Summary / Abstract

Title: Multisystemic therapy: an effective violence prevention approach for serious juvenile offenders

Synopsis: This article provides an overview of a treatment approach, Multisystemic Therapy (MST), that hasdemonstrated long-term reductions in criminal activity and violence among youth at high-risk for perpetrating violence.Importantly, central aspects of MST are consistent with the recent public health agenda of violence prevention in the UnitedStates. Moreover, as demonstrated from the findings of controlled clinical trials evaluating MST with serious juvenile offenders,the viability of the public health approach is supported. MST, treatment, youth, violence, Henggeler, prevention, multisystemic therapy, juvenile offenders, public health, clinical trials, risk, adolescents, effectiveness, school, crime, Homer, term reductions, interventions, antisocial behavior, delinquency, criminal activity, social support, controlled clinical trials, primary prevention, public health agenda, incarceration, youth receiving, usual services, deviant peers, substance abuse,

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journal adolescence 1996 19 47 61 multisystemic therapy effective violence prevention approach serious juvenile offenders scott w henggeler phillippe b cunningham susan g pickrel sonja k schoenwald michael j brondino article provides overview treatment approach multisystemic therapy mst demonstrated long term reductions criminal activity violence youth high risk perpetrating violence importantly central aspects mst consistent recent public health agenda violence prevention united states demonstrated findings controlled clinical trials evaluating mst serious juvenile offenders viability public health approach supported 1996 association professionals services adolescents introduction rising tide crime violence america caught youth everexpanding wake american youth intimately acquainted violence perpetrators victims crime statistics show adolescents responsible approximately 29 crime 17 violent crime fbi 1992 commensurate rates offending adolescents high rates victimization homicide emerged second leading cause death adolescents aged 15 34 highest risk non fatal assault cited mercy et al 1993 public outraged escalation youth violence concerned health vitality young mandated done mandate met costly largely ineffective feel good criminal justice initiatives deterrence fear based programs e g shock incarceration programs bootcamps research suggests iatrogenic effects lipsey 1992 henggeler schoenwald 1994 responses politically expedient better policy makers violence epidemic continues largely unabated recently great deal enthusiasm generated placing violence auspices public health attendant emphasis primary prevention reprint requests correspondence concerning article addressed w henggeler department psychiatry behavioral sciences family services research center medical university south carolina 171 ashley avenue charleston sc 29425 0742 u preparation article supported national institute drug abuse grant da 08029 national institute mental health grant mh51852 01a1 0140 1971 96 01004714 12 00 0 1996 association professionals services adolescents 48 w henggeler et al acknowledging violence public health issue refreshing offers new hope mercy et al noted new vision americans work prevent epidemic violence raging society emerged public health community new vision places emphasis preventing violence occurs making science integral identifying effective policies programs integrating efforts diverse scientific disciplines organizations communities sustained effort levels society required successfully address complex deeply rooted problem 1993 pp 8 article provides overview treatment approach multisystemic therapy mst henggeler borduin 1990 demonstrated long term reductions criminal activity violence youth greatest risk perpetrating violence importantly central aspects mst consistent recent public health agenda concerning violence prevention demonstrated findings controlled clinical trials henggeler et al 1992 1993 borduin et al 1995 success mst supports viability public health approach applied serious juvenile offenders public health violence prevention advance public health violence prevention infancy public health approaches previously made significant contributions health related areas preventable diseases smoking unintentional injuries mortality rates contagious infectious diseases motor vehicle injuries chronic diseases associated lifestyles e g smoking heart disease decreased due public health investment commitment prevention mercy et al 1993 proponents envisage investment commitment violence prevention public health community result dramatic substantial reductions rates premature death disability intentional injury caused violence public health approaches assume violence prevented place special emphasis primary prevention mercy et al 1993 primary prevention programs aim prevent violence occurring i e reducing incidence new cases opposed reducing severity duration disorder i e secondary prevention rehabilitating treating i e tertiary prevention perpetrators violence victims violence primary prevention