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Multisystemic Therapy-Family Integrated Transitions (MST-FIT) for youth in state institutions

Juvenile Justice
Benefit-cost methods last updated December 2023.  Literature review updated February 2019.
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Multisystemic Therapy-Family Integrated Transitions (MST-FIT) is a manualized adaptation of Multisystemic Therapy (MST) designed for youth with co-occurring mental health and substance use disorders who are returning to the community after confinement. MST-FIT aims for behavioral change in the youth’s home environment, emphasizing the strengths of family, peers, school, and neighborhoods to promote change. Youth receive intensive family and community-based treatment targeting serious antisocial behavior. MST-FIT incorporates the therapeutic principles from MST, Dialectical behavior therapy, and Motivational Enhancement Therapy for youth and includes parent skills training for a youth’s parent or guardian. The first phase of the program lasts two to three months while youth reside in a juvenile rehabilitation facility. The second phase occurs in the community for four to six months.

The study included in this analysis took place in Washington State. In this study, 29% of youth were people of color and 15% were female. Both the program and comparison group youth had access to usual services.

We exclude evaluations of Multisystemic Therapy-Substance Abuse, Multisystemic Therapy-Problem Sexual Behavior, and Multisystemic Therapy for court-involved youth from this analysis and analyze them separately.

Key Terms

Court-involved youth: Youth who are processed through the juvenile justice system but who are not ordered to a period of confinement in a residential or correctional facility. This includes populations of arrested youth, diverted youth, charged youth, adjudicated youth, and youth on probation or formal supervision.

Youth in state institutions: Youth who are confined in a residential or correctional facility when they participate in the program.

Youth post-release: Youth who are returning to the community following a period of confinement in a residential or correctional facility and who participate in the program after release to the community.

For an overview of WSIPP's Benefit-Cost Model, please see this guide. The estimates shown are present value, life cycle benefits and costs. All dollars are expressed in the base year chosen for this analysis (2022). The chance the benefits exceed the costs are derived from a Monte Carlo risk analysis. The details on this, as well as the economic discount rates and other relevant parameters are described in our Technical Documentation.
Benefit-Cost Summary Statistics Per Participant
Benefits to:
Taxpayers $5,089 Benefits minus costs $2,413
Participants $656 Benefit to cost ratio $1.17
Others $15,411 Chance the program will produce
Indirect ($4,659) benefits greater than the costs 53%
Total benefits $16,496
Net program cost ($14,083)
Benefits minus cost $2,413

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic in order to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the types of program impacts that were measured in the research literature (for example, crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases. See Estimating Program Effects Using Effect Sizes for additional information.

Adjusted effect sizes are used to calculate the benefits from our benefit cost model. WSIPP may adjust effect sizes based on methodological characteristics of the study. For example, we may adjust effect sizes when a study has a weak research design or when the program developer is involved in the research. The magnitude of these adjustments varies depending on the topic area.

WSIPP may also adjust the second ES measurement. Research shows the magnitude of some effect sizes decrease over time. For those effect sizes, we estimate outcome-based adjustments which we apply between the first time ES is estimated and the second time ES is estimated. We also report the unadjusted effect size to show the effect sizes before any adjustments have been made. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured Treatment age No. of effect sizes Treatment N Adjusted effect sizes(ES) and standard errors(SE) used in the benefit - cost analysis Unadjusted effect size (random effects model)
First time ES is estimated Second time ES is estimated
ES SE Age ES SE Age ES p-value
16 1 104 -0.150 0.166 17 -0.150 0.166 25 -0.150 0.368
1In addition to the outcomes measured in the meta-analysis table, WSIPP measures benefits and costs estimated from other outcomes associated with those reported in the evaluation literature. For example, empirical research demonstrates that high school graduation leads to reduced crime. These associated measures provide a more complete picture of the detailed costs and benefits of the program.

2“Others” includes benefits to people other than taxpayers and participants. Depending on the program, it could include reductions in crime victimization, the economic benefits from a more educated workforce, and the benefits from employer-paid health insurance.

3“Indirect benefits” includes estimates of the net changes in the value of a statistical life and net changes in the deadweight costs of taxation.
Detailed Monetary Benefit Estimates Per Participant
Affected outcome: Resulting benefits:1 Benefits accrue to:
Taxpayers Participants Others2 Indirect3 Total
Crime Criminal justice system $4,836 $0 $15,021 $2,418 $22,276
Labor market earnings associated with high school graduation $325 $765 $422 $0 $1,512
Costs of higher education ($72) ($109) ($33) ($36) ($250)
Program cost Adjustment for deadweight cost of program $0 $0 $0 ($7,041) ($7,041)
Totals $5,089 $656 $15,411 ($4,659) $16,496
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Detailed Annual Cost Estimates Per Participant
Annual cost Year dollars Summary
Program costs $11,938 2016 Present value of net program costs (in 2022 dollars) ($14,083)
Comparison costs $0 2016 Cost range (+ or -) 10%
The per-participant cost estimate reflects five months in Multisystemic Therapy-Family Integrated Transitions (MST-FIT), provided by C. Redman (personal communication, Washington State Juvenile Rehabilitation, April 16, 2019). This cost reflects estimates from Barnoski, R. (2009). Providing evidence-based programs with fidelity in Washington State juvenile courts: Cost analysis (Doc. No. 09-12-1201). Olympia: Washington State Institute for Public Policy.
The figures shown are estimates of the costs to implement programs in Washington. The comparison group costs reflect either no treatment or treatment as usual, depending on how effect sizes were calculated in the meta-analysis. The cost range reported above reflects potential variation or uncertainty in the cost estimate; more detail can be found in our Technical Documentation.
Benefits Minus Costs
Benefits by Perspective
Taxpayer Benefits by Source of Value
Benefits Minus Costs Over Time (Cumulative Discounted Dollars)
The graph above illustrates the estimated cumulative net benefits per-participant for the first fifty years beyond the initial investment in the program. We present these cash flows in discounted dollars. If the dollars are negative (bars below $0 line), the cumulative benefits do not outweigh the cost of the program up to that point in time. