The Effectiveness of Forensic Outpatient Systemic Therapy: a Multiple Case Experimental Design
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 21
- 试验地点
- 4
- 主要终点
- Change in Juvenile-Caregiver Conflict assessed by the Network of Relationship Inventory (NRI)
研究概览
简要总结
The purpose of this study is to investigate the effectiveness and mediators of Forensic Outpatient Systemic Therapy (FAST).
详细描述
Forensic Outpatient Systemic Therapy (in Dutch: Forensische Ambulante Systeem Therapie; FAST) is a promising treatment for juveniles showing severe antisocial behavior, including aggression, (domestic) violence, and delinquent behavior. FAST has a flexible intensity and length, addresses individual and systemic risk and protective factors, and is responsive to the abilities of the client (system), intervention characteristics all considered crucial for effective treatment. The current study will investigate whether FAST is effective in reducing aggression of the juvenile, in reaching client formulated subgoals, and in improving family functioning (i.e., reducing juvenile-caregiver conflict and increasing caregiver responsiveness). In addition, processes of change will be examined, as well as mediation by reaching client formulated subgoals and improved family functioning. A Multiple Case Experimental Design (MCED) with an ABC design will be performed (A = baseline, B = intervention, and C = follow-up). Juveniles with primary aggression and/or anger problems (N = 15) and their caregiver(s) will be recruited.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Only
- 时间视角
- Prospective
入排标准
- 年龄范围
- 12 Years 至 21 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •FAST therapists determine whether clients meet inclusion and
排除标准
- •of FAST during the standard intake procedure of FAST. The FAST inclusion criteria are:
- •Juvenile has an estimated IQ-score of 80 or higher and/or sufficient adaptive skills to benefit from FAST;
- •Juvenile is aged 12 to 21 years old at the start of the intervention;
- •Juvenile exhibits externalizing behavior resulting in problems in at least two life areas (family, school, or leisure time), determined by clinical impressions based on information from intake and/or referrer information;
- •Juvenile has a medium to high recidivism risk, measured by the Risk Assessment Instrument for Outpatient Forensic Mental Health Care Youth (RAF GGZ Youth);
- •Presence of juvenile-caregiver relationship problems, measured by the RAF GGZ Youth;
- •Juvenile has a diagnosis of a DSM-5 behavioral disorder, which is determined using a new diagnostic process or case file analysis;
- •Juvenile and caregiver(s) cannot be motivated to follow treatment at the treatment site after multiple attempts by the therapist;
- •Juvenile resides with their caregiver(s) or is expected to return to residing with their caregiver(s) within the first two months of FAST.
- •The FAST exclusion criteria are:
- •Juvenile exhibits severe psychiatric symptoms requiring admission;
- •Problem behavior of the juvenile is caused primarily by substance abuse problems and it is expected that treatment of the substance abuse problems will decrease the problem behavior;
- •The safety of the family members or therapist cannot be sufficiently guaranteed.
- •To be eligible for participation in this study, one modified study inclusion criterium applies, i.e., the juvenile has primary aggression and/or anger problems (approximately 80% of referred juveniles). In addition, one study exclusion criterium applies, i.e., the juvenile is in secure residential care or confined in a correctional or detention facility at start of the intervention.
结局指标
主要结局
Change in Juvenile-Caregiver Conflict assessed by the Network of Relationship Inventory (NRI)
时间窗: T1 (baseline); twice a week during phase A, up to 5 weeks; every other week during phase B, up to 8 months; T2 (post-intervention) up to 9 months; weekly during phase C, 6 weeks
The NRI is a self-reported instrument for juveniles and caregivers. The NRI contains six items with possible scores ranging from 1 (not at all) to 100 (the most).
Change in Additional Criminogenic Needs assessed by individualized items
时间窗: Twice a week during phase A, up to 5 weeks; every other week during phase B, up to 8 months; weekly during phase C, 6 weeks
If severe truancy, substance use, contact with deviant peers, or delinquent behavior are reported at T1 but not prioritized in the top three goals, single items will be administered on these problems as well.
Change in Aggression assessed by the Aggressive Behavior scale of the Child Behavior Checklist (CBCL)
时间窗: Twice a week during phase A, up to 5 weeks; every other week during phase B, up to 8 months; weekly during phase C, 6 weeks
The CBCL is a caregiver-reported instrument. The Aggressive Behavior scale contains 19 items assessing aggression. Possible scores range from 1 (never) to 100 (always).
