The NYT Magazine includes a profile of a program for violent youth that results in 54% fewer arrests and 57% spending fewer days in jail over a 14 year follow-up [Home Remedy - New York Times]. Multisystemic therapy (MST) uses a social ecological approach to create tailored interventions for the child and his/her family.
Henggeler studies the ecosystem composed by family, neighborhood, schools, peer groups and the broader community. Instead of removing children from that ecosystem, he tries to change it: solve the drug problems and the legal problems, get kids away from delinquent peers and encourage academic success for each child and his/her family.
A central idea is to focus on the parents. "We want the therapist to build the competency of the parents, because the parents are going to be there after the therapist leaves," he says. If the parents can't handle the job, he might ask an uncle, aunt or grandparent to fill in... The single most important piece of the treatment is getting children away from deviant peers.
While the approach can be demonstrated to be cost-competitive when compared to upwards of $50,000 per year for residential treatment or jail, MST therapists normally have caseloads of only between 4-6 families. Scaling up such interventions so that they can be more broadly implemented is one of the ways in which policy-makers and funders should consider the value of a [social] marketing perspective.
The commercial sector if filled with stories of the small upstart that 'roared' with a mix of production and marketing talent. Occasionally, such a story appears in the public health literature. One of the more frustrating things to witness is the many fine programs that are developed and tested to solve various types of social and health problems, but then left to collect dust because of the lack of expertise, will and resources to market and adopt them broadly and over the long run.