MultifunC: an example of evidence based program in therapeutic residential care

Many youths are placed in residential treatment in most countries. Generally it has been a problem that the content – the black box – within residential treatment has been poorly described. In addition there has been a... [ view full abstract ]

Many youths are placed in residential treatment in most countries. Generally it has been a problem that the content – the black box – within residential treatment has been poorly described. In addition there has been a lack of knowledge of the outcomes of residential treatment.
The Norwegian Ministry of Children, Family and Equality initiated together with The National Board of Institutional Care in Sweden in year 2000 a comprehensive review of the research on residential treatment of youth with serious behavior problems, published in 2003. Based on this review the residential treatment model “MultifunC” or “Multifunctional Treatment in Residential and Community Settings” was developed. The presentation will give a picture of the MultifunC-model.
The length of residential treatment in the model is about 6 months. An intensive aftercare is integrated into the model and the total treatment process has a duration of about one year. The treatment model target medium to high-risk juvenile offenders, that means offenders with medium to high level of risk factors. The targets of the interventions are known dynamic risk factors for change, implying an assessment of the criminogenic needs both within the individual and in his or her environment. The treatment focus on changing dynamic risk factors within youth, the family, the peer relations, and function at school. Cognitive behavioral methods (Aggression Replacement Training) for changing the behavior and help him/her to develop control of aggression, social skills, and moral development are applied. In carrying out the treatment, there is a focus on individual differences like cognitive level, anxiety, depression, trauma, etc. The treatment climate seek to balance autonomy/support and control for the staff and the adolescents. The staff needs to be competent in how to prevent and manage violent behavior constructively. Family work is in focus during the whole treatment based on principles from PMTO and MST (Multisystemic Therapy). Written manuals or guidelines for all parts of the model are developed.
When the MultifunC project started it was decided that research would be part of the project. The complexity of the model reflects the youth’s complex needs and it takes time to integrate new knowledge into practice. An implementation study was first conducted to assure that MultifunC was correctly performed according to it's manuals and guidelines. When that was obtained two effect studies would start. Studies of the effects of the model started in 2010 and is still ongoing in Norway and Sweden. The aim is to study if the program has positive effect on outcome for the youths.
MultifunC is implemented in Norwegian, Swedish and Danish institutions. More than 600 youths has gone through the program in Norway and Sweden where the units have been in operation since 2005. The journey to convert the written manuals to practice, the obstacles, challenges and potentials will also be shortly presented. The experiences shows that the implementation is an ever ongoing process.