Pickrel, S. G. (1995).
Multisystemic therapy: Bridging the gap between university- and
community-based treatment. Journal of Consulting and Clinical
Psychology, 63, pp. 709-717.
