What works for
whom? Gender differences in intake characteristics and treatment outcomes
following Multisystemic Therapy.
Terje Ogden*, Kristine Amlund Hagen
How
do gender differences play a role in the effectiveness of therapy? Is Multisystemic
Therapy (MST) as effective for girls as it is for boys?
The
article presented a study that investigated whether girls and boys had similar referral symptoms and
background characteristics at intake to Multisystemic Therapy (MST) and whether
adolescent girls with serious behavior problems benefited as much from MST
treatment as did boys. The study also examined gender differences in rate of
co-morbidity at intake and whether the families of boys and girls referred to
MST differed in their evaluation of the treatment received.
117 Norwegian participants consisted
of (35%) adolescent girls and (65%) boys, ranging in age from 12 to 17, were
referred to MST treatment. This treatment lasted four to six months. Inclusion criteria were: (1) problem behavior such as law-breaking or
other antisocial acts, verbal aggression and threats of hurting others, (2) age
between 12 and 17 years, (3) parents (or other primary caregivers) sufficiently
involved and motivated to start MST. The most common reason for referral for
girls (63%) was statutory offenses (e.g. truancy and runway from home) which was
a significantly higher proportion for females than for males. Boys’ most common
referral reason was being identified as having serious behavior problems (55%),
but that percentage of males was not significantly different from the
proportion of girls being referred for that reason (59%). Girls were more
likely to have drug abuse problems than boys (girls: 59% vs. boys: 38%), but
with an alpha level of .01,
It seems likely
that even if girls have risk factors that are different than those for boys,
and even if girls may present different problem profiles, MST is flexible,
sensitive, and robust enough to attend to such issues and to be effective for
most adolescents in the present sample.
Gender differences appeared for some referral reasons, intake
characteristics and treatment changes, but the similarities between girls and
boys far outnumbered their differences.
Although girls
may present a somewhat different problem profile than do boys and their risk
factors for developing conduct problems may be somewhat different, MST seemed
flexible and robust enough to be effective for most adolescents in the present
sample, regardless of gender.
It's interesting to consider how gender might affect treatment outcomes as well as even diagnoses. Many would argue, for example, that the higher rates of depression in females compared to males may be less because of differences in prevalence than in symptom expression, leading male depression to go unrecognized. As you very accurately pointed out, however, the goal of MST is to meet the clients where they're at and offer whatever is most needed. This means that the exact way in which MST is carried out can be tailored to fit any gender (or cultural, racial, socioeconomic, etc.!) differences that may arise. It's therefore not surprising that treatment outcomes demonstrated more similarities than differences. Thanks for summarizing these findings!
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