OBJECTIVE: This study examined the effects of an innovative treatment
model that was designed to reduce treatment dropout among substance abusing
or dependent juvenile offenders. METHOD: One hundred eighteen delinquents
who met diagnostic criteria for substance abuse or dependence were randomly
assigned to receive either home-based multisystemic therapy (N=58) or
treatment that was provided by the usual community services (N=60).
RESULTS: In the multisystemic therapy condition, 98% (N=57) of the families
completed a full course of treatment, which lasted an average of 130 days.
In contrast, 78% (N=47) of the families assigned to treatment through the
usual community services received no mental health or substance abuse
treatment in the 5 months after referral. CONCLUSIONS: The serious and
long-standing problem of high dropout rates in the substance abuse field
can be greatly attenuated by services that increase accessibility and place
greater responsibility for engagement on service providers.