The effectiveness of a community-based intensive intervention for young people with complex psychological and forensic needs

Abstract

This thesis examined the effectiveness of an intensive, community-based intervention for youth presenting with complex psychological needs, and their families, and discussed the need to understand and address the multiple risk and protective factors across several systems associated with aggressive, violent, antisocial and offending behaviour in young people, in order to intervene effectively. The intervention is based on the principles of Multi-Systemic Therapy (MST), a renowned intensive, community-based intervention for aggressive, violent and antisocial young people, which is explored in the literature review (Chapter 1). The available evidence-base on MST demonstrates that the behaviour of young people considered at significant risk to themselves and/or others can be managed safely within the community, while engaging their caregivers and wider ecology to effect positive changes that are sustainable. The research study (Chapter 2) reports on a modest sample of 17 young people and 12 caregivers who completed research measures prior to and following the receipt of the intensive intervention based on MST principles aimed at improving youth and family functioning. Positive changes in both individual functioning and family environment observed were found to be consistent with the existing evidence-base regarding the effectiveness of community based interventions. This provides support for moving away from traditional office-based approaches to engaging these clients in order to prevent further deterioration in behaviour and subsequent placement of the young person away from his/her family and community. A discussion surrounding the use of psychometric measures provides insight into the role of the family environment in assessing and intervening with this client group in Chapter 3. Finally, the importance of recognising families as the key to a successful system of care is further explored in the case study in Chapter 4. Overall, this thesis provides support for the abandonment of a simplistic superficial understanding of social, emotional, and behavioural difficulties in young people to a more ecological, dynamic approach, which has implications for prevention of the detrimental and long lasting costs of youth social, emotional and behavioural difficulties