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Effective treatments for juvenile sexual offenders are needed to reduce the societal impact of sexual crimes. The purpose of this paper is to review the empirical literature on treatments for this clinical population.

The authors searched PsycInfo and MEDLINE (via PubMed) for studies that evaluated outcomes of treatments with juvenile sexual offenders.

There are a small but growing number of treatment studies (n=10) with juvenile sexual offenders, and all of these studies evaluated cognitive-behavioral therapy or multisystemic therapy for problem sexual behaviors. The results of these studies are promising, although conclusions about treatment effectiveness have been frequently limited by methodological problems.

The authors provide recommendations for treatment providers and policymakers to consider in their decisions about interventions for juvenile sexual offenders. Furthermore, the authors offer suggestions for researchers who seek to develop effective interventions targeting this clinical population.

This paper aims to report on the results of a global search to identify the characteristics of successful sexual offender treatment programs, with a view to providing guidance for program development.

A keyword search was conducted of criminology and social science databases. Successful programs were selected on evaluations that used standard scientific designs.

This study identified 18 evaluations of 16 programs showing significant reductions in reconvictions. Most programs used cognitive behavioural therapy (CBT), with both group and individual sessions; and many evidenced multisystemic therapy (MST) approaches involving families and/or local communities. CBT-based approaches were also common in the 20 unsuccessful programs identified in the study, although fewer MST-oriented features were in evidence. Noncustodial settings, and combined custodial-noncustodial settings, were also more prominent in the successful programs.

There is a shortage of studies focused on the specific components of successful treatment programs for sexual offenders, including for subsets of offenders, such as ethnic minority groups and women.

The findings demonstrate the need for more investment in treatment programs with strict evaluation processes. New and modified programs are likely to benefit from the application of CBT, MST and a community-based reintegration component. More research is needed on effective elements of sexual offender treatment programs.

To the best of the authors’ knowledge, this appears to be the first study that examines features of successful sexual offender treatment programs, compared to unsuccessful programs, using a case-study approach. The findings reinforce the known value of CBT and systemic approaches as core features of programs but raise important questions about what other components are key to activating success.

Multisystemic therapy (MST) is described and contrasted with practice in traditional services for young people who have committed crime, behaved anti‐socially, abused substances or suffered family conflict. The challenges to traditional services posed by MST are examined, including consideration of the process of engagement in therapy, the intensive individualised therapy delivered in the young person's own home or local community, and the quality assurance systems.

In order to examine the sustainability of programme effectiveness, we investigated whether the effects of multisystemic treatment (MST) on a second group of adolescents would match those reported in an earlier randomised controlled trial (RCT). Pre‐ and post‐treatment assessments were analysed in a participant group of 105; 55 youths were referred to MST in the programme's second year of operation (MST2), and 50 youths were included in the RCT the first year in which 30 were randomly assigned to MST (MST1) and 20 to regular services (RS).At two project sites, MST clinical outcomes in the second year of programme operation matched and, for key indices of anti‐social behaviour, surpassed those achieved during the first year. In addition the MST treatment delivered in the second year was more effective than regular child welfare services in preventing out of home placement and reducing internalising and externalising behaviour. Together, these results demonstrated sustained effectiveness of the programme as well as indication of programme maturation effects. No group differences were registered for social competence. MST youths treated in the second year were significantly younger than those referred to treatment in the first year (MST1) but age had no moderating effect on the outcomes.

John Pitts reports on recent developments in youth justice policy in the US. A task force is charged with transforming juvenile justice by looking at ways to strengthen alternatives to custody, improve residential care and enhance re‐entry programmes. Pitts looks forward to a more rational approach to policy‐making in the US.

This study aims to investigate outcomes of multisystemic therapy (MST) using the Youth Level of Service/Case Management Inventory (YLS/CMI) – part I.

This study, using a pre-post design, included a sample of 2,123 Norwegian youths (mean age = 14.7, SD = 1.34). The MST team supervisors assessed the YLS/CMI risk factors in addition to five behavioral treatment goals (Lives at home, Attends school/work, No violence/threats, Law-abiding and Drug-free) before and after treatment. In addition, data included responses from parent interviews six months post treatment.

Significant correlations were found between the total and dynamic YLS/CMI change scores and the additive index of behavioral treatment goals. In addition, the YLS/CMI change scores predicted the five treatment goals at the termination of treatment and at six-month follow-up.

The results indicate that the YLS/CMI is a valuable assessment tool for predicting the achievement of MST behavioral goals in adolescents with serious problem behavior.

This study provides an evaluation of the YLS/CMI in a Norwegian context and adds support for continued use of the YLS/CMI in MST.

This paper provides new insights about the YLS/CMI inventory as a tool for examining treatment change in MST. Results show that the YLS/CMI captures relevant risk factors in the youths’ environment.

The article aims to examine the process and challenges of setting up and implementing evidence‐based programmes in regular service systems.

The article offers a first‐hand account of a service manager seeking to implement Multisystemic Therapy and Triple P.

The process of setting up and implementing evidence‐based programmes involved significant challenges, including securing funding, managing stakeholders, finding suitable staff, arranging training, and managing supply and demand. Various relational, cultural and systemic issues need to be addressed if the professional system is to embrace evidence‐based programmes.

Few evidence‐based programmes in the UK have been implemented extensively in regular service systems. This is a first‐hand account of a rare attempt to do so.

This article is an extended version of an ‘experts’ briefing' commissioned to inform senior child welfare managers in English local authorities and voluntary agencies about the available evidence to inform the provision of effective services in complex child protection cases. It starts by noting how differences in the approach to service provision in different jurisdictions affect both the nature of research conducted and its transferability across national boundaries. It then summarises the characteristics both of parents who are likely to maltreat their children and also of the children most likely to be maltreated. The factors that make some families ‘hard to engage’ or ‘hard to help/change’ are then discussed, as are the essential elements of effective professional practice in child protection. Particular attention is paid to effective approaches to helping families and young people who are hard to identify or engage.

Two major reform movements have shaped child and adolescent mental health services over the past quarter-century: the Systems of Care movement, and more recently, the movement toward evidence-based practice. Results from several studies indicate that youth served in traditional residential or inpatient care may experience difficulty re-entering their natural environments, or were released into physically and emotionally unsafe homes (Bruns & Burchard, 2000; President's Commission on Mental Health, 1978; Stortz, 2000; Stroul & Friedman, 1986; U.S. Department of Health and Human Services, 1999). The cost of hospitalizing youth also became a policy concern (Henggeler et al., 1999b; Kielser, 1993; U.S. Department of Health and Human Services, 1999). For example, it is estimated that from the late 1980s through 1990 inpatient treatment consumed nearly half of all expenditures for child and adolescent mental health care although the services were found not to be very effective (Burns, 1991; Burns & Friedman, 1990). More recent analyses indicate that at least 1/3 of all mental health expenditures for youth are associated with inpatient hospitalization (Ringel & Sturm, 2001).