Multisystemic Therapy - Building Stronger Families (MST-BSF): Substance misuse, child neglect, and parenting outcomes from an 18-month randomized effectiveness trial

• Published in: Child abuse & neglect Vol. 122; p. 105379
• Main Authors: Schaeffer, Cindy M., Swenson, Cynthia Cupit, Powell, Jennifer Smith
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.12.2021; Elsevier Science Ltd
• Subjects: Abused children; Addiction; Alcohol abuse; Alcohol use; Child; Child Abuse; Child abuse & neglect; Child Abuse - prevention & control; Child maltreatment; Child Neglect; Child Protective Services; Child Rearing; Child welfare; Childrearing practices; Children; Clinical research; Clinical trials; Community-based programs; Drug abuse; Effectiveness; Families & family life; Family (Sociological Unit); Humans; Intervention; Multisystemic therapy; Narcotics; Opioids; Parenting; Parents & parenting; Psychotherapy; Recruitment; Resistance (Psychology); Substance abuse; Substance misuse; Substance-Related Disorders - therapy; Therapists; Trauma; Treatment methods; Treatment outcomes; United States > US; Connecticut; Addiction; Multisystemic therapy; Substance misuse; Child maltreatment; Trauma; Opioids
• ISSN: 0145-2134; 1873-7757
• DOI: 10.1016/j.chiabu.2021.105379

Parental substance misuse impacts millions of children globally and is a major determinant of repeat maltreatment and out-of-home placement. There is little published research on family-based, comprehensive treatment models that simultaneously address parental substance misuse and child maltreatment. This study reports outcomes from a randomized clinical trial examining the effectiveness of the Multisystemic Therapy – Building Stronger Families (MST-BSF) treatment model with families involved with Child Protective Services due to physical abuse and/or neglect plus parental substance misuse. Ninety-eight families who had an open case with Child Protective Services in two areas of the state of Connecticut participated. Families referred by the Connecticut Department of Children and Families were randomly assigned to MST-BSF or Comprehensive Community Treatment (CCT). Both interventions were delivered by community-based therapists. Outcomes were measured across 5 assessments extending 18 months post-baseline. Intent-to-treat analyses showed that MST-BSF was significantly more effective than CCT in reducing parent self-reported alcohol and opiate use and in improving child-reported neglectful parenting. Although means were in predicted directions, new incidents of abuse across 18 months did not differ between groups. The study features high recruitment and engagement rates for a population experiencing multiple involvements with child protection. The outcomes of this study support the effectiveness of MST-BSF, an intensive family- and ecologically- based treatment, for significantly reducing parental alcohol and opiate misuse and child neglect. These findings help in our understanding of how best to address the understudied issue of interventions for child neglect.