Project 173067

The rate of adolescents in Canada charged with violent crimes has increased by 12% in the last decade and 30% since 1991. Effective interventions are critical not only for the well-being of antisocial adolescents and their families, but also to protect victims. Randomized clinical trials have established Multisystemic Therapy (MST) as one of the most effective interventions for antisocial youth. However, not all youth benefit from this approach. Our program of research aims to understand this variation by identifying the key mechanisms of change underlying successful MST outcomes. Over the last five years, we have partnered with community agencies across Ontario and developed a clinical research network comprised of scientists, clinical directors, MST consultants, supervisors and therapists. The large body of knowledge we have gained from our first round of studies on mechanisms of change in real-world MST settings has been shared with participating community agencies and stakeholders. The next step is to change practice behaviour with this knowledge. The current proposal has four goals: (1) to work in partnership with MST consultants and supervisors to develop training materials that target the mechanisms of change we have empirically identified as key predictors of MST success; (2) to evaluate the uptake of this new knowledge by MST therapists; (3) to analyze extant data from audiotaped therapy sessions in order to identify fine-grained therapeutic strategies most predictive of MST success; (4) to hold interactive roundtable discussions with our network plus selected MST clients to collectively analyze and interpret findings from these data and to develop plans for a second round of dissemination to further refine practice behaviour. Overall, effective and ineffective therapeutic interactions will be specified, MST supervisors will be better able to train clinicians to tailor treatment to diverse families, and MST will be more effective and cost-efficient.