conceptualized proactive opposed reactive leitenberg 1987 historically three strategies public health useful primary prevention albee 1989 first strategy involves identification risk factors e g pathogens noxious agents subsequent interventions designed neutralize eliminate agents second strategy focuses protective factors i e individual environmental characteristics ameliorate buffer person response risk factors strengthen host characteristics increase resistance inoculate pathogen third strategy interventions designed prevent block transmission pathogen host primary prevention entails counteracting risk factors reinforcing protective factors effort neutralize processes contribute human pathology coie et al 1993 mst best conceptualized tertiary secondary prevention immediate application mst shares characteristics primary prevention approaches 49 multisystemic therapy reinforcing protective factors ameliorating addressing systematically factors associated dysfunction antisocial behavior particular mst neutralization risk factors key assumption mst treatment effectiveness rests thorough understanding etiological factors associated antisocial behavior factors explicated multidimensional causal modeling studies e g agnew 1985 elliott et al 1985 patterson dishion 1985 simcha fagan schwartz 1986 fagan wexler 1987 huizinga et al 1993 office juvenile justice delinquency prevention 1993 demonstrate antisocial behaviour multidetermined important correlates pertaining individual e g low cognitive functioning poor social skills family e g low warmth ineffective discipline parental criminal behaviour peers e g association deviant peers school functioning e g poor academic performance dropping community e g criminal subculture comprehensive reviews see kazdin 1987 henggeler 1991 elliott et al 1985 longitudinal evaluation representative national sample adolescents found delinquency predicted directly prior delinquency association deviant peers association deviant peers predicted indirectly family school difficulties study attest multidetermined etiology serious antisocial behavior multidetermined etiology antisocial behaviour adolescents mst interventions individually tailored ameliorate factors systems subsystems i e family peers school community contributing antisocial behavior consequently factors determined attenuate treatment outcome targeted barriers effective parenting high stress low social support parental substance abuse marital problems lack knowledge initial targets mst interventions mst promotion protective factors addition ameliorating risk factors mst empowers parents youth deal effectively independently future difficulties noted rappaport 1981 aim empowerment enhance possibilities individuals control lives empowerment perspective suggests new competencies needed best learned context social ecology rappaport 1981 commensurate empowerment ideology mst treatment goals developed full collaboration youth parents mst interventions emphasize family strengths implemented family environment great deal therapist time initially devoted establishing positive therapeutic alliance parents guardians established interventions designed provide youth parents resources skills needed successfully navigate social ecology focus building competencies e g problem solving skills resources e g social support concrete services e g adequate housing lays foundation stable family functioning life transitions attendant stressors foundation provide 50 w henggeler et al positive long term impact children psychosocial development winett et al 1989 mst blocking social disease entities responsible violence multiple clear related specific biological diseases social circumstances appear fertile breeding conditions violence mentioned strongest predictors violent behavior delinquency association deviant peers factors directly influence association deviant peers low parental monitoring low school integration consequently mst treatment goals provisions increasing parental monitoring severing relationships deviant peers developing relations prosocial peers increasing educational vocational options summary mst common public health agenda violence prevention neutralizing risk factors promoting protective factors blocking transmission noxious agent mst follows social ecological theory behavior recognizes optimal child development result complex interdependent factors traverse multiple levels influence consequently providing prevention strategies flexible comprehensive multifaceted result reduced antisocial behavior target child children family two recent controlled clinical trials mst date mst enjoyed considerable success clinical populations historically recalcitrant treatment effectiveness mst supported clinical trials impoverished inner city juvenile offenders henggeler et al 1986 adolescent sexual offenders borduin et al 1990 maltreating parents brunk et al 1987 success followed extensive clinical trials serious juvenile offenders conducted simpsonville south carolina columbia missouri successes simpsonville columbia led considerable federal funding develop refine mst extension difficult clinical populations i e substance abusing delinquents youth presenting