Talk:Multisystemic therapy

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 26 January 2021 and 10 May 2021. Further details are available on the course page. Student editor(s): Patricia Kristine.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 01:16, 18 January 2022 (UTC)

Wiki Education Foundation-supported course assignment
This article was the subject of a Wiki Education Foundation-supported course assignment, between 9 January 2019 and 24 April 2019. Further details are available on the course page. Student editor(s): Shifflet.18.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 04:36, 17 January 2022 (UTC)

comment
Internal wikipedia links are to only have two sets of "[" and "]" around them to link to other pages.

Under "MST Adaptations," the links should not link offsite, but have an explanation about each with references pointing to the reference section for offsite links.

Under "Recognition," the links should not link to outside wikipedia. Offsite links are to be placed in the external links section.

Thank you —Preceding unsigned comment added by 69.204.7.102 (talk) 19:46, 24 November 2010 (UTC)

Heading
Lack of effectiveness? Might want to read some of these and revise that paragraph: Klietz, S. J., Borduin, C. M., & Schaeffer, C. M. (2010). Cost–benefit analysis of multisystemic therapy with serious and violent juvenile offenders. Journal Of Family Psychology, 24(5), 657-666. doi:10.1037/a0020838 ..... http://evidencebasedprograms.org/1366-2/multisystemic-therapy-for-juvenile-offenders http://www.blueprintsprograms.com/factSheet.php?pid=cb4e5208b4cd87268b208e49452ed6e89a68e0b8 http://www.crimesolutions.gov/ProgramDetails.aspx?ID=192 http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=254 — Preceding unsigned comment added by 130.253.34.104 (talk) 19:25, 3 February 2015 (UTC)

Changes
These changes break a bunch of stuff, removed a bunch of sources and generally do not appear to be an improvement. Doc James (talk · contribs · email) 20:32, 17 March 2015 (UTC)

COI
have added COI tag to article and connected contibutor tag above, and posted a case to WP:COIN Jytdog (talk) 22:38, 17 March 2015 (UTC)
 * I reviewed this and then removed the COI tag. it is ~OK~ now. Jytdog (talk) 03:08, 18 March 2015 (UTC)
 * nice work on cleaning this up Jytdog. 79616gr (talk) 03:46, 18 March 2015 (UTC)
 * Yup looks good. Doc James  (talk · contribs · email) 04:51, 18 March 2015 (UTC)

disclosure
I worked on this page before the new disclosure policy. I would really like to say that I am a paid editor-writer for MST. However, I have read many, many articles on doing so. They say put something on your user page, but I can't figure out where. Should I delete my present user page and start all over?

Would really appreciate some guidance.

Thank you.

Sandra Lee StuartSandraleestuart (talk) 18:40, 18 March 2015 (UTC)
 * You can add something here  Doc James  (talk · contribs · email) 20:20, 18 March 2015 (UTC)

additional sources
To help ensure that this page maintains the neutral POV as required by Wikipedia's guidelines ("representing fairly, proportionately, and, as far as possible, without bias, all of the significant views that have been published by reliable sources" [emphasis added]), I would suggest adding several peer-reviewed references that have found statistically significant results using the MST model. These sources were published by authors having no connection to MST, and appear to me statistically sound. Examples are:

Aos, S., Miller, M., & Drake, E. (2006). Evidence-Based Public Policy Options to Reduce Future Prison Construction, Criminal Justice Costs, and Crime Rates. Washington State Institute for Public Policy #06-10-1201. http://www.wsipp.wa.gov/ReportFile/952/Wsipp_Evidence-Based-Public-Policy-Options-to-Reduce-Future-Prison-Construction-Criminal-Justice-Costs-and-Crime-Rates_Full-Report.pdf.

Baldwin, S. A., Christian, S., Berkeljon, A., Shadish, W. R., & Bean, R. (2012). The effects of family therapies for adolescent delinquency and substance abuse: A meta-analysis. Journal of Marital and Family Therapy, 38, 281-304. http://www.healthevidence.org/view-article.aspx?a=22901.

