Abstract
This study evaluated the economics of Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) by applying the Washington State Institute for Public Policy (WSIPP) cost-benefit model to data from a randomized effectiveness trial with 86 families (Swenson et al. in JFP 24:497–507, 2010b). The net benefit of MST-CAN, versus enhanced outpatient treatment, was $26,655 per family at 16 months post-baseline. Stated differently, every dollar spent on MST-CAN recovered $3.31 in savings to participants, taxpayers, and society at large. Policymakers and public service agencies should consider these findings when making investments into interventions for high-need families involved with child protective services.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Arias, E. (2010). United States life tables, 2006 (National Vital Statistics Reports vol. 58, no. 21). Washington, DC: United States Department of Health and Human Services, National Vital Statistics System, Table 1.
Bax, L., Yu, L. M., Ikeda, N., Tsuruta, H., & Moons, K. G. (2006). Development and validation of MIX: Comprehensive free software for meta-analysis of causal research data. BMC Medical Research Methodology, 6, 50–61. https://doi.org/10.1186/1471-2288-6-50.
Belfield, C., Hollands, F., & Levin, H. (2011). What are the social and economic returns? New York, NY: Columbia University. Retrieved February 19, 2018 from http://w.cbcse.org/wordpress/wp-content/uploads/2012/10/18664_Final4belfield.pdf.
Brunk, M., Henggeler, S. W., & Whelan, J. P. (1987). Comparison of multisystemic therapy and parent training in the brief treatment of child abuse and neglect. Journal of Consulting and Clinical Psychology, 55, 171–178. https://doi.org/10.1037/0022-006X.55.2.171.
Bureau of Labor Statistics (2016). Consumer price index. Retrieved May 27, 2016 from http://www.bls.gov/cpi/.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
Council for Community and Economic Research (2016). Cost of living index. Retrieved June 1, 2016 from https://www.coli.org/.
Cox, D. R. (1970). Analysis of binary data. New York: Chapman & Hall/CRC.
Currie, J., & Widom, C. S. (2010). Long-term consequences of child abuse and neglect on adult economic well-being. Child Maltreatment, 15, 111–120. https://doi.org/10.1177/1077559509355316.
Dinkmeyer, S., McKay, G. D., McKay, J. L., & Dinkmeyer, D. (1998). Systematic training for effective parenting of teens. Circle Pines, Minnesota: American Guidance Services, Inc.
Dopp, A. R., Borduin, C. M., Wagner, D. V., & Sawyer, A. M. (2014). The economic impact of multisystemic therapy through midlife: A cost-benefit analysis with serious juvenile offenders and their siblings. Journal of Consulting and Clinical Psychology, 82, 694–705. https://doi.org/10.1037/a0036415.
Drake, E. K., Aos, S., & Miller, M. G. (2009). Evidence-based public policy options to reduce crime and criminal justice costs: Implications in Washington State. Victims and Offenders, 4, 170–196. https://doi.org/10.1080/15564880802612615.
Dubowitz, H., Kim, J., Black, M. M., Weisbart, C., Semiatin, J., & Magder, L. S. (2011). Identifying children at high risk for a child maltreatment report. Child Abuse and Neglect, 35, 96–104. https://doi.org/10.1016/j.chiabu.2010.09.003.
Elmore, R. F. (1987). Instruments and strategy in public policy. Review of Policy Research, 7(1), 174–186. https://doi.org/10.1111/j.1541-1338.1987.tb00036.x.
Fang, X., Brown, D. S., Florencea, C. S., & Mercya, J. A. (2012). The economic burden of child maltreatment in the United States and implications for prevention. Child Abuse and Neglect, 36, 156–165. https://doi.org/10.1016/j.chiabu.2011.10.006.
Feldstein, M. (1978). The welfare cost of capital income taxation. Journal of Political Economy, 86, S29–S51. https://doi.org/10.1086/260693.
Gelles, R. J., & Perlman, S. (2012). Estimated annual cost of child abuse and neglect. Chicago, IL: Prevent Child Abuse America.
