Multiple-Family Group Intervention for Incarcerated Adolescents and Their Families: A Pilot Project
Keiley, Margaret K., Journal of Marital and Family Therapy
The Multiple-Family Group Intervention (MFGI) was developed to address the need for an effective and yet affordable treatment for reducing recidivism for incarcerated adolescents and altering the families' coercive interactional patterns from an affect regulation and attachment perspective. The 8-week MFGI program was conducted in two Indiana juvenile correctional institutions. The research study utilized pre- and postintervention assessments and a 6-month follow-up assessment. Data from both male (n = 43) and female (n = 30) adolescents were combined, yielding a total sample of 140 respondents (73 adolescents, 67 caretakers). The 6-month follow-up assessment indicated a recidivism rate of only 44% compared to the national norm of 65-85%. Linear growth models were fit to determine the nature of the changes in adolescent behavior over the three assessments. Adolescents and caregivers reported that adolescents' externalizing behaviors significantly declined over time. Adolescent-reported internalizing symptoms as well as their alcohol and drug use significantly declined over the follow-up period, while caregiver reports of these behaviors showed no change over time. Adolescent-reported attachment to their parents, particularly mothers, increased significantly as did both adolescent and caregiver-reported functional affect regulation.
At present, many adolescents after release from correctional facilities to which they have been remanded for criminal behavior return to these delinquent behaviors, alcohol and drug abuse, and sexual offending (Santos, Henggeler, Burns, Arana, & Meisler, 1995). The recidivism rate for incarcerated adolescents is extremely high, hovering in the range of 65-85%;1 many re-offend and are re-incarcerated at great cost to communities, court systems, and mental health service agencies (Deschenes & Greenwood, 1998; Henggeler, 2003; Santos et al., 1995). Often, this cycle is repeated until adolescents reach the age of 18 and transition into the adult mental health and criminal justice systems (Borduin, 1994; Lipsey, 2000).
While incarcerated, the adolescents attend school and individual and/or group therapy, but their relationships with their families are often not targets for treatment. As a result, the coercive interactional patterns common in these families do not improve (Henggeler, Smith, & Schoenwald, 1994; Patterson, 1982, 1994, 2002). These conflictual cycles are associated with high levels of negative emotion that disrupt family members' attachment bonds (Ducharme, Doyle, & Markiewicz, 2002), impair cognitive functioning (Gottman, 1993), and foster chronic physiological arousal (El-Sheikh, 2001; Gottman & Katz, 2002). The result is that adolescents leave the institutions disconnected from their families, unable to cope well with conflict and negative affect/emotion, and therefore are less likely to integrate new information and develop alternative solutions to problems. Instead, they are more likely to revert to old, overlearned and often maladaptive behaviors, leaving them at risk for re-offending and relapse (Henggeler, 2003; Santos et al., 1995). Evidence-based and effective family treatments exist for delinquency and conduct disorder (see Keiley, 2002a, for a review), but many of them are expensive to implement, requiring extensive resources and additional personnel that state-funded juvenile correctional systems seldom can afford. The clinical and research project Multiple-Family Group Intervention (MFGI) was developed and conducted to address the need for effective, yet affordable, treatment for incarcerated adolescents and their families.
Development of Delinquent Behaviors
Adolescents at risk for entry into the juvenile justice system often have already experienced behavior problems in early (Oppositional Defiant Disorder) or late (Conduct Disorder) childhood (American Psychiatric Association, 2000). As a result, they may have social information processing and other cognitive deficits such as hostile attributional bias and poor problemsolving abilities (Dodge, 1993). …