Painter, K., & Scannapieco, M. (2012). Part 1: A review of the literature on multisystemic treatment within an evidence-based framework: Implications for working with culturally diverse families and children. Journal of Family Social Work, 12, 73-92. http://www.tandfonline.com/doi/full/10.1080/10522150802654302.

Spas, J., Ramsey, S., Paiva, A. L., & Stein, L. A. R. (2012). All might have won, but not all have the prize: Optimal treatment for substance abuse among adolescents with conduct problems. Substance Abuse: Research and Treatment, 6, 141-155. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3498967/.

Lee, S., Aos, S., & Pennucci, A. (2015). What works and what does not? Benefit-cost findings from WSIPP. Washington State Institute for Public Policy #15-02-4101. http://www.wsipp.wa.gov/ReportFile/1602/Wsipp_What-Works-and-What-Does-Not-Benefit-Cost-Findings-from-WSIPP_Report.pdf.

For full disclosure, I am an employee at the Medical University of South Carolina's tech transfer office, and while we hold the license for some of MST's technology, I receive no direct or indirect compensation as a result of the success or failure of MST. Williamlduke1 (talk) 19:12, 9 June 2015 (UTC)

We have taken out references to Wikipedia pages with problems. We are adding links to approved Wikipedia pages and links from Wikipedia pages to Multisystemic Therapy so that it is not an orphan.

The page is being reformatted so that the references appear in two columns.

Is there anything else we should do to keep the page from being deleted? Also, would the flagger who suggests the page reads like an advertisement give us guidance as to specific words, phrases, sentences, paragraphs.

Thank you. — Preceding unsigned comment added by Sandraleestuart (talk • contribs) 17:55, 3 November 2010 (UTC)
 * Please read WP:MEDRS. We need reviews published in the biomedical literature (what we call "secondary sources") not primary sources, which is what you have presented here.  Using secondary sources (and especially ones that are "independent" - where the authors and publishers have no conflict of interest)) is what ensures NPOV.  Happy to discuss if you don't understand. Jytdog (talk) 19:51, 9 June 2015 (UTC)

Jytdog – Thank you for your reply. First let me confirm to you that we are in complete agreement that only high quality secondary sources should be included in all Wikipedia entries including the one for Multisystemic Therapy. I was very careful in the selection of the five of the sources provided and all are secondary sources, four are literature reviews and one is a meta-analysis. All are written by independent experts. Additionally, all are published either in highly respected peer-reviewed journals or are published as position statements published by the Washington Institute for Public Policy, a nationally recognized expert body in the united States. My specific suggestion for edits to the Multisystemic Therapy entry is very simple. First, we would like to have the five references added to the page bringing the total number of references to twelve. Second, we would like to have these five sources added as references to the second line of the entry as follows.

“Multisystemic therapy (MST) is an intensive, family-focused and community-based treatment program for chronic and violent youth. Reviews of clinical studies have been unable to establish a consensus as to its effectiveness in comparison to other interventions.[1][2][8][9][10][11][12]“

Would you allow these changes to the entry for Multisystemic Therapy? Thank you for your guidance in this process! Williamlduke1 (talk) 15:27, 24 July 2015 (UTC)

Could someone provide an explanation as to why my changes were deleted from the page? I added several references to this page, all of which were peer-reviewed secondary sources. The goal of these additions was merely to ensure that this page maintains the neutral POV mandated by Wikipedia. I added no content to the page; my goal was not to paint a picture of Multisystemic Therapy as positive or negative. My goal was only to provide additional sources such that readers are able to access all independent viewpoints as to MST's effectiveness.

Some clarification would be greatly appreciated.