Habetha, S., Bleich, S., Weidenhammer, J., & Fegert, J. M. (2012). A prevalence-based approach to societal costs occurring in consequence of child abuse and neglect. Child and Adolescent Psychiatry and Mental Health. https://doi.org/10.1186/1753-2000-6-35.
Heckman, J. J., Moon, S. H., Pinto, R., Savelyev, P. A., & Yavitz, A. (2010). The rate of return to the HighScope Perry Preschool Program. Journal of Public Economics, 94, 114–128. https://doi.org/10.1016/j.jpubeco.2009.11.001.
Henggeler, S. W., Schoenwald, S. K., Borduin, C. M., Rowland, M. D., & Cunningham, P. B. (2009). Multisystemic therapy for antisocial behavior in children and adolescents. London: Guilford Press.
Hussey, J. M., Chang, J. J., & Kotch, J. B. (2006). Child maltreatment in the United States: Prevalence, risk factors, and adolescent health consequences. Pediatrics, 118, 933–942. https://doi.org/10.1542/peds.2005-2452.
Kniesner, T. J., Viscusi, W. K., & Ziliak, J. P. (2010). Policy relevant heterogeneity in the value of a statistical life: New evidence from panel data quantile regressions. Journal of Risk and Uncertainty, 40, 15–31. https://doi.org/10.1007/s11166-009-9084-y.
Lee, S., Drake, E., Pennucci, A., Bjornstad, G., & Edovald, T. (2012). Economic evaluation of early childhood education in a policy context. Journal of Children’s Services, 7, 53–63. https://doi.org/10.1108/17466661211213670.
McMahon, W. W. (2010). The external benefits of education. In D. Brewer & P. McEwan (Eds.), Economics of education (pp. 68–80). Oxford: Academic Press.
Miller, T. R., Fisher, D. A., & Cohen, M. A. (2001). Costs of juvenile violence: Policy implications. Pediatrics, 107, e3. https://doi.org/10.1542/peds.107.1.e3.
Pérez, T., Rhiner, B., Fux, E., Fürstenau, U., & Schmid, M. (2018). New directions in child protection: The cost effectiveness of multisystemic therapy for child abuse and neglect (MST-CAN). Manuscript submitted for publication.
Pew Charitable Trusts. (2018). Pew-MacArthur results first initiative. Retrieved February 19, 2018 from http://www.pewtrusts.org/en/projects/pew-macarthur-results-first-initiative.
Sánchez-Meca, J., Marín-Martínez, F., & Chacón-Moscoso, S. (2003). Effect-size indices for dichotomized outcomes in meta-analysis. Psychological Methods, 8, 448–467. https://doi.org/10.1037/1082-989X.8.4.448.
Schoenwald, S. K. (2016). The Multisystemic Therapy® quality assurance/quality improvement system. In W. O’Donohue & A. Maragakis (Eds.), Quality improvement in behavioral health (pp. 169–192). Cham: Springer International Publishing.
South Carolina Department of Health and Human Services. (2013). RBHS—LEA rates effective 12-01-2013. Retrieved June 3, 2016 from https://www.scdhhs.gov/sites/default/files/RBHS-LEA%20Provider%20Rates%20eff%2012-1-13%20web%20pdf.pdf.
South Carolina Department of Health and Human Services. (2014). RBHS—DAODAS codes and rates effective 12-1-2014. Retrieved November 23, 2015 from https://www.scdhhs.gov/sites/default/files/RBHS-DAODAS%20Provider%20-%20Rates%20eff%2012-1-2014%20web%20file.pdf.
South Carolina Department of Health and Human Services. (2015). RBHS—LEA rates effective 03-01-2015. Retrieved November 23, 2015 from https://www.scdhhs.gov/sites/default/files/RBHS-LEAProviderRateseff03-01-2015.pdf.
Springer, K. W., Sheridan, J., Kuo, D., & Carnes, M. (2007). Long-term physical and mental health consequences of childhood physical abuse: Results from a large population-based sample of men and women. Child Abuse and Neglect, 31, 517–530. https://doi.org/10.1016/j.chiabu.2007.01.003.
Steuerle, E., & Jackson, L. M. (2016). Advancing the power of economic evidence to inform investments in children, youth, and families. Washington, DC: National Academies Press.
