Juvenile justice girls' depressive symptoms and suicidal ideation 9 years after Multidimensional Treatment Foster Care

Abstract

Objective: Multidimensional Treatment Foster Care (MTFC) has been found to reduce delinquency among girls in juvenile justice through 2-year follow-up. Given that such girls are at elevated risk for suicide and depression into adulthood, we tested MTFC effects on long-term trajectories of suicidal ideation and depressive symptoms.

Method: Girls (N = 166; mean [SD] age = 15.3 [1.2] years; 68% White) with a recent criminal referral who were mandated to out-of-home care were enrolled in 2 sequential cohorts. Girls were randomized to receive MTFC (n = 81) or group care (GC) treatment as usual (TAU; n = 85); the second MTFC cohort also received modules targeting substance use and risky sexual behavior. Depressive symptoms and suicidal ideation were assessed repeatedly through early adulthood (mean [SD] follow-up = 8.8 [2.9] years). Suicide attempt history was assessed in early adulthood.

Results: Girls assigned to MTFC showed significantly greater decreases in depressive symptoms across the long-term follow-up than GC girls (π = -.86, p < .05). Decreases in suicidal ideation rates were slightly stronger in MTFC than in GC as indicated by a marginal main effect (odds ratio [OR] = .92, p < .10) and a significant interaction that favored MTFC in the second cohort relative to the first (OR = .88, p < .01). There were no significant MTFC effects on suicide attempt.

Conclusions: MTFC decreased depressive symptoms and suicidal thinking beyond the decreases attributable to time and TAU. Thus, MTFC has further impact on girls' lives than originally anticipated.

Conflict of interest statement

Disclosure of financial interests: Patricia Chamberlain is an owner/partner in TFC Consultants, Inc. (Eugene, Oregon), the organization that disseminates Multidimensional Treatment Foster Care.

PsycINFO Database Record (c) 2014 APA, all rights reserved.

Figures

Figure 1

Model-based nonlinear probability trajectories of suicidal ideation for groups defined by cohort and random assignment to multidimensional treatment foster care (MTFC) or group care (GC) controls.

Figure 2

HLM model-based estimates of Multidimensional Treatment Foster Care (MTFC) compared to group care (GC) effects on long term linear growth in depressive symptoms controlling for covariates.