The aim of this study is to investigate the effectiveness of MST-ID for adolescents with severe behavioural problems from families with an intellectual disability (ID), compared to standard MST. It is hypothesised that MST-ID (n = 150 families) is…
ID
Source
Brief title
Condition
- Personality disorders and disturbances in behaviour
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary parameter is rule-breaking behaviour of adolescents. This parameter
is primarily considered from the parental perspective, using the Child Behavior
Check List (CBCL; Achenbach & Rescorla, 2001) as answered by parents, and
additionally from the adolescent perspective, using the Youth Self Report (YSR;
Achenbach & Rescorla, 2001) as answered by adolescents.
Secondary outcome
The secondary parameters are: 1. Externalising and internalising behavioural
problems of adolescents; 2. Parenting stress; 3. Out-of-home placement; 4.
Delinquency; 5. Schoolgoing or employment; 6. Addictions; 7. Social network; 8.
Instrumental outcomes. For the parameter 'Externalising and internalising
behavioural problems of adolescents', the CBCL (6-17; Achenbach & Rescorla,
2001) as answered by parents and the YSR (Achenbach & Rescorla, 2001) as
answered by adolescents are used. For the parameter 'Parenting stress', the
Parenting Stress Questionnaire (OBVL; Vermulst et al., 2012) is used as
completed by parents. For the parameters 'Out-of-home placement',
'Delinquency', 'Schoolgoing or employment', 'Addictions', 'Social network', and
'Instrumental outcomes' which all concern the adolescent and/or parents, the
Social Demographic Information (SDI 3.0; Praktikon/MST-Netherlands/Belgium,
2022) is used as completed by the therapist (sometimes in cooperation with
parents). Finally, the parameter 'Experiences of families receiving MST-ID'
will be assessed in the qualitative part of the study.
Background summary
Over the years, a large body of research has shown that adolescents with
intellectual disability are 3-4 times more likely to develop severe behaviour
problems than adolescents without intellectual disability. Families in which
adolescents and/or one or both parent(s) have an intellectual disability (from
now on, families with ID) often deal with complex problems, putting the
adolescent at an increased risk of out-of-home placement. Multisystemic therapy
(MST) is an intensive home-based treatment, effective in reducing severe
behaviour problems and preventing the out-of-home placement of adolescents. A
specialisation of MST has been developed for families with ID: MST-ID. In
MST-ID, among other alterations, simplified language and visual support is
used, sessions are more structured and more time is scheduled for practicing
exercises, and extra attention is paid to the generalisation of what has been
learned in the sessions (with the aim of attaining long-term outcomes). Pilot
studies show that when compared to standard MST, MST-ID shows similar or better
treatment outcomes in families with adolescents with ID. Meanwhile, MST-ID has
been disseminated more widely and the target population extended by including
families in which only the parent(s) have an ID.
Study objective
The aim of this study is to investigate the effectiveness of MST-ID for
adolescents with severe behavioural problems from families with an intellectual
disability (ID), compared to standard MST. It is hypothesised that MST-ID (n =
150 families) is more effective - in terms of fewer behavioural problems, more
adolescents living at home, being in school/work, no new police contacts, less
parenting stress - than regular MST (n = 150 families). Treatment outcomes are
considered both quantitatively and qualitatively.
Study design
For the quantitative part, the Propensity Score (PS) method is used to balance
treatment groups. This is combined with Multilevel Modelling (MLM) to estimate
treatment effect over time. For the qualitative part, the experiences of
approximately 10 adolescents and/or parents are centralised. The qualitative
research methods will be decided upon in a participatory manner with
respondents. Examples of potential research methods are interviews, focus group
discussions, or photo elicitation.
Intervention
Following standard referral procedures, families were either referred to
standard MST or MST-ID treatment (i.e., non-randomly). Both standard MST and
MST-ID are intensive, home-based treatments with 3-5 home visits per week,
targeting the severe behavioural problems of adolescents across multiple life
domains. MST-ID is tailored to the needs and skill deficits of adolescents
and/or parents with ID. Concretely, more attention is paid to how therapists
create engagement, implement interventions, and realise support from informal
supports, in a tailored, developmentally appropriate, and simplified manner
(meaning in a more structured way and using accessible language, among others),
when compared to standard MST.
Study burden and risks
No specific risks are associated with this study. MST(-ID) treatments have been
implemented in the Netherlands over ten years ago, showing medium to large
effect sizes in various studies. Therefore, both treatments can be expected to
be effective. Most questionnaires that are used in this study are part of
routine outcome monitoring procedures. For the purpose of this study*s aims,
two questionnaires were added to the baseline measurement (with a maximum
duration of 30 minutes).
De Beeklaan 2
Halsteren 4661EP
NL
De Beeklaan 2
Halsteren 4661EP
NL
Listed location countries
Age
Inclusion criteria
1. Adolescent must be 10 to 19 years old at the start of treatment;
2. Adolescent presents with severe behavioural problems in at least two life
areas;
3. Adolescent lives with a family or there is a family the adolescent can live
with, in which parent(s) have parental custody for a longer period of time;
4. Parent(s) consent(s) and is/are willing to engage in treatment to prevent an
out-of-home placement of the adolescent;
5. A known or suspected intellectual disability (operationalised as an
intelligence quotient [IQ] score of between 50-85 and additional deficits in
adaptive functioning) in the adolescent and/or parent(s);
6. Have sufficient knowledge of the Dutch language (as assessed by a clinician
and/or researcher) in order to understand and answer the various (self-report)
questionnaires. This pertains to adolescents as well as parent(s).
Exclusion criteria
1. Adolescent lives independently; 2. Adolescent presents with severe
problematic sexual behaviours, without presenting with other severe behavioural
problems; 3. Adolescent presents suicidal, psychotic, or homicidal requiring
specialised treatment (such as a crisis placement in a residential facility);
4. Adolescent has a severe Autism Spectrum Disorder (level 2-3 according to the
DSM-V criteria) or a severe ID (IQ score lower than 50); 5. Adolescent has
internalising psychiatric problems which are the primary reason for referral,
or has serious psychiatric problems (similar to #3 as well as for example
eating disorder; Henggeler et al., 2009).
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL84030.078.23 |