This project entails to gain a deeper understanding of the development of treatment motivation over the course of intramural and outpatient forensic youth care. Research questions are 1) How does treatment motivation of youth and parents develop over the course of forensic systemic therapy, and following the transition from inpatient to outpatient therapy?; 2) Which client factors, interpersonal factors, and contextual characteristics moderate the development of treatment motivation?; 3) Which mechanisms play a role in the development of treatment motivation?; and 4) How does treatment motivation affect treatment retention and the achievement of primary therapy goals?
Multidimensional Family Therapy (MDFT) has been shown to motivate youth and parents in forensic care for treatment. The current study will investigate the development of treatment motivation of youth and parents over the course of MDFT, offered in a juvenile justice center. Furthermore, mechanisms and moderators will be examined, in addition to the impact of treatment motivation on treatment retention and goal achievement. Two studies with a Multiple Case Experimental Design (MCED), one with an ABC design (A = baseline, B = residential MDFT, and C = outpatient MDFT) and one with an AB design, will be conducted. Juveniles who enter residential MDFT, during a short detention period (study 1; 10 cases) or during a longer detention period (study 2; 6 cases) will be recruited, as will their parents.
Study Type
OBSERVATIONAL
Enrollment
16
Multidimensional family therapy is a manualized,evidence-based, intensive intervention program with assessment and treatment modules focusing on four areas: (a) the individual adolescents' issues regarding substance use disorder, delinquency, and comorbid psychopathology, (b) the parents' child-rearing skills and personal functioning, (c) communication and relationship between adolescent and parent(s), and (d) interactions between family members and key social systems (Liddle, 2002).
JJC Teylingereind
Sassenheim, Netherlands
RECRUITINGTreatment motivation youth perspective (validated questionnaires)
Treatment Motivation Questionnaire for Adolescents (van der Helm et al., 2013; van der Helm et al., 2018; 5-point Likert scale ranging from 1 (completely disagree) to 5 (completely agree), with a higher score indicating more motivation for treatment; Cooperation Scale (Tolan et al., 2002; 5-point Likert scale ranging from 1 (completely disagree) to 5 (completely agree. A higher total score indicates more motivation for treatment).
Time frame: at least 5 times during phase A (2-6 weeks); every other week during phase B (1-9 months; at least 5 assessments), at least 5 times during phase C (1-3 months).
Treatment motivation caregiver perspective (validated questionnaires)
Parent Motivation Inventory (Nock \& Photos, 2006); Cooperation Scale (Tolan et al., 2002). Participants respond on a 5-point Likert scale on both questionnaires ranging from 1 (completely disagree) to 5 (completely agree). Higher total scores indicate more motivation for treatment.
Time frame: at least 5 times during phase A (2-6 weeks); every other week during phase B (1-9 months; at least 5 assessments), at least 5 times during phase C (1-3 months).
Treatment motivation therapist perspective (validated questionnaires)
Cooperation Scale (Tolan et al., 2002; 5-point Likert scale ranging from 1 (completely disagree) to 5 (completely agree). A higher score indicates more motivation for treatment).
Time frame: every other week during phase B (1-9 months; at least 5 assessments), at least 5 times during phase C (1-3 months).
Treatment motivation (qualitative data)
Youth/Caregivers: semi-structured interview
Time frame: Youth/Caregivers: at the end of each phase (A (after 2-6 weeks), B (after 1-9 months) and C (after 1-3 months))
Therapeutic alliance youth perspective
Session Rating Scale (SRS; Duncan et al., 2003). The SRS is scored by adding the total of the client's marks on the four 10-cm lines, with a higher total score indicating a stronger alliance.
Time frame: every other week during phase B (1-9 months; at least 5 assessments), at least 5 times during phase C (1-3 months).
Therapeutic alliance caregiver perspective
Session Rating Scale (Duncan et al., 2003). The SRS is scored by adding the total of the client's marks on the four 10-cm lines, with a higher total score indicating a stronger alliance.
Time frame: every other week during phase B (1-9 months; at least 5 assessments), at least 5 times during phase C (1-3 months).
Sense of competence youth perspective
Basic Psychological Need Satisfaction and Frustration Scale (Chen et al., 2015), subscales Competence Satisfaction and Competence Frustration. Participants respond on a 5-point Likert scale ranging from 1 (completely disagree) to 5 (completely agree). A higher total score indicates a higher sense of competence.
Time frame: at least 5 times during phase A (2-6 weeks); every other week during phase B (1-9 months; at least 5 assessments), at least 5 times during phase C (1-3 months).
Sense of competence caregiver perspective
Basic Psychological Need Satisfaction and Frustration Scale (Chen et al., 2015), subscales Competence Satisfaction and Competence Frustration. Participants respond on a 5-point Likert scale ranging from 1 (completely disagree) to 5 (completely agree). A higher total score indicates a higher sense of competence.
Time frame: at least 5 times during phase A (2-6 weeks); every other week during phase B (1-9 months; at least 5 assessments), at least 5 times during phase C (1-3 months).
Aggression and rule-breaking behavior youth perspective
Youth Self Report (YSR; Achenbach, 1991), subscale aggression and rule-breaking behavior. Youth complete the YSR by rating their behavior on a three-point scale for the 30 items in this subscale. Specifically, the child rates the behavioral symptoms as '0' if not present, a '1' if the child sometimes exhibits the symptom and '2' if the child frequently demonstrates the symptom. A higher total score indicates more aggression and rule breaking behavior.
Time frame: The complete subscale is administered in phase A (2-6 weeks), every other week during phase B (1-9 months) and C (1-3 months) the (3-5) items reflecting the most severe problems are selected.
Aggression and rule-breaking behavior caregiver perspective
Child Behavior Checklist (CBCL; Achenbach, 1991), subscale aggression and rule-breaking behavior. Parents complete the CBCL by rating their children on a three-point scale for the 30 items in this subscale. Specifically, a parent rates the behavior as a '0' if it is not present, a '1' if the child sometimes exhibits the symptom, and a '2' if the child frequently demonstrates the symptom. A higher total score indicates more aggression and rule breaking behavior.
Time frame: The complete subscale is administered in phase A (2-6 weeks), every other week during phase B (1-9 months) and C (1-3 months) the (3-5) items reflecting the most severe problems are selected.
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