MOTIV8 - Treatment Motivation in Forensic Youth Treatment

Motiv8: Examining Treatment Motivation Among Youth and Parents in Forensic Treatment

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?

Study Overview

• Status: Recruiting
• Conditions: Motivation
• Intervention / Treatment: Behavioral: Multidimensional Family Therapy

Detailed Description

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 (Estimated): 16

Contacts and Locations

• Study Contact: Name: Hanneke E Creemers; Phone Number: +31 (0)6 55 40 28 94; Email: h.e.creemers@uva.nl
• Study Contact Backup: Name: Jet Westerveld; Email: j.westerveld@uva.nl

Study Locations

• Netherlands
  • Sassenheim, Netherlands
    • Recruiting
    • JJC Teylingereind
    • Contact: Kees Mos

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Residents in a juvenile justice center

Description

Inclusion Criteria:

- entering residential MDFT

Exclusion Criteria:

- (only for short term residents) residing more than an hours' drive from the juvenile justice center after detention

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
short-stay residents juvenile justice center; For the first group (first series case studies), ten short-stay residents will be included who enter residential MDFT and, after 1-3 months in the facility, continue MDFT on an outpatient basis. MDFT is a systemic intervention for juveniles and young adults exhibiting delinquent behavior and/or experiencing disorders related to alcohol and/or drug use. MDFT for short-term residents is indicated by a behavioral scientist following multidisciplinary consultation if there are serious concerns about the parent-child relationship and/or the family situation	Behavioral: Multidimensional Family Therapy; 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).; Other Names: MDFT
long-stay residents juvenile justice center; For the second group (second series of case studies), six long-term residents will be included. For long-term residents, MDFT is routinely recommended, provided that the inclusion criteria are met.	Behavioral: Multidimensional Family Therapy; 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).; Other Names: MDFT

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment 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).	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.	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).	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	Youth/Caregivers: at the end of each phase (A (after 2-6 weeks), B (after 1-9 months) and C (after 1-3 months))

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
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.	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.	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.	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.	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.	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.	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.

Collaborators and Investigators

• Sponsor: University of Amsterdam
• Collaborators: Kwaliteit Forensische Zorg Jeugd

Publications and helpful links

General Publications

• Duncan, B. L., Miller, S. D., Sparks, J. A., Claud, D. A., Reynolds, L. R., Brown, J., & Johnson, L. D. (2003). The Session Rating Scale: Preliminary psychometric properties of a "working" alliance measure. Journal of brief Therapy, 3(1), 3-12.
• Chen, B., Vansteenkiste, M., Beyers, W., Boone, L., Deci, E. L., Van der Kaap-Deeder, J., ... & Verstuyf, J. (2015). Basic psychological need satisfaction, need frustration, and need strength across four cultures. Motivation and Emotion, 39, 216-236. https://doi.org/10.1007/s11031-014-9450-1
• Achenbach, T. M. (1991b). Manual for the Youth Self-Report and 1991 Profile. Burlington: University of Vermont, Department of Psychiatry.
• Liddle, H. A. (2002). Multidimensional family therapy for adolescent cannabis users. Cannabis Youth Treatment (CYT) Series, Volume 5. Rockville: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration.
• Nock, M. K., & Photos, V. (2006). Parent motivation to participate in treatment: Assessment and prediction of subsequent participation. Journal of Child and Family Studies, 15, 333-346. https://doi.org/10.1007/s10826-006-9022-4
• Tolan PH, Hanish LD, McKay MM, Dickey MH. Evaluating process in child and family interventions: aggression prevention as an example. J Fam Psychol. 2002 Jun;16(2):220-36. doi: 10.1037//0893-3200.16.2.220.
• Van der Helm GH, Wissink IB, De Jongh T, Stams GJ. Measuring treatment motivation in secure juvenile facilities. Int J Offender Ther Comp Criminol. 2013 Aug;57(8):996-1008. doi: 10.1177/0306624X12443798. Epub 2012 May 23.
• van der Helm, P., Kuiper, C. H. Z. , & Stams, G. J. J. M. (2018). Group climate and treatment motivation in secure residential and forensic youth care from the perspective of self determination theory. Children and Youth Services Review, 93, 339-344. https://doi.org/10.1016/j.childyouth.2018.07.028

Study record dates

Study Major Dates

• Study Start (Actual): March 5, 2024
• Primary Completion (Estimated): May 1, 2025
• Study Completion (Estimated): October 1, 2025

Study Registration Dates

• First Submitted: June 5, 2024
• First Submitted That Met QC Criteria: June 19, 2024
• First Posted (Actual): June 25, 2024

Study Record Updates

• Last Update Posted (Actual): June 25, 2024
• Last Update Submitted That Met QC Criteria: June 19, 2024
• Last Verified: June 1, 2024

More Information

Terms related to this study

• Keywords: Parents; Youth; Delinquency; Multidimensional Family Therapy; Treatment Motivation
• Other Study ID Numbers: JWesterveld

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Due to the sensitive nature of the data, they will not be made publicly available.