psychiatric emergencies simpsonville south carolina henggeler et al 1992 nimh funded study 84 serious juvenile offenders i e chronic offenders violent offenders referred department youth services dys due imminent risk incarceration youths randomly assigned usual services n 41 e g court ordered curfew school attendance referral community agencies mst n 43 consistent judgement dys youth imminent risk incarceration 47 usual services youth subsequently incarcerated referral 68 incarcerated 59 week follow participants involved extensive criminal activity evidenced average 3 5 previous arrests 9 5 51 multisystemic therapy weeks prior incarceration addition 54 previous arrest violent offense average age participants 15 2 years d 1 4 77 male 56 african american 42 caucasian 2 hispanic american 26 lived biological parent average hollingshead 1975 social status score 25 d 9 i e semiskilled workers results showed mst effective reducing rates criminal behavior ofhome placement post treatment serious offenders mst condition reported significantly criminal offenses counterparts usual services condition 59 week post referral follow youth receiving mst significantly arrests m 0 87 vs 1 52 weeks incarcerated m 5 8 vs 16 2 youth receiving usual services post treatment youth receiving mst reported significantly greater reduction criminal activity youth receiving usual services families receiving mst reported cohesion post treatment reported family cohesion decreased usual services condition addition families receiving mst reported decreased adolescent aggression peers aggression remained youth receiving usual services survival analysis shown figure 1 reveals 2 4 years follow mst approximately doubled survival rate i e percentage youth rearrested serious juvenile offenders henggeler et al 1993 relative efficacy mst moderated demographic characteristics i e race age social class gender arrest incarceration history mediated psychosocial variables i e family relations peer relations social competence behavior problems parental symptomatology 1 0 weeks suvival probabillity 20 0 2 0 8 0 6 0 4 40 60 100 120 figure 1 survival functions multisystemic therapy mst youth usual services youth simpsonville sc project henggeler et al 1993 mst usual services 52 w henggeler et al columbia missouri comprehensive extensive completed evaluation mst date effectiveness mst compared individual therapy participants 200 12 17 year old juvenile offenders families borduin et al 1995 randomly assigned receive mst n 92 n 84 24 families refusing participate treatment condition focused personal family academic issues therapist providing support feedback encouragement behavior change theoretical orientations therapists n 6 psychodynamic e g promoting insight expression feelings client centered e g building close relationship providing empathy warmth behavioral e g providing social approval school attendance positive behaviors approaches borduin et al 1995 juvenile offenders involved extensive criminal activity evidenced average 4 0 previous arrests d 1 3 fact 61 previously incarcerated average age youths 14 7 years d 1 6 67 male 67 caucasian 32 2 african american 65 families characterized low socio1800 1 0 days survival probability 0 6 200 400 600 800 1000 0 0 8 0 2 0 4 1600 1400 1200 figure 2 survival functions multisystem therapy mst completers mst dropouts individual therapy completers dropouts treatment refusers columbia mo project borduin et al 1995 53 multisystemic therapy economic class hollingshead 1975 50 lived two parental figures e g biological parents step foster adoptive parents adult relatives post treatment families receiving mst reported showed observational measures positive changes dyadic interactions families mst families reported increased cohesion adaptability showed increased supportiveness decreased conflict hostility compared families note parents mst group evidenced greater reductions psychiatric symptomatology parents figure 2 reveals youth receiving mst significantly likely rearrested youth receiving individual therapy follow specifically approximately 4 year follow mst completers lower recidivism rates n 77 22 1 mst dropouts n 15 46 6 completers n 63 71 4 dropouts n 21 71 4 treatment refusers n 24 87 5 mst dropouts lower risk rearrest completers dropouts refusers examination recidivists group revealed mst youth arrested follow arrested serious offences youth arrested follow follow data revealed mst youth significantly lower rate substance related arrests youth 4 vs 16 henggeler et al 1991 importantly mst youth likely arrested violent crimes e g rape attempted rape sexual assault aggravated assault assault battery treatment youth summary findings controlled clinical trials provide strong evidence mst produce short term long term reductions criminal behavior serious juvenile offenders mst relatively inexpensive henggeler et al 1992 able reduce home placements findings suggest contrasted clinically effective family based treatment usual services i e incarceration costs fails protect community returning offenders perpetrate higher rates counterparts treated community theoretical clinical features multisystemic therapy believe success mst due distinctive