Home-based multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis: Clinical outcomes

Objective: The primary purpose of this study was to determine whether multi systemic therapy (MST), modified for use with youths presenting psychiatric emergencies, can serve as a clinically viable alternative to inpatient psy chiatric hospitalization. Method: One hundred sixteen children and adolesce nts approved for emergency psychiatric hospitalization were randomly assign ed to home-based MST or inpatient hospitalization. Assessments examining sy mptomatology, antisocial behavior, self-esteem, family relations, peer rela tions, school attendance, and consumer satisfaction were conducted at 3 tim es: within 24 hours of recruitment into the project, shortly after the hosp italized youth was released from the hospital (1-2 weeks after recruitment) , and at the completion of MST home-based services (average of 4 months pos trecruitment). Results: MST was more effective than emergency hospitalizati on at decreasing youths' externalizing symptoms and improving their family functioning and school attendance. Hospitalization was more effective than MST at improving youths' self-esteem. Consumer satisfaction scores were hig her in the MST condition. Conclusions: The findings support the view that a n intensive, well-specified, and empirically supported treatment model, wit h judicious access to placement, can effectively serve as a family-and comm unity-based alternative to the emergency psychiatric hospitalization of chi ldren and adolescents.