Original Title: Intervenciones terapéuticas en el tratamiento de enfermedades mentales en los menores

Authors' objectives: 1. To systematically review the state of affairs of scientific knowledge on the effectiveness of the programmes aimed at preventing and treating psychopathologic problems in juvenile offenders, as well as of those aimed at reducing recidivism. 2. To systematically review the literature in order to identify which intervention strategies and theoretical models are the most effective when treating juvenile offenders. 3. To identify in which subgroups of individuals the best results are obtained as well as in which settings or contexts the programmes are more useful.

Authors' results and conclusions: RESULTS: A total of 3671 references in the electronic databases were found. Once the duplicates were discarded, 2916 references were reviewed. Were retrieved 172, of which 45 were included. In addition, 6 extra references were found manually, four from the Campbell Collaboration’s database (C2- RIPE), and two from the reference lists mentioned in the selected studies. A total of 51 studies were included: 15 SRs, 15 RCTs, 3 NRCTs and 18 other CSs. According to the Jadad Scale, the total quality of RCTs was 2.2 points out of 5. According to the Estabrooks Scale, the total quality of the NRCTs was 17.3 points out of 33, and 15.8 points out of 33 for the other CSs. According to the Oxman Scale, the mean score for the global quality of the SRs was 9.1 points out of 10. Among the outcomes assessed from the selected SRs, the relation between familiar intervention and juvenile delinquency as well as the effectiveness of Restorative Justice programmes, dissuasive and discipline programmes (Scared Straight, Boot Camps), therapeutic communities, cognitive-behavioural interventions, residential treatments and programmes aimed at reducing substance use or abuse were measured. Twenty two different types of intervention in the RCTs were identified. Among these modalities, 45.5 % represented interventions with community and family orientation, the Multisystemic Therapy was found the most used programme. The three NRCTs belonged to the same study. The intervention was applied in a therapeutic community and it was considered effective since recidivism was reduced, especially in serious and violent offenders. Eighteen different types of intervention in the other CSs were identified. Therapeutic communities, cognitive-behavioural interventions and multidimensional interventions were the most frequently used. The most common outcome measure among the selected studies was the offender/recidivism conduct. The cognitive-behavioural therapy and the therapeutic community were the most effective interventions for reducing them, followed by community therapy and family therapy. The most frequently assessed mental health measure was substance use or abuse, and were found that the most effective interventions for reducing it are therapeutic communities, cognitive-behavioural interventions and family interventions. In the other measures (conduct disorder, specific skills and family, psychosocial and psychological-emotional functioning), cognitive-behavioural therapy and family therapy were also the most effective interventions. CONCLUSIONS: Cognitive-behavioural therapy and programmes aimed at training specific skills have turned out to be the most effective for the improvement of the following change measures: psychologicalemotional and psychosocial functioning, social skills, conversational skills and anxiety disorders (disorders caused by post-traumatic stress). Regarding substance use or abuse, therapeutic communities and family intervention, mainly in the community, have turned out to be the most effective in the reduction of this measure. As far as recidivism is concerned, it is possible to conclude that therapeutic communities, cognitive-behavioural therapy, community therapy and family therapy (multisystemic) are the most effective, whereas the least effective are those which use dissuasive and discipline programmes (Boot Camps and Scared Straight).

Project Status: Completed

Year Published: 2007

URL for published report: https://sescs.es/intervenciones-terapeuticas-en-el-tratamiento-de-enfermedades-mentales-en-los-menores/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es