innovative features apart contemporary treatments violence prevention approaches theoretical model mst highly individualized family community based therapeutic approach consistent social ecological models behavior bronfenbrenner 1979 social ecology posits individuals nested complex interconnected systems encompass proximal individual family peer school distal neighborhood community child adolescent service systems social influences behavior seen end product reciprocal interactions individuals interconnected systems nested mst common family systems e g haley 1976 minuchin 1974 conceptualizations behavior emphasize reciprocal interplay child familial relations mst substantive departures traditional family therapies 54 w henggeler et al pertinent acknowledge antisocial behavior maintained dysfunctional transactions interconnected systems combinations thereof outside immediate family b behavior influenced individual child developmental variables cognitive abilities moral reasoning c efficacious intervention particular child nonsystemic e g cognitive therapy behavioral parent training comprehensive services clinical foci mst closely fit multidimensional causal models delinquency utilizes comprehensive strategy case conceptualization treatment henggeler borduin press important aspect mst assessment identifying factors system subsystem promote attenuate irresponsible behavior youth family henggeler et al 1994 information treatment plan developed collaboration family integrates interventions family peers school community systems mst aims provide family total care e g individual family marital therapy peer group interventions case management address barriers attaining treatment goals e g parental substance abuse psychopathology concrete services housing family preservation model service delivery mst implemented family preservation model service delivery model emphasizes providing home based family focused services intensive time limited pragmatic goal oriented services delivered real world settings i e home school neighborhood hope maintaining youths natural environment nelson 1991 delivering services family preservation advantages 1 valid assessment contingencies maintaining antisocial behavior mitigating circumstances attenuate treatment gains 2 enhanced generalization treatment gains addressing factors youth social ecology fostered antisocial behavior promote positive adaptation 3 enhanced maintenance treatment gains linking adaptive prosocial behaviors natural contingencies youth social ecology 4 communication respect partnership therapeutic endeavour 5 promotion family co operation treatment minimization missed appointments treatment specificity treatment specificity accomplished therapists adhering nine intervention principles see henggeler et al 1994 represent fundamental nature mst guidelines mst therapists utilize pragmatic goal oriented strategies based empirical literature techniques derived behavior therapy e g blechman 1985 cognitive behavior therapy e g kendall braswell 1985 comprehensive ecological framework nine intervention principles described clinical case appears conclusion paper 55 multisystemic therapy individualized care light unique strengths weaknesses family therapist mst therapists develop individualized treatment plans specific family strengths ameliorate identified problems attain treatment goals targeting unique contributing factors operative family social ecology increases probability successfully decreasing antisocial behavior empowerment major focus mst empower families providing skills resources needed deal effectively independently future difficulties end treatment focuses facilitating development enduring social support networks parents natural environment e g encouraging rapprochement extended family engagement church community activities time energy devoted empowering youth cope inevitable challenges face negotiate systems nested youth taught requisite skills e g assertiveness training anger management linked academic vocational resources needed long term success accountability hallmark mst emphasis outcome accountability therapists treatment teams supervisor emphasis accountability based tangible evidence behavior change contrasts traditional approaches treatment failures attributed client resistance lack motivation mst therapists expected takes engage family bring enduring change context goals objectives established mutually family therapist henggeler et al 1994 light accountability therapists provided resources achieve favorable outcomes e g low caseloads extensive training supervisory support case consultation attenuate adverse stressors typically encountered treating serious clinical problems e g therapist burn frustration treatment principles clinical case mst flexible individualized treatment approach addresses multiple determinants antisocial behavior youth natural ecology flexibility individualization mst central effectiveness consequently integrated treatment manual largely serves basis ongoing clinical trials henggeler et al 1994 manual specifies nine treatment principles viewed central multisystemic approach principles noted described clinical case operating assumption mst