Systematic Review and Meta-Analysis: Multisystemic Therapy and Functional Family Therapy Targeting Antisocial Behaviour in Adolescence

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dc.contributor.authorHunkin, H.
dc.contributor.authorMalvaso, C.G.
dc.contributor.authorChittleborough, C.R.
dc.contributor.authorGialamas, A.
dc.contributor.authorMontgomerie, A.
dc.contributor.authorFalster, K.
dc.contributor.authorLynch, J.
dc.contributor.authorPilkington, R.M.
dc.date.issued2025
dc.descriptionAvailable online 18 October 2024
dc.description.abstractObjective. Youth criminal justice systems are under growing pressure to reduce re-offending behaviour and support young people’s health and developmental needs. This systematic review and meta-analysis sought to synthesise evidence for two prominent community-based interventions for delinquent and antisocial behaviour, multisystemic therapy (MST) and functional family therapy (FFT). Method. We searched Medline, PsycInfo, Scopus, Web of Science, and Social Services Abstracts for randomised controlled trials (RCTs) and quasi-experimental studies evaluating MST/FFT. Included studies involved participants aged under 18; included interventions targeted delinquent/antisocial behaviour, but not maltreatment. We estimated effect sizes for 6 primary outcomes, synthesising RCTs comparing MST/FFT to usual care using correlated hierarchical effects meta-analysis. We assessed risk of bias and evidence strength using bestpractice tools. Given the additional resources needed to implement MST/FFT, we rated evidence strength against a minimum clinically important difference rather than a null effect. This study is registered with PROSPERO, CRD42021279736. Results. We included 35 studies for MST (16 RCTs meta-analysed comprising 4095 participants, 26% female) and 19 studies for FFT (7 RCTs meta-analysed comprising 1471 participants, 22% female). MST had a likely clinically important effect on time in out-ofhome care, but no clinically important effects on other primary outcomes (delinquency, new offences/convictions, placement in out-of-home care, substance use), with low-to-moderate evidence strength. FFT demonstrated possible clinically important effects for the number of new offences/convictions, time in out-of-home care, and substance use, but evidence strength was low. Conclusion. Contrary to reports in some evidence clearinghouses indicating that MST/FFT are supported by the highest level of evidence strength, there is limited evidence that these interventions are superior to usual care in reducing delinquent and antisocial behaviour in adolescence. These findings should be viewed in the context of important methodological differences with prior reviews, including the rating of evidence strength against a minimum clinically important difference.
dc.description.statementofresponsibilityHugh Hunkin, Catia G. Malvaso, Catherine R. Chittleborough, Angela Gialamas, Alicia Montgomerie, Kathleen Falster, John Lynch, Rhiannon M. Pilkington
dc.identifier.citationJournal of the American Academy of Child and Adolescent Psychiatry, 2025; 64(4):427-446
dc.identifier.doi10.1016/j.jaac.2024.10.008
dc.identifier.issn0890-8567
dc.identifier.issn1527-5418
dc.identifier.orcidHunkin, H. [0000-0003-3306-8450]
dc.identifier.orcidMalvaso, C.G. [0000-0003-1227-5434]
dc.identifier.orcidChittleborough, C.R. [0000-0003-3196-7137]
dc.identifier.orcidGialamas, A. [0000-0001-7440-8154]
dc.identifier.orcidMontgomerie, A. [0000-0002-9620-3894]
dc.identifier.orcidLynch, J. [0000-0003-2781-7902]
dc.identifier.orcidPilkington, R.M. [0000-0001-6974-8496]
dc.identifier.urihttps://hdl.handle.net/2440/143068
dc.language.isoen
dc.publisherElsevier
dc.relation.granthttp://purl.org/au-research/grants/arc/DE200100679
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1187489
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1099422
dc.rights© 2024 Published by Elsevier Inc. on behalf of the American Academy of Child and Adolescent Psychiatry.
dc.source.urihttps://doi.org/10.1016/j.jaac.2024.10.008
dc.subjectadolescent
dc.subjectevidence-based practice
dc.subjectfamily therapy
dc.subjectjuvenile delinquency
dc.subjectproblem behaviour
dc.titleSystematic Review and Meta-Analysis: Multisystemic Therapy and Functional Family Therapy Targeting Antisocial Behaviour in Adolescence
dc.typeJournal article
pubs.publication-statusPublished

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