Talk that works

Multisystemic Therapy, a family-based intervention, has been shown to be effective with troubled teens

November 09, 2008|By Julie Bykowicz | Julie Bykowicz,

For months, the therapist took her place on the Langstons' overstuffed burgundy couch in Randallstown and listened to the teenager talk about his juvenile record, problems in school and the inability to control his anger. The father chimed in with his own woes - 12 years of drug addiction, stints in jail and now a difficult relationship with his namesake son.

The father, Tyrone Langston II, says he can't remember precisely when the therapist arrived last year or when she left. "It was just so smooth. She came in, she did her thing, and she left. Even today, right now, we're still using everything she taught us. She still calls from time to time to check on us."

Added the younger Tyrone: "For a minute, I thought she was part of our family."

The Langstons are one of a small number of Maryland families who have undergone Multisystemic Therapy, an intense, family-based intervention program meant as an alternative to juvenile prison. Statewide, there are spaces for about 100 families at a time to undergo the therapy.

By January, the state Department of Juvenile Services plans to double that number, adding 80 slots in Baltimore and 20 in Baltimore County. Secretary Donald W. DeVore says he will pay for the program's expansion by using some of the $1.5 million saved by closing the Thomas O'Farrell juvenile facility in Carroll County.

"Maryland ought to have this in droves," said Bart Lubow, the director of programs for high-risk youth at the Annie E. Casey Foundation. "Multisystemic Therapy is one of a very small group of interventions in juvenile justice that has been rigorously tested under scientific conditions and determined to produce less risk-taking, improved [education], less recidivism."

Developed in the 1970s by a clinical psychologist in South Carolina, Multisystemic Therapy is used by 30 states. With 15 published outcome studies on the program's effectiveness, it has been endorsed by the surgeon general and the National Institutes of Health.

Baltimore County was the first place in Maryland to offer the therapy to juvenile delinquents, beginning three years ago. At about $8,000 per youth, it costs more than most other community intervention programs, but advocates say that's because it is much more intense. Families spend about 60 hours over the course of four months with a therapist - someone who is also available 24 hours a day, seven days a week, to provide advice in emergencies.

The program is designed to strengthen parenting skills and improve decision-making in kids through in-home therapy. The therapist talks not just to the youth, but to his or her parents and other people in the household, such as siblings and girlfriends, about structure and behavior.

"We've done a lot of research into what works for kids in our system, and this is the most effective," said Arleen Rogan, director of behavioral health for the Department of Juvenile Services.

DeVore says programs such as Multisystemic Therapy have three major benefits: initial cost savings because treatment at home is cheaper than out-of-home placement, outcomes for the kids who participate, and long-term tax dollar savings by keeping reformed kids away from the criminal justice system.

The elder Langston, 42, said his family's therapist offered suggestions for improving communication and building a more positive environment. For example, Tyrone, 17, stopped attending Pikesville High School in the 10th grade. But next week he plans to take a test for entry into a program at Aberdeen Proving Ground that would include working toward obtaining his high school diploma and a driver's permit.

The therapist "taught me to try to balance the things I told him not to do with telling him what he could do," the elder Langston said. Langston admits he was absent off and on over the years while he struggled with an addiction problem that he said he conquered five years ago.

"If it can help us, it can help anybody," he said.

Tyrone completed therapy earlier this year. He has not been in trouble since, he said. That in itself is a revolution. He entered the juvenile justice system at 11 or 12 when a group of middle school boys were caught scratching cars in a parking lot. That resulted in a lengthy probation. Years later, still being monitored by juvenile services, Tyrone landed in front of a Baltimore County juvenile judge after pushing a girl who had slapped him.

The judge sentenced him to a week at the Hickey School. "It wasn't fun, I can tell you that much," he said. "But the way they teach you there - it actually did help." But after left Hickey, he returned to the contentious relationship with his dad. His probation agent thought Multisystemic Therapy might help.

The family recently moved to a Baltimore apartment after the foreclosure of their Randallstown home. There are still squabbles between father and son over typical teenage matters such as doing (or not doing) household chores. Father and son say they've used lessons from the therapy program.

"It has not been all gravy," the elder Langston said. "But there definitely have been less lumps."

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