Thanks, Williamlduke1 (talk) 19:10, 16 November 2015 (UTC)
 * Formatted them and trimmed a few. We do not need huge numbers of references. The few best ones are sufficient.  Doc James  (talk · contribs · email) 14:10, 17 November 2015 (UTC)

Capitalise "Therapy"
As this is a proprietary, trademarked treatment, not a generic description, should not this article have the title "Multisystemic Therapy"? Pol098 (talk) 18:52, 7 September 2015 (UTC)
 * I would lean towards no. If a company writes the name in all caps we do not. It has one cap which is enough. Doc James (talk · contribs · email) 21:11, 7 September 2015 (UTC)

Cochrane review
The review says "There is inconclusive evidence of the effectiveness of MST compared with other interventions with youth"

We have summarized this as "A 2005 systematic review by the Cochrane Collaboration found unclear evidence regarding MST compared to other services for young people." Doc James (talk · contribs · email) 19:42, 24 April 2017 (UTC)
 * The results section says "The most rigorous (intent-to-treat) analysis found no significant differences between MST and usual services in restrictive out-of-home placements and arrests or convictions. Pooled results that include studies with data of varying quality tend to favor MST, but these relative effects are not significantly different from zero" Doc James  (talk · contribs · email) 19:44, 24 April 2017 (UTC)

Just trying to good faith clarify the reasons for the unclear evidence (low sample size) :). The authors discuss this on page 11: "The overall direction of effects usually favors MST and, given the low statistical power of the analysis...we cannot rule out the possibility that MST is no more effective than other services."PeterFernuk (talk) 20:22, 24 April 2017 (UTC)PeterFernuk (talk) 20:22, 24 April 2017 (UTC)
 * Sure the addition looks good. Best Doc James  (talk · contribs · email) 22:48, 24 April 2017 (UTC)

Tried to edit the first/summary section to be more in line with the "Medical Uses" section (which has been modified more recently than the summary section). Studies were an interesting read, glad to participate in the Wikipedia community. PeterFernuk (talk) 00:34, 25 April 2017 (UTC)PeterFernuk
 * We tend to avoid the word "recent". Have adjusted the lead sentence. Doc James  (talk · contribs · email) 18:43, 25 April 2017 (UTC)

Thanks for letting me know about 'recent.' Now that I think about it, the term is ambiguous. Making another edit for consistency with the systematic review findings.

The authors of the Cochrane review discuss (pg 11), that the sample size was too small to make a determination on effectiveness. In other words, they didn't have enough information to determine if MST was effective or not. The most recent edit to the Wikipedia page states that of the reviews, "some finding benefit and others not." The Cochrane review didn't determine that there was no benefit, rather, the authors felt that the systematic review had "low statistical power," so they couldn't come to a conclusion.

From page 11 of the Cochrane review: "The overall direction of effects usually favors MST and, given the low statistical power of the analysis, it is possible that MST has some effects that cannot be detected in this small set of heterogeneous studies. However, we cannot rule out the possibility that MST his no more effective than other services...In sum, evidence about the effectiveness of MST is inconclusive."

My sense is that, since this was 2005, there wasn't as much literature out there as the 2014 and 2017 meta-analyses found. Let me know what you think and thanks again for the insight.PeterFernuk (talk) 19:32, 25 April 2017 (UTC)


 * The 2014 review found "Small but significant treatment effects were found on delinquency (primary outcome)"
 * The 2012 review found "not statistically significant" on outcomes.
 * The 2017 review "produced modest, yet long-lasting"
 * The 2005 Cochrane review found "is inconclusive evidence of the effectiveness of MST compared with other interventions with youth"
 * So I guess the question is how should we paraphrase this?
 * How about "Reviews in 2014 and 2017 found a small degree of benefit while 2012 and 2005 reviews concluded the evidence was unclear". Doc James (talk · contribs · email) 20:14, 25 April 2017 (UTC)

In reading the full studies, I'd propose that there's some additional substantive comments to consider in the paraphrase summary.

2017 review (pg 349) "In conclusion, the present meta-analysis demonstrated that family-based treatments for serious juvenile offenders (in particular, MST, TFCO, and FFT) produced greater reductions in antisocial behavior and more improvements in a variety of secondary outcomes than did usual community services. These findings suggest that increased implementation of family-based treatments with serious juvenile offenders is likely to result in greater reductions in youth antisocial behavior, financial savings for taxpayers, and decreases in victimization."

