Child and Adolescent Violence Research at NIH

pool delinquent youth together will, in some cases, exacerbate and escalate youth violence. Even promising interventions for delinquent youth can be overwhelmed by the negative effect of grouping such youth together.

This research finding has led to two highly successful treatment models for serious offending delinquents. One is multisystemic therapy (MST), in which specially trained therapists work with the youth and family in their home, with a particular focus on changing the peers with whom the youths associate. MST therapists identify strengths in the families and use these strengths to develop natural support systems and to improve parenting. Specific interventions are individualized to the family and address the needs of the child, family, school, peers, and neighborhood. Multiple, rigorous outcome evaluations have demonstrated the efficacy of this approach, and an independent cost-benefit analysis found that this model had a very high cost-benefit payoff. Although a number of states are now attempting to implement this model, the majority of programming for delinquent youth is based on models that bring together youth with problem behavior, rather than target separation of youth from problem peers.

The other model is Therapeutic Foster Care. This model offers a community-based intervention for serious and chronic offending delinquents. Therapeutic foster parents are carefully selected and supported with research-based procedures for working with serious and chronic delinquents in their homes. Treatment typically lasts 6 to 7 months. This intervention results in fewer runaways and fewer program failures than the usual placement in group homes is less expensive, and is dramatically more effective in reducing delinquency than traditional group homes. The Foster Family-based Treatment Association, developed under NIMH leadership, now has some 400 members across the U.S. who promote the use of this research-based and effective model.

Conclusion As important as the problem of violence is, there will be no quick, inexpensive, and fail-safe solution. Recent years have witnessed a strong growth in our understanding of the risk factors and processes that contribute to and shape child and adolescent antisocial behavior.

Yet gaps remain in our scientific understanding of how child, family, school/community, and peer factors interact, and which are the most appropriate targets for prevention and early intervention in different settings. We are also learning that being "at risk" does not doom any one child to become violent; conversely, the apparent absence of certain risk does not necessarily protect any one child from problem behavior.

The development of serious behavior problems

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