Change in Client Formulated Subgoals assessed by the FAST Goal list
时间窗: Twice a week during phase A, up to 5 weeks; every other week during phase B, up to 8 months; weekly during phase C, 6 weeks
The FAST Goal list is a self-report instrument for juveniles and caregivers. It contains 21 items with possible scores ranging from 0 (not true at all) to 100 (definitely true). The FAST Goal lists are used in an idiographic and client-guided approach. The first questionnaire in phase A contains the entire FAST Goal list and a follow-up question asks participants to prioritize their top three FAST goals. In the subsequent measurements, only the items measuring the three prioritized goals are administered. Added to these three items, a fourth item measures whether prioritization or goals have changed. If so, the participant is asked to state their new prioritization or goals, and the questions about the new goals are added in the subsequent measurements.
Change in Aggression assessed by the Aggressive Behavior scale of the Youth Self Report (YSR)
时间窗: Twice a week during phase A, up to 5 weeks; every other week during phase B, up to 8 months; weekly during phase C, 6 weeks
The YSR is a self-reported instrument. The Aggressive Behavior scale contains 19 items assessing aggression. Possible scores range from 1 (never) to 100 (always).
Change in Caregiver Responsiveness assessed by the the Responsiveness Scale of the Nijmeegse Parenting Questionnaire (NPQ)
时间窗: T1 (baseline); twice a week during phase A, up to 5 weeks; every other week during phase B, up to 8 months; T2 (post-intervention) up to 9 months; weekly during phase C, 6 weeks
The NPQ is a self-reported instrument for juveniles and caregivers. The the Responsiveness Scale contains eight items with possible scores ranging from 1 (completely disagree) to 100 (completely agree).
次要结局
- Change in Externalizing Behavior assessed with the Child Behavior Checklist (CBCL)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Percentage of Participants with Out of Home Placement assessed using File Analysis(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Delinquency assessed with the Self-Report Delinquent Behavior (SDB)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Caregiver-Adolescent Relationship Quality assessed by the Nijmeegse Parenting Stress Index (NPSI)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Externalizing Behavior assessed by the Youth Self Report (YSR)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Social Support assessed by the Parental Support Questionnaire (PSQ)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Psychological Control assessed by the Psychological Control Scale Youth Self-Report (PCS-YSR)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Personality assessed by the Inventory of Callous-Unemotional Traits (ICU)(T1 (baseline))
- Change in Substance Use assessed with the Peilstation Middelengebruik(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Cognitive Distortions assessed by the Brief Irrational Thoughts Inventory (BITI)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Demographics assessed by a Demographic Information Questionnaire(T1 (baseline))
- Primary Diagnosis assessed by Therapist File Search(T1 (baseline))
- Therapist-Client Alliance assessed by the Relationship with Interventionist(T2 (post-intervention) up to 9 months from baseline)
- Change in Substance Use assessed with the FAST Goal list(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Contact with Deviant Peers assessed with the Basic Peer Questionnaire (BPQ)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Caregiver-Adolescent Relationship Quality assessed by the Inventory of Parent and Peer Attachment (IPPA)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Caregiver Consistency assessed by the Consistency Scale of the Parenting Dimensions Inventory (PDI)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Discipline Practices assessed by the Parenting Dimensions Inventory (PDI)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Treatment Intensity assessed by Therapist File Search(T2 (post-intervention) up to 9 months from baseline)
- Change in Treatment Motivation assessed by the Treatment Motivation Scales for Forensic Outpatient Treatment (TMS-F)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Percentage of Participants with Out of Home Placement assessed using an Out of Home Placement Questionnaire(T2 (post-intervention) up to 9 months)
- Change in Recidivism Risk assessed with the RAF GGZ Youth(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Substance Use assessed with the RAF GGZ Youth(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Behavioral Control assessed by the Parenting Practices(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Parental Monitoring assessed by the Parental Monitoring Scale(T1 (baseline); T2 (post-intervention) up to 9 months)
- Change in Personality assessed by the Narcissism and Impulse Control scales of the Antisocial Process Screening Device (APSD)(T1 (baseline))
- Treatment Completion assessed by Therapist File Search(T2 (post-intervention) up to 9 months from baseline)
- Caregiver Psychopathology assessed by the RAF GGZ Youth(T1 (baseline))
- Change in Caregiver Competence assessed by the Nijmeegse Parenting Stress Index (NPSI)(T1 (baseline); T2 (post-intervention) up to 9 months)
- Treatment Integrity assessed by the FAST Evaluation Forms(T2 (post-intervention) up to 9 months from baseline)
- Treatment Duration assessed by Therapist File Search(T2 (post-intervention) up to 9 months from baseline)
- Treatment Expectancies assessed by the Parent Expectancies for Therapy Scale (PETS)(T1 (baseline))
- Treatment Cooperation assessed by the Cooperation Scale(T2 (post-intervention) up to 9 months from baseline)
研究者
Marjolein van Cappellen
PhD Student
Utrecht University