Juvenile Justice Girls Randomized Control Trial: Young Adult Follow-up

• Delinquency [ Time Frame: Months 12, 24, 36, and young adulthood (ave. of 7 year follow-up) ] [ Designated as safety issue: No ]
  Measured as self-reported criminal activity and count of official arrests and criminal referrals
• Depression [ Time Frame: Month 12, 24, 36 and young adulthood (ave. of 7-year follow-up) ] [ Designated as safety issue: No ]
  Measured on the CESD depression inventory and the Brief Symptom Inventory, and via diagnostic interview
• substance use [ Time Frame: Months 12, 24, 36 and young adulthood (ave. of 7-year follow-up) ] [ Designated as safety issue: No ]
  Measured via self-reported use and diagnostic interview assessment

• HIV risk behavior [ Time Frame: Months 12, 24, 36 and young adulthood (ave. of 7-year follow-up) ] [ Designated as safety issue: No ]
  Measured as self-reported engagement in sexual behaviors
• economic costs [ Time Frame: young adulthood (age 18-28; average of 7-year follow-up) ] [ Designated as safety issue: No ]
  Measured by comparing the costs of intervention delivery relative to the two intervention programs relative to costs incurred through time in detention, jail, and prison; relative to costs incurred due to child welfare involvement; and relative to symptom counts on self-report inventories.

This study is a young adult follow-up of 166 females who originally participated in an RCT during adolescence due to their involvement in the juvenile justice system.

Females under age 18 years old are the fastest-growing segment of the juvenile justice population and are at risk for negative co-occurring outcomes including drug abuse, HIV/STI risk, criminal behavior, and educational failure. As they enter young adulthood, this constellation of behaviors puts them at heightened risk for early parenthood and subsequent involvement in the child welfare system (for their parenting behaviors) and the adult corrections system (for criminal behaviors). Such system involvement is costly, and its prevention would be of great significance to public health; however, very little is known about factors leading to females' success/failure in young adulthood and factors that might prevent involvement in these two public systems. This study aims to further our understanding of the pathways to and the prevention of HIV/STI risk, drug use, and child welfare and adult corrections involvement by following-up 166 women who participated in two randomized intervention trials aimed at reducing delinquency during adolescence. In the original studies, juvenile justice girls who had been referred for out-of-home placement due to chronic delinquency were randomly assigned to services as usual or to Multidimensional Treatment Foster Care (MTFC). Efficacy of the MTFC intervention with this sample has been shown at 12- and 24-month follow-ups on criminal referral rates, days spent in locked settings, deviant peer associations, educational engagement, and pregnancy prevention. The investigators propose to examine the developmental pathways for these juvenile justice girls into young adulthood (ages 21-28 years) using innovative data collection and data analytic techniques, with foci on the long-term effects of MTFC, the mediators of young adult adjustment and child welfare/corrections involvement, and the cost effectiveness and cost avoidance of MTFC on these outcomes. The overarching aim is to identify potential targets for subsequent intervention. One in-person assessment is proposed with each female and her current romantic partner (if she has one); in addition, telephone interviews will be conducted every 6 months for the duration of the study, and system data from child welfare and adult corrections will be collected.

• Delinquency
• Drug Use

• Behavioral: Multidimensional Treatment Foster Care (MTFC)
  Youth placed individually in well-trained and supervised foster homes. Basic components: (a) daily telephone contact with MTFC parents; (b) weekly foster parent group meetings focused on supervision, training in parenting practices, and support; (c) an individualized behavior management program implemented daily in the home by foster parent; (d) individualized skills training for the youth; (e) family therapy for aftercare family focused on parent management strategies; (f) close monitoring of school attendance, performance, and homework completion; (g) case management to coordinate MTFC, family, peer, and school settings; (h) 24-hour on-call staff availability to MTFC and biological parents; and (i) psychiatric consultation. Services typically last approximately 6 months.
• Behavioral: Group Care
  Group Care is the usual service for youth placed in out-of-home care for chronic delinquency in Oregon. These programs represented typical services for girls being referred to out-of-home care by the juvenile justice system and had 2-51 youth in residence (M = 21) and 1-50 staff members (Mdn = 2); most also had onsite schooling. Although the programs differed somewhat in theoretical orientations, 86% reported that they endorsed a specific treatment model, of which the primary philosophy was a behavioral (70%), eclectic (26%), or family-style therapeutic approach (4%). Services typically last approximately 6 months.

• Experimental: Multidimensional treatment Foster Care
  Youth are placed individually in well-trained and supervised foster homes. Basic components include: (a) daily telephone contact with MTFC parents using the Parent Daily Report; (b) weekly foster parent group meetings focused on supervision, training in parenting practices, and support; (c) an individualized behavior management program implemented daily in the home by foster parent; (d) individualized skills training for the youth; (e) family therapy for aftercare family focused on parent management strategies; (f) close monitoring of school attendance, performance, and homework completion; (g) case management to coordinate MTFC, family, peer, and school settings; (h) 24-hour on-call staff availability to MTFC and biological parents; and (i) psychiatric consultation.
  Intervention: Behavioral: Multidimensional Treatment Foster Care (MTFC)
• Active Comparator: Group Care
  Group Care is the usual service for youth placed in out-of-home care for chronic delinquency in Oregon. These programs represented typical services for girls being referred to out-of-home care by the juvenile justice system and had 2-51 youth in residence (M = 21) and 1-50 staff members (Mdn = 2); most also had onsite schooling. Although the programs differed somewhat in theoretical orientations, 86% reported that they endorsed a specific treatment model, of which the primary philosophy was a behavioral (70%), eclectic (26%), or family-style therapeutic approach (4%).
  Intervention: Behavioral: Group Care

• Harold GT, Kerr DC, Van Ryzin M, Degarmo DS, Rhoades KA, Leve LD. Depressive Symptom Trajectories Among Girls in the Juvenile Justice System: 24-month Outcomes of an RCT of Multidimensional Treatment Foster Care. Prev Sci. 2013 Feb 17. [Epub ahead of print]
• Chamberlain P, Leve LD, Degarmo DS. Multidimensional treatment foster care for girls in the juvenile justice system: 2-year follow-up of a randomized clinical trial. J Consult Clin Psychol. 2007 Feb;75(1):187-93.
• Leve LD, Chamberlain P, Reid JB. Intervention outcomes for girls referred from juvenile justice: effects on delinquency. J Consult Clin Psychol. 2005 Dec;73(6):1181-5.
• Level LD, Chamberlain P. Association with delinquent peers: intervention effects for youth in the juvenile justice system. J Abnorm Child Psychol. 2005 Jun;33(3):339-47.
• Leve LD, Chamberlain P. A Randomized Evaluation of Multidimensional Treatment Foster Care: Effects on School Attendance and Homework Completion in Juvenile Justice Girls. Res Soc Work Pract. 2007 Nov 1;17(6):657-663.
• Van Ryzin MJ, Leve LD. Affiliation with delinquent peers as a mediator of the effects of multidimensional treatment foster care for delinquent girls. J Consult Clin Psychol. 2012 Aug;80(4):588-96. doi: 10.1037/a0027336. Epub 2012 Feb 20.

Inclusion Criteria:

• female
• 13-17 years old
• at least one criminal referral in the prior year
• court-mandated placement in out-of-home care

Exclusion Criteria:

• Currently pregnant

• National Institute on Drug Abuse (NIDA)
• National Institute of Mental Health (NIMH)