Absence of conflict of interest.
Citation
Highlights
- The study’s objective was to examine the impact of the Multisystemic Therapy for Emerging Adults (MST-EA) on employment outcomes.
- The study was a randomized controlled trial that assigned participants to either multisystemic therapy with a vocationally enhanced coach (treatment) or without (control). Using interview data, the authors conducted statistical tests to examine differences in outcomes between the groups.
- The study did not find any significant differences in employment between the treatment and control groups.
- The quality of causal evidence presented in this report is high. This means we would be confident that the estimated effects were attributable to the multisystemic therapy with vocational coaching, and not to other factors. However, the study did not find any significant effects.
Intervention Examined
Multisystemic Therapy for Emerging Adults (MST-EA)
Features of the Intervention
Mutlisystemic therapy (MST) is a community and family-based intervention that attempts to assist in reducing recidivism among delinquent youths aged 12-17 years. Multisystemic Therapy for Emerging Adults (MST-EA) was adapted from the MST and applied to emerging adults with a serious mental health condition and recent arrest or reentry from previous incarceration. MST-EA provided support for mental illness, promoted gainful activity (including school, work, housing, and positive relationships) and assisted in working through substance use. The program included vocational coaches to help teach life skills and engage participants in social activities. Also, vocational coaches used an additional vocational curriculum developed by MST-EA clinical supervisors to further develop skills for employment and education. On average, the program lasted for 7-8 months with sessions occurring in-person or over the phone, multiple times during the week. Therapists were available 24/7 and used cognitive behavioral therapy, behavioral and motivational interviewing, and educational skill building. The vocational coaches met with participants twice a week for a one-hour session each. The program served recently arrested or recently incarcerated individuals aged 17-20 with a diagnosed mental health condition, including individuals with a mood, anxiety, and/or psychotic disorder.
Features of the Study
This study was a randomized controlled trial that assigned participants to MST-EA with a vocationally enhanced coach (treatment group) or without (control group). Participants were recruited from case management services through child welfare or mental health services or through juvenile or adult system services. Participants had a recent arrest or incarceration, mood/anxiety disorder or psychotic disorder and stable housing. The sample included 32 individuals between 17-20 years old, with an average age of 18 years. The majority of participants were male (78 percent) and were of a minority racial or ethnic background (70 percent). After a baseline interview, participants were randomly assigned to one of two study groups. Half of the participants (16) were assigned to the treatment group with vocational coaches who worked within the multisystemic therapy model with no access to the state vocational rehabilitation program and the remaining 16 participants were assigned to the control group and received standard coaches who did not use vocational skills within the multisystemic therapy model. If employment were an interest to control participants, they were linked to the state vocational rehabilitation agency to provide vocational support. Data were collected through an in-person baseline interview, monthly phone interviews during treatment, and one- and four-month in-person follow up interviews. In-person interviews were conducted at the participants' home or a location of their choosing. The authors used statistical models to compare outcomes between the treatment and control groups.
Findings
Employment
- The study did not find any significant differences in employment between treatment and control participants at the four-month follow up.
Considerations for Interpreting the Findings
Study authors noted that one participant completed their one-month follow up interview but did not complete their four-month follow up. This participant’s data was included in the four-month follow up data and study authors did not identify if this participant was in the vocational coaching group or the standard coaching group.
Causal Evidence Rating
The quality of causal evidence presented in this report is high because it was based on a well-implemented randomized controlled trial. This means we would be confident that any estimated effects would be attributable to Multisystematic therapy with vocational coaching and not to other factors. However, the study did not find any significant effects.