The economic impact of multisystemic therapy through midlife: a cost-benefit analysis with serious juvenile offenders and their siblings.

ABSTRACT

OBJECTIVE: This study investigated the economic benefits of multisystemic therapy (MST) versus individual therapy (IT) using arrest data from 176 serious juvenile offenders and 129 of their closest-in-age siblings who participated, on average, 25 years earlier in a randomized clinical trial (Borduin et al., 1995). METHOD: Two types of benefits of MST were evaluated (a) The value to taxpayers was derived from measures of criminal justice system expenses (e.g., police and sheriffs' offices, court processing, community supervision), and (b) the value to crime victims was derived from measures of both tangible (e.g., property damage and loss, health care, lost productivity) and intangible (e.g., pain, suffering, reduced quality of life) losses. RESULTS: Reductions in criminality in the MST versus IT conditions were associated with lasting benefits to both taxpayers and crime victims, with cumulative benefits of MST estimated at $35,582 per juvenile offender and $7,798 per sibling. Overall, every dollar spent on MST recovered $5.04 in savings to taxpayers and crime victims in the 25 years following treatment. CONCLUSIONS: This study represents the most comprehensive cost-benefit analysis of an MST clinical trial to date and demonstrates that an evidence-based treatment such as MST can produce modest economic benefits well into adulthood. Implications of the authors' findings for policymakers and public service agencies are discussed.