Evidence-Based Practice Outcomes for Youth Involved in the Juvenile Justice System

Background and Purpose: Since 2009 the Maryland Department of Juvenile Services (DJS) has significantly increased the availability of Evidence-Based Programs (EBPs), especially Multisystemic Therapy (MST) and Functional Family Therapy (FFT), in order to reduce recidivism as well as the use of out-of-home placements for youth across the State. While MST and FFT have proven to be efficacious for this population in controlled trials (Schaeffer & Borduin, 2005; Gordon et al., 1998), little research has assessed youth outcomes in systems that have significantly scaled up these services. The RE-AIM evaluation framework includes two domains to assess impact on program participants—effectiveness of the intervention in attaining intended outcomes and maintenance of positive effects over time. Accordingly, this study addresses two main research questions:

1. What is the impact of participation in MST and FFT on out-of-home placement, school/vocational participation, and reoffending as of program discharge (effectiveness)?
2. Are intervention outcomes (i.e., recidivism and out-of-home placement) sustained one year after discharge, relative to a matched sample of youth who did not receive an EBP (maintenance)?

Method: Data used in this study include EBP provider data, which contain information about referrals, admissions, and discharges for youth referred to EBP, as well as DJS administrative and assessment data. The study sample consisted of 293 DJS-involved youth who were discharged from MST or FFT between July 2009 and June 2010. A comparison sample of 314 demographically-similar youth (e.g., matched on race, gender, age, location, and referral history), who were under DJS supervision and discharged from a group home during the same time frame, was utilized to assess long-term outcomes. Short-term outcomes included whether the youth was residing in the home, attending school and/or working, and remained arrest-free as of discharge. Long-term outcomes included separate measures for whether youth had a new arrest, conviction, and placement as of one year post discharge.

Results: At discharge, the majority of youth who participated in MST and FFT were living at home, participating in school or employment, and remained arrest-free. While there were no significant differences in new arrest rates between EBP and comparison youth in the year following discharge, EBP participants were significantly more likely to have a new conviction. EBP participants were significantly less likely to be admitted to a new residential placement than comparison youth during the one year follow-up period.

Conclusions and Implications: Findings from these analyses regarding the short-term effectiveness of MST and FFT are promising. However, results for the maintenance of outcomes over time were mixed. Taken as a whole, the results of this study suggest that MST and FFT may be viable program alternatives to out-of-home placements for youth under DJS supervision. One limitation of this study is that data were obtained with a sample of youth during the early phases of EBP scale-up.  Prior to the presentation in San Diego, the current analyses will be replicated using updated cohorts to examine whether outcomes improve as the programs are better implemented over time.