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Objective: To evaluate whether Multisystemic Therapy (MST) is more effective in reducing youth offending and out-of-home placement in a large, ethnically diverse, urban U.K. sample than an equally comprehensive management protocol; and to determine whether MST leads to broader improvements in youth sociality and in mediators believed to be responsible for change in MST. Method: 108 families were randomized to either MST (n=56) or the comprehensive and targeted usual services delivered by youth offending teams (YOT, n = 52). Results: Although young people receiving both MST and YOT interventions showed improvement in terms of reduced offending, the MST model of service-delivery reduced significantly further the likelihood of nonviolent offending during an 18-month follow-up period. Consistent with offending data, the results of youth-reported delinquency and parental reports of aggressive and delinquent behaviors show significantly greater reductions from pre-treatment to post-treatment levels in the MST group. In this study MST was observed to have some delayed impact on offending, the nature and causes of which will require further study. Conclusions: The superiority of the MST condition in reducing offending and antisocial behavior suggests that MST adds value to current U.K. statutory evidence-based youth services. The provision of MST does not supplant existing services but is best used to facilitate the appropriate and cost-effective organization of statutory services for young persons and their families. (Contains 2 figures and 4 tables.)

Part one presents the case for school-based mental health services in terms of low utilization of community-based clinics and the high dropout rate among adolescents attending clinics. Part two discusses lessons learned from delivering psychotherapy services in mainstream and special schools to tackle mental health problems presented by troubled pupils. (BF)

The author argues for psychology services for adolescents in school because teenagers are reluctant to use community-based psychiatric services. He also studies the advantages and disadvantages experienced by schools that offer psychological counseling.

Illustrates the challenges associated with carrying out analytic work with disturbed adolescents. Investigation on whether the adolescent's ambivalent responses to analysis are primarily pathological or are inevitable; Presentation of case materials in which the adolescent patient's opposition to treatment is primarily treated as a pathological solution.

Discusses the problems encountered by psychotherapists at a community-based center in engaging in psychotherapy with hard-to-reach young people with severe developmental disturbance in the United States. Description of the assessment process used; Developmental disturbance in adolescence; Therapeutic work in the engagement period.

The article describes the moral tales of parents who encounter with the health professions. The central feature in all the atrocity stories is to analyze the mishap involved with the respondents, one of their children and members of the health professions. The respondents attend to the issue of their appearance as moral persons, competent members and adequate performers. The stories also describe encounters with health professionals that have taken place early on in the child's medical career which are characterized by conflict and disagreement. In various ways, members of the health professions are depicted as casting doubt on the competence and rationality of parents. Parents acknowledge their inexperience at dealing with the medical aspects of their child's welfare but at the same time maintain that health professionals expect them to be accomplished in this sphere. Through the atrocity story, parents account for their inability display the status of adequate parenthood. Thus an analysis of atrocity stories has important policy implications for encounters between parents and paediatricians.

Presents a preface to the November 1981 issue of the journal "Sociology of Health and Illness."