Straus, M. A., Hamby, S. L., Finkelhor, D., Moore, D. W., & Runyan, D. (1998). Identification of child maltreatment with the parent–child conflict tactics scales: Development and psychometric data for a national sample of American parents. Child Abuse and Neglect, 22, 249–270. https://doi.org/10.1016/S0145-2134(97)00174-9.
Swenson, C. C., Penman, J., Henggeler, S. W., & Rowland, M. D. (2010a). Multisystemic therapy for child abuse and neglect. Charleston, SC: Medical University of South Carolina, Family Services Research Center.
Swenson, C. C., Schaeffer, C. M., Henggeler, S. W., Faldowski, R., & Mayhew, A. (2010b). Multisystemic therapy for child abuse and neglect: A randomized effectiveness trial. Journal of Family Psychology, 24, 497–507. https://doi.org/10.1037/a0020324.
Truman, J. L., & Langton, L. (2015). Criminal victimization, 2014. Washington, DC: Bureau of Justice Statistics. Retrieved June 4, 2016 from http://www.bjs.gov/content/pub/pdf/cv14.pdf.
U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Children’s Bureau. (2016). Child maltreatment 2014. Washington, DC: U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Children’s Bureau.
Viscusi, W. K. (2008). How to value a life. Journal of Economics and Finance, 32, 311–323. https://doi.org/10.1007/s12197-008-9030-x.
Washington State Economic and Revenue Forecast Council. (2016). Washington state economic and revenue forecast, February 2016. Retrieved May 27, 2016 from http://www.erfc.wa.gov/publications/documents/feb16pub.pdf.
Washington State Institute for Public Policy. (2016a). Benefit-cost results. Olympia, WA: Washington State Institute for Public Policy. Retrieved November 23, 2016 from http://www.wsipp.wa.gov/BenefitCost.
Washington State Institute for Public Policy. (2016b). Benefit-cost technical documentation. Olympia, WA: Washington State Institute for Public Policy. Retrieved November 23, 2016 from http://www.wsipp.wa.gov/ TechnicalDocumentation/WsippBenefitCostTechnicalDocumentation.pdf.
Watmuff, C., & Ross, E. (2016). Costs and benefits of MST-CAN in Leeds: A preliminary internal report to the Chief Officer Children’s Services. Leeds: Leeds City Council.
Wekerle, C. (2011). The dollars and senselessness in failing to prioritize childhood maltreatment prevention. Child Abuse and Neglect, 35, 159–161. https://doi.org/10.1016/j.chiabu.2011.02.001.
World Health Organization (2006). Preventing child maltreatment: A guide to taking action and generating evidence. Geneva: WHO Press.
Acknowledgements
We sincerely thank Dr. David Ward, the health economist who worked on the randomized trial on which the present study is based, for his numerous contributions to examining costs during this study, as well as Dr. Scott Henggeler for scientific guidance. We thank all the families who helped us learn how to provide treatment in respectful ways that keep their children with them safely. We thank Cathy Joyner, the Charleston-Dorchester Mental Health Center therapists, Eugene Caldwell, all Charleston County Child Protective Services supervisors and caseworkers, Amy Mayhew, Anthony Joyner, Dawn Allen, Mary Grady, Dr. Elena Tuerk, Wiktor Wisniewski, and Hannah Ward.
Funding
This research was supported by National Institute of Mental Health (Grant No. R01MH60663), awarded to Swenson (PI).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Cindy M. Schaeffer and Cynthia Cupit Swenson are consultants in the development of Multisystemic Therapy for Child Abuse and Neglect and related programs through MST Services, Inc., which has the exclusive licensing agreement through the Medical University of South Carolina for the dissemination of Multisystemic Therapy technologies. Alex R. Dopp and Jennifer S. Powell declare that they have no conflicts of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Dopp, A.R., Schaeffer, C.M., Swenson, C.C. et al. Economic Impact of Multisystemic Therapy for Child Abuse and Neglect. Adm Policy Ment Health 45, 876–887 (2018). https://doi.org/10.1007/s10488-018-0870-1
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10488-018-0870-1