One-year follow-up of multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis

J Am Acad Child Adolesc Psychiatry. 2003 May;42(5):543-51. doi: 10.1097/01.CHI.0000046834.09750.5F.


Objective: This study presents findings from a 1-year follow-up to a randomized clinical trial comparing multisystemic therapy (MST), modified for use with youths presenting psychiatric emergencies, with inpatient psychiatric hospitalization.

Method: One hundred fifty-six children and adolescents approved for emergency psychiatric hospitalization were randomly assigned to home-based MST or inpatient hospitalization followed by usual services. Assessments examining mental health symptoms, out-of-home placement, school attendance, and family relations were conducted at five times: within 24 hours of recruitment, shortly after the hospitalized youth was released from the hospital (1-2 weeks after recruitment), at the completion of MST (average of 4 months postrecruitment), and 10 and 16 months postrecruitment.

Results: Based on placement and youth-report measures, MST was initially more effective than emergency hospitalization and usual services at decreasing youths' symptoms and out-of-home placements and increasing school attendance and family structure, but these differences generally dissipated by 12 to 16 months postrecruitment. Hospitalization produced a rapid, but short-lived, decrease in externalizing symptoms based on caregiver reports.

Conclusion: Findings suggest that youths with serious emotional disturbance might benefit from continuous access to a continuum of evidence-based practices titrated to clinical need.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adolescent Health Services
  • Child
  • Combined Modality Therapy
  • Crisis Intervention*
  • Ethnic Groups
  • Female
  • Follow-Up Studies
  • Home Care Services*
  • Hospitalization*
  • Humans
  • Length of Stay
  • Male
  • Mental Disorders / therapy*
  • Self Concept
  • Treatment Outcome