defined adherence principles homer 15 year old caucasian male extensive history delinquent behavior 56 w henggeler et al assault battery intent kill simple assault battery malicious destruction real property trespassing petty larceny contempt court resisting arrest school homer reputation fighting bullying peers expelled seventh grade assaulting classmate cursing teachers homer gang juvenile delinquents affectionately called death row aside criminal record association deviant peers homer extensive history abusing inhalants marijuana alcohol time referral homer recently released 45 day juvenile justice evaluation facility resides mother employed full time history alcohol abuse homer 17 year old sister history crack cocaine dependence recently released state supported treatment facility time referral living boyfriend family maternal uncle lived community refused contact homer due antisocial behavior homer treatment provided masters level therapist adhered mst treatment principles 1 primary purpose assessment understand fit identified problems broader systemic context homer antisocial behavior substance abuse made sense light ecological context first homer deeply committed group deviant peers older street wise families significant antisocial histories homer friends sold drugs drugaddicted father sold guns arrested recently robbing store gun point second homer refused go school spent school days home getting high peers mother reported found house trashed beer cans strewn returned work third homer exhibited attributional biases form attributing hostile intentions attributed peer family members failure comply requests dissing i e disrespectful grounds aggressive fourth homer family lived neighborhood best described crime ridden drug infested fifth homer antisocial behavior substance abuse maintained mother failure monitor consequate behavior homer allowed stay long wanted pretty pleased mother parenting style fit systemic context busy work schedule lacked adequate parenting skills minimal social support low social support linked death husband 3 years previously mother recent death estrangement extended family mother felt inadequate hopeless fearful dealing large threatening substance abusing adolescent help adult male 2 therapeutic contacts emphasize positive systemic strengths levers change number factors contributed homer antisocial behavior strengths identified first homer mother emotionally attached son willing learn new skills initially quite reluctant fearful second family adequate funds adjunctive recreational activities third homer individual skills age 12 age found father dying stroke homer enjoyed sports excelled homer numerous school suspensions expulsions intelligent quite personable homer mother wanted attend high school continue seventh grade homer wanted attend play football 57 multisystemic therapy described subsequently strengths facilitate attainment treatment goals 3 interventions designed promote responsible behavior decrease irresponsible behavior family members mother homer exhibited irresponsible behaviors targeted change mother history covering homer got trouble community undermining natural consequences refused call police found drugs home homer ran away failed provide meaningful consequences misbehavior require age appropriate responsibilities i e household chores homer irresponsible behavior failure comply mother requests school refusal association deviant peers substance abuse addition homer stayed night mother parenting skills lack social supports initially targeted intervention therapy progressed mother able see save homer child loved required consistently monitor whereabouts consequate misbehavior allow experience natural consequences accomplished therapist aligning mother developing mutual goals providing mother assistance support ran away signed order probate court picked similarly mother established developmentally appropriate chores homer complete daily weekly provided appropriate rewards consequences contingent completion mother demanded homer comply family rules meeting curfew completing school assignments disassociating deviant peers end mother homer door key refused allow house curfew actually put house continued associate drug peers aversive consequences failed therapist readily accessible mother daily contact person telephone pager implemented new strategies 4 interventions present focused action oriented targeting specific defined problems collaboration mother teachers coaches probation staff specific problems targeted change 1 separating antisocial peers 2 eliminating drug alcohol 3 curfew 4 attending school completing assignments 5 completing household chores likewise mother support therapist 1 closely monitor homer whereabouts peer associations school performance 2 provide consequences inappropriate behavior rewards appropriate behavior 5 interventions target sequences behavior multiple systems noted interventions focused mother capacity interact effectively son importantly mother social network enhanced provide ongoing support needed deal effectively son specifically support therapist mother actively involved church activities elicited brother help support addition establishing working