Adapting multisystemic therapy for disruptive behavior problems in youth with autism spectrum disorder : conceptual and empirical development
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[ACCESS RESTRICTED TO THE UNIVERSITY OF MISSOURI AT AUTHOR'S REQUEST.] Youths with autism spectrum disorders (ASD) often engage in serious disruptive behaviors that interfere with their ability to successfully manage day-to-day responsibilities and contribute to relationship problems with caregivers, peers, and teachers. Effective treatments are needed to address the factors linked with disruptive behavior problems in this population of youths. Multisystemic therapy (MST) is a comprehensive family- and community-based treatment approach that has been effective with other difficult-to-treat populations of youths and holds promise for youths with ASD. This dissertation presents a conceptual model for adapting MST for youths with ASD (MST-ASD) and discusses the stages of treatment development completed thus far, including a pilot study, a small efficacy trial, and initial steps in the development of a treatment manual. Pilot work indicated that MST led to reductions in parenting stress and youth problem behavior and improvements in family functioning. In addition, findings from a small efficacy trial indicated that, when compared to usual community services, MST demonstrated increased family functioning and decreased youth problem behaviors. Furthermore, clinical observations from the pilot study and efficacy trial helped to identify key components of this adaptation of MST-ASD and will contribute to the development of a treatment manual. The implications of this dissertation for the continued development and evaluation of MST-ASD are discussed.
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