Cecilia Andrée Löfholm

ABSTRACT Although research has repeatedly shown that residential care for youth with a serious behavior problem has little rehabilitation success, there is a group of youth for whom residential care in a locked setting is necessary. In this article, a manualized therapeutic residential treatment model for adolescents with serious behavior problems, MultifunC, is evaluated. The program theory of MultifunC is based on a review of the literature and synthesis effective treatment components. This study included 80 youth aged 15–17 years with a medium high or high risk for reoffending. Half of the participants received MultifunC, and half treatment as usual (TAU). Although non-randomized, the two groups were found to be equivalent on important background variables. After 24 months, this first evaluation of MultifunC demonstrated that youth participating in MultifunC had a reduced need for residential care in a locked setting as well as out-of-home placement in general compared to youth in the TAU group. The economic analysis found MultifunC to be a cost-effective alternative to TAU due to the reduced need of residential care in locked settings. There were no significant effects on reoffending or psychiatric care.

Treatment effects may not be observed if an empirically supported intervention is not administered with treatment adherence. This retrospective study investigated how therapists' adherence to Multisystemic therapy (MST) varied during a 6-year period in Sweden. Adherence was measured using the Therapist Adherence Measure, which was provided by caregivers. The associations between treatment adherence and therapist-reported posttreatment youth outcomes were also assessed. Retrospective adherence data were obtained for 973 families with youths between 12 and 17 years old who received MST from 68 therapists divided into 10 teams. Implementation of MST occurred in 2 waves between March 2003 and August 2009. Multilevel structural equation modelling was used to evaluate family- and cohort-level predictors and outcomes of treatment adherence. The results confirm previous research: Treatment adherence predicts MST treatment outcomes. With respect to the relationship between MST treatment experience and MST treatment adherence, the analysis showed mixed results. An increase in years that a team had been active predicted an increase in therapist adherence to MST. Therapists from the 2nd implementation wave had higher therapist adherence rates than therapists from the 1st implementation wave. Nevertheless, a therapists' experience with MST did not predict MST treatment adherence. The results suggest that the found links among treatment experience, treatment adherence, and treatment outcomes provide support for the hypothesis that the collective experience of the team members promotes treatment adherence. However, results are mixed and further research is needed.

... Lars-Henry Gustle, PhD, is affiliated with Department of Psychology; Kjell Hansson, PhD, and Cecilia Andree-Löfholm, doctoral candidate, are affiliated ... Results from Norway (Ogden & Hagen, in press; Ogden & Halliday-Boykins, 2004) showed that MST was more effective than ...

OBJECTIVE To assess the effectiveness of noninstitutional psychosocial interventions in preventing recidivism among criminal adolescents. METHOD We performed a systematic review and meta-analysis of randomized and nonrandomized controlled trials assessing the impact on recidivism among juveniles aged 12-17. The included studies had a low to medium risk of bias and were published between 2000 and 2019. Standardized mean differences or risk differences were calculated. RESULTS We included 35 (20 randomized, 15 nonrandomized) studies evaluating 17 unique, noninstitutional psychosocial interventions. A meta-analysis found no significant reductions in recidivism for studied interventions compared to control conditions. Although single studies suggested some positive effects, the evidence provided by these studies was found to have very low certainty. Post hoc analyses indicated that studies including a low-intensity control condition might have stronger relative intervention effects comp...

This dissertation deals with the transferability of an evidence-based treatment method from one cultural context to another, with Multisystemic Therapy (MST) in Sweden as an example. The primary research question is whether the evidence-based treatment intervention MST can be transferred from the US to Sweden with retained treatment effects. This thesis is organized around four separate but interrelated studies. The first of these studies focused on the annual incidence and childhood prevalence of children and youth receiving child welfare interventions in Sweden. It showed that the annual incidence and childhood prevalence of child welfare services among adolescents were comparably high. The second study, a randomized trial, assessed the effectiveness of MST within the normally operating social service system for 156 youths who met the diagnostic criteria for conduct disorder. Youth were randomly assigned between MST and treatment-as-usual (TAU) groups. Assessments were conducted a...

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.

... Cecilia Andrée Löfholm,1 Tina Olsson, Knut Sundell and Kjell Hansson ... Similar positive short-term (Ogden and Halliday-Boykins, 2004) and long-term (Ogden and Hagen, 2006; Ogden et al, 2007) treatment results have been reported from Norway. ...