2012 review (statistically "modest" but "clinically significant" results ....not statistically significant because only 4 studies used a control condition) In the Conclusions section (pg 298): "Family therapy - specifically BSFT, FFT, MDFT, and MST - appears to modestly exceed the effects of TAU and alternative therapies." In the discussion section (pg 297): "The difference between family therapy and control was...not statistically significant. We suspect that the lack of significance is owing to the fact that only four studies used a control condition.  Consequently, we do not discuss these results further except to say more research of this type is needed." (pg. 299) "The advantages over...alternative therapies, although deemed statistically "modest," can be considered clinically significant because of associated cost savings to the juvenile justice system and other social/welfare services."

2005 Cochrane review (inconclusive because of small sample size)

Let me know if you think the new paraphrase adjustment I made appropriately characterizes the above notes. PeterFernuk (talk) 21:06, 25 April 2017 (UTC)PeterFernuk (talk) 21:17, 25 April 2017 (UTC)

Rex: Genuinely not trying to whitewash. The Main Results section (pg 1) indicates that "The study sample size is small and effects are not consistent across studies; hence, it is not clear whether MST has clinically significant advantages over other services." — Preceding unsigned comment added by PeterFernuk (talk • contribs) 21:26, 25 April 2017 (UTC)
 * I do not believe that you are deliberately trying to whitewash, but that is the result. The lack of conclusive evidence in the Cochrane Review may be due to a small sample size, but it just as easily may be due to the absence of any effect. You simply can't draw those sort of conclusions yourself. It has to be explicitly stated in the source, otherwise it's WP:Original research. Let's stick to what the sources say, please. Your summary in the lead simply does not reflect the bulk of the conclusions in the three principal sources. I'm going to re-write the lead to attempt to redress that. I hope that you'll be able to see that I'm trying to accurately and neutrally summarise those sources. If not, I'm happy to debate further. --RexxS (talk) 21:44, 25 April 2017 (UTC)

While I was attempting 'neutrally summarize' the sources, I think you did it much better. Thanks for taking a look. PeterFernuk (talk) 22:12, 25 April 2017 (UTC)
 * Thank you for the kind words. It's possible I may have had a little more practice. I'm finished for this evening, but I felt it necessary to make more use of the literature review from Spas 2012, as it draws meaningful comparisons between different therapies, and is particularly significant in its commentary about MST. My goal is always to try to focus on content that I think the general audience would want to read about: in other words, nobody but academics care about the details of statistical significance or sample sizes, so I tend to leave that out unless the source makes an big deal of it. See how it reads to you now and ping me if you want me to look at anything else. --RexxS (talk) 22:23, 25 April 2017 (UTC)
 * Thank you for the kind words. It's possible I may have had a little more practice. I'm finished for this evening, but I felt it necessary to make more use of the literature review from Spas 2012, as it draws meaningful comparisons between different therapies, and is particularly significant in its commentary about MST. My goal is always to try to focus on content that I think the general audience would want to read about: in other words, nobody but academics care about the details of statistical significance or sample sizes, so I tend to leave that out unless the source makes an big deal of it. See how it reads to you now and ping me if you want me to look at anything else. --RexxS (talk) 22:23, 25 April 2017 (UTC)

What can I say, practice makes perfect :)PeterFernuk (talk) 22:34, 25 April 2017 (UTC)

New Citations
We edited and added a lot of information to the page. A lot of the language was not inclusive, so we updated that. We were also able to fix a lot of the citations but there was one that we couldn't. We think this may be due to our lack of experience with Wikipedia. Emacmillan (talk) 15:10, 11 April 2019 (UTC) Emacmillan

I went back in and found our mistakes. Everything is now clean and updated Emacmillan (talk) 15:20, 11 April 2019 (UTC) Emacmillan