Multisystemic Therapy for Adolescents Through the COVID-19 Pandemic in Norway

Multiple studies have demonstrated that Multisystemic Therapy (MST) is an effective treatment for youths with serious conduct problems. This study aims to investigate the extent to which Norway’s MST was affected by the COVID-19 lockdowns and to examine the factors associated with treatment outcomes before and during the pandemic using a natural comparison group design. It included 2,021 adolescents (63.4% boys; Mage = 14.83, SDage = 1.60), and their families were referred to the MST for serious and persistent conduct problems. Treatment outcomes were compared among three temporal groups: A: fully prior to, B: partly prior to and C: during the pandemic. The Youth Level of Service/Case Management Inventory (YLS/CMI) and five behavioral treatment goals were assessed at intake and discharge. In addition, the five behavioral goals were assessed through parent interviews at 6-, 12-, and 18-month post-treatment. A decline in treatment fidelity was evident post-COVID-19 onset, and some subgroups experienced reduced benefits. Treatment fidelity was more strongly associated with treatment outcomes post-pandemic. Latent growth curve models revealed that boys entering MST post-pandemic had advantageous rates of behavioral improvements. Although most of the MST participants demonstrated progress in behavioral outcomes, several youths showed regress in treatment outcomes as the pandemic set in. Further studies are needed to identify factors particularly sensitive of subgroups of adolescents for deriving MST benefits in crisis situations. This study extends the existing knowledge on youths receiving MST by examining treatment outcomes during the COVID-19 pandemic. A significant decline in treatment fidelity was evident post-pandemic onset. There was a change in predictors associated with MST effectiveness. Treatment fidelity was a stronger predictor for positive treatment outcome post-pandemic.