Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2010 Aug;78(4):537-50.
doi: 10.1037/a0019160.

Randomized trial of MST and ARC in a two-level evidence-based treatment implementation strategy

Charles Glisson  1 , Sonja K Schoenwald, Anthony Hemmelgarn, Philip Green, Denzel Dukes, Kevin S Armstrong, Jason E Chapman
Affiliations
Randomized Controlled Trial

Randomized trial of MST and ARC in a two-level evidence-based treatment implementation strategy

Charles Glisson et al. J Consult Clin Psychol. 2010 Aug.

Abstract

Objective: A randomized trial assessed the effectiveness of a 2-level strategy for implementing evidence-based mental health treatments for delinquent youth.

Method: A 2 x 2 design encompassing 14 rural Appalachian counties included 2 factors: (a) the random assignment of delinquent youth within each county to a multisystemic therapy (MST) program or usual services and (b) the random assignment of counties to the ARC (for availability, responsiveness, and continuity) organizational intervention for implementing effective community-based mental health services. The design created 4 treatment conditions (MST plus ARC, MST only, ARC only, control). Outcome measures for 615 youth who were 69% male, 91% Caucasian, and aged 9-17 years included the Child Behavior Checklist and out-of-home placements.

Results: A multilevel, mixed-effects, regression analysis of 6-month treatment outcomes found that youth total problem behavior in the MST plus ARC condition was at a nonclinical level and significantly lower than in other conditions. Total problem behavior was equivalent and at nonclinical levels in all conditions by the 18-month follow-up, but youth in the MST plus ARC condition entered out-of-home placements at a significantly lower rate (16%) than youth in the control condition (34%).

Conclusions: Two-level strategies that combine an organizational intervention such as ARC and an evidence-based treatment such as MST are promising approaches to implementing effective community-based mental health services. More research is needed to understand how such strategies can be used effectively in a variety of organizational contexts and with other types of evidence-based treatments.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Recruitment and random assignment of youth within counties
Figure 2
Figure 2
MST x ARC interaction effect on CBCL Total Problem T score outcomes at 6 months
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Achenbach TM. Manual for the Child Behavior Checklist/4-18 and 1991 profile. Burlington, VT: University of Vermont Department of Psychiatry; 1991.
    1. Appalachian Regional Commission. Annual Report. Washington, DC: 2000.
    1. Barth RP, Wildfire J, Green RL. Placement into foster care and the interplay of urbanicity, child behavior problems, and poverty. American Journal of Orthopsychiatry. 2006;76(3):358–366. - PubMed
    1. Beeson PG, Britain C, Howell ML, Kirwan D, Sawyer DA. Rural mental health at the millennium. In: Manderscheid RW, Henderson MJ, editors. Mental health, United States, 1998. 1998. pp. 82–97. Vol. DHHS Pub. No. (SMA) 99-3285.
    1. Bjorklund RW, Pippard JL. The mental health consumer movement: Implications for rural practice. Community Mental Health Journal. 1999;35:347–359. - PubMed

Publication types