relationships school personnel mother communicated weekly concerning son school performance behavior 6 interventions developmentally appropriate fit development needs youth homer 15 years age required considerable family support encouragement light age large physical size fact 58 w henggeler et al seventh grade mother therapist convinced school personnel allow homer advance ninth grade play football homer athletic prowess interest sports intelligence increased probability intervention succeed felt therapist treatment team re entry school admittance ninth grade serve 1 structure homer school hours 2 increase school bonding 3 increase association prosocial peers school needed convinced homer improve academic behavioral performance allowed participate sports small accomplishment high school principal wrote assistant superintendent school district letter seeking block homer admittance due past failure assaultive behavior clearly school needed reassurance students staff safe homer attending consequently mother therapist assured principal assistant superintendent event homer difficulties come school moment notice difficulties firmly addressed 7 interventions designed require daily weekly effort family members homer provided mother ample opportunities practice new parenting skills mentioned mother assigned chores monitored completion daily completed provided rewards homer required report daily whereabouts mother leaving notes calling home addition mother therapist routinely called homer teachers check behavior academic progress initially therapist called mother daily offer encouragement monitor progress completing assignments event mother follow failed efforts therapist reframed failure opportunity practice reinforced successive approximations desired behavior 8 intervention efficacy evaluated continuously multiple perspectives aspects aforementioned treatment tasks evaluated multiple perspectives i e homer mother school personnel coaches therapist rely solely positive verbal reports homer mother obtained reports school personnel probation staff addition therapist observed periodically homer classroom behavior interactions football practice 9 interventions designed promote treatment generalization longterm maintenance therapeutic change mother decision provide homer natural consequences monitor whereabout school behavior enroll ninth grade high school football provide age appropriate expectations enhance social support network i e rapprochement extended family members school personnel provided ecological context homer path positive psychosocial development enrolled high school making b grades star junior varsity football players plans play basketball baseball upcoming year sports activities provided homer predominantly prosocial peer group substantial opportunities obtain social approval mother school personnel consequently expressed interest seeing gang members feel urge hurt i feel bad gained new sense self worth positive feedback gets mother fellow students concomitantly mother successful gaining control house evinced greater sense empowerment affect brighter developed closer relationship adjusted brother begun spend time 59 multisystemic therapy homer addition homer home school environments nurturing adversarial aggressive violent acting eliminated problems arise school home addressed quickly mother established personal relations homer teachers principal taken special interest summary mst interventions homer opportunity responsible citizen previous behavior academic failure assuring life crime violence addiction minimal subsistence successful outcome accomplished applying multifaceted approach assessment treatment addressing unique factors surrounding homer antisocial behavior empowering homer mother providing treatment directly social ecology conclusion evidenced clinical trials exemplified homer case mst offers two opportunities prevent violence first youths engage serious antisocial behavior engage behaviors place high risk criminal victimization e g carrying weapons mercy et al 1993 consequently criminal victimization reduced changing high risk behavior patterns carrying weapons staying night associating gang members second perpetration violence reduced successfully targeting high risk youth families responsible vast majority crimes communities wolfgang et al 1972 west farrington 1973 huesmann et al 1984 moore 1993 noted limit commit violence crime career great deal violence prevented violence comes offenders persistent active p 37 light broad range psychosocial difficulties exhibited serious juvenile offenders cost society violence prevention strategies relatively complex recognize multiple determinants behavior target youth greatest risk commiting acts help stem tide references agnew r 1985 social control theory delinquency longitudinal test criminology 23 47 61 albee g w 1989 primary prevention public health problems challenges behavior change prevention primary prevention aids psychological approaches mays v m et al eds newbury park sage blechman e 1985 solving child behavior problems home school champaign il research press borduin c m henggeler w blaske d m stein r 1990 multisystemic treatment adolescent sexual