MULTISYSTEMIC THERAPY WITH VIOLENT AND CHRONIC JUVENILE-OFFENDERS ANDTHEIR FAMILIES - THE ROLE OF TREATMENT FIDELITY IN SUCCESSFUL DISSEMINATION

The effects of multisystemic therapy (MST) in treating violent and chr onic juvenile offenders and their families in the absence of ongoing t reatment fidelity checks were examined. Across 2 public sector mental health sites, 155 youths and their families were randomly assigned to MST versus usual juvenile justice services. Although MST improved adol escent symptomology at posttreatment and decreased incarceration by 47 % at a 1.7-year follow-up, findings for decreased criminal activity we re not as favorable as observed on other recent trials of MST. Analyse s of parent, adolescent, and therapist reports of MST treatment adhere nce, however, indicated that outcomes were substantially better in cas es where treatment adherence ratings were high. These results highligh t the importance of maintaining treatment fidelity when disseminating complex family-based services to community settings.