Individuals who were receiving case management services in a northeastern state were recruited for the study. Recruitment occured from March 2011 to January 2013. To be eligible for the study, individuals were required to be 17 to 20 years old, have been arrested or released from incarceration within the past 18 months, be diagnosed with a severe mental health condition, and be residing in a stable community setting. Individuals were randomly assigned to one of two study groups after a baseline interview. Sixteen individuals were randomly assigned to each of the two study groups. Coaches were also randomly assigned to deliver either vocational or standard coaching. Follow-up interviews occurred one and four months after program completion.
Recruitment occurred from March 1, 2011, to January 31, 2013. The final follow-up interview occurred an average of 11 months after services began and 4 months after an individual exited treatment.
The study was supported by grants from the National Institute of Mental Health (R34MH081374) and the National Institute on Disability, Independent Living, and Rehabilitation Research (H133B090018).
All individuals were ages 17 to 20 (average age 17.8), had been involved in the justice system (with 63 percent having been in juvenile detention and 36 percent having been to jail or prison), and had a mental health condition (with 50 percent having a major depressive disorder, 25 percent having an anxiety disorder, and 16 percent having a bipolar disorder). Most participants in the study were male (78 percent), and most were of a minority racial or ethnic background (47 percent Black, 3 percent Asian, 19 percent Hispanic, 6 percent biracial, and 44 percent White).
An unspecified private nonprofit organization.
Both the intervention and comparison conditions were pilot programs, although Multisystemic Therapy (MST) has been implemented since at least the 1990s.
Youth in the intervention group received Multisystemic Therapy for Emerging Adults (MST-EA) with additional coaching. MST-EA is designed to help individuals improve recidivism, mental illness, substance use, education, and employment outcomes using several types of therapy. Therapists were continually available to participants and met over the phone and in person with participants several times each week. Vocational coaches provided services to individuals in the intervention group, meeting with clients for two one-hour sessions each week. Coaches covered a wide variety of domains, including (but not limited to) employment, education, health, housing, parenting, and financial literacy. Each domain was the focus of between three and seven sessions. Participants in the intervention condition were not connected to state vocational rehabilitation services.
Youth in the comparison group also received MST-EA but with standard coaching. Standard coaches provided the same skills development services as the vocational coaches but did not provide coaching related to vocational domains. If participants in this group were interested in employment services, their MST-EA therapist connected them to the state vocational rehabilitation agency, which would then provide support.
Emerging adults typically received services through MST, including contact with therapists and coaches, over an average of seven to eight months.
An unspecified state agency provided funding.
The study took place in a northeastern state. Coaching and post-intervention interviews occurred in person at participants’ homes or in another place of their choice.