offenders international journal offender therapy comparative criminology 34 105 113 borduin c m mann b j cone l t henggeler w fucci b r blaske d m williams r 1995 multisystemic treatment serious juvenile offenders long term prevention criminality violence journal consulting clinical psychology 63 569 578 bronfenbrenner u 1979 ecology human development experiments nature design cambridge ma harvard university press 60 w henggeler et al brunk m henggeler w whelan j p 1987 comparison multisystemic therapy parent training brief treatment child abuse neglect journal consulting clinical psychology 55 171 178 coie j d watt n f west g hawkins j d asarnow j r markman h j ramey l shure m b long b 1993 science prevention conceptual framework directions national research program american psychologist 48 1013 1022 elliott d huizinga d ageton 1985 explaining delinquency drug beverly hills ca sage fagan j wexler 1987 family origins violent delinquents criminology 25 643 669 federal bureau investigation 1992 uniform crime reports u 1991 washington d c u government printing office haley j 1976 problem solving therapy san francisco jossey bass henggeler w 1991 multidimensional causal models delinguent behavior thie implications treatment r cohen w siegel eds context development hillsdale nj lawrence erlbaum henggeler w borduin c m 1990 family therapy multisystemic approach treating behavior problems children adolescents pacific grove ca brooks cole henggeler w borduin c m press multisystemic treatment juvenile offenders families forthcoming chapter family home based services schwartz i m ed lincoln ne university nebraska press henggeler w borduin c m melton g b mann b j smith l hall j cone l fucci b r 1991 effects multisystemic therapy drug abuse serious juvenile offenders progress report two outcome studies family dynamics addiction quarterly 1 40 51 henggeler w melton g b smith l 1992 family preservation multisystemic therapy effective alternative incarcerating serious juvenile offenders journal consulting clinical psychology 60 953 961 henggeler w melton g b smith l schoenwald k hanley j h 1993 family preservation multisystemic treatment long term follow clinical trial serious juvenile offenders journal child family studies 2 283 293 henggeler w rodick j d borduin c m hanson c l watson m urey j r 1986 multisystemic treatment juvenile offenders effects adolescent behavior family interaction developmental psychology 22 132 141 henggeler w schoenwald k 1994 boot camps juvenile offenders say journal child family studies 3 243 248 henggeler w schoenwald k pickel g brandino m j borduin c m hall j 1994 treatment manual family preservation multisystemic therapy charleston sc south carolina health human services finance commission hollingshead b 1975 four factor index social status unpublished manuscript yale university department sociology new haven huesmann l r lefkowitz m m eron l d walder l o 1984 stability aggression time generations developmental psychology 20 1120 1134 huizinga d esbensen f van kammen w b thornberry t p 1993 epidemiology d huizinga r loeber t p thornberry eds urban delinguency technical report office juvenile justice delinguency prevention u department justice washington d c kazdin e 1987 treatment antisocial behavior children current status future directions psychological bulletin 102 187 203 kendall p c braswell l 1985 cognitive behavioral therapy impulsive children new york guilford kendall p c braswell l 1993 cognitive behavioral therapy impulsive children 2nd edn new york guilford leitenberg h 1987 primary prevention delinquency prevention delinquent behavior vol x primary prevention psychopathology burchard j d burchard n eds new york sage lipsey m w 1992 effects treatment juvenile delinquents results meta analysis paper presented nimh meeting research prevent youth violence bethesda md 61 multisystemic therapy mercy j rosenberg m l powell k e broome c v roper w l 1993 public health policy preventing violence health affairs 12 7 29 minuchin 1974 families family therapy cambridge ma harvard university press moore m h 1993 violence prevention criminal justice public health health affairs 12 34 45 nelson k e 1991 populations outcomes five family preservation programs family preservation services research evaluation k wells d e biegel eds newbury park ca sage office juvenile justice delinquency prevention 1993 urban delinquency substance abuse technical report office justice programs washington dc u department justice patterson g r dishion t j 1985 contributions families peers delinquency criminology 23 63 79 rappaport j 1981 praise paradox social policy empowerment prevention american journal community psychology 9 1 25 simcha fagan o schwartz j e 1986 neighborhood delinquency assessment contextual effects criminology 24 667 703 west d j farrington d p 1973 delinquent london heinemann winett r riley w king c altman d g 1989 prevention mental health proactive development ecological perspective handbook child psychopathology ollendick t h hersen h eds new york plenum wolfgang m e figlio r m sellin t 1972 delinquency birth cohort chicago university chicago press, com_apnet_jado_jado_1996_0005, KnowledgeStor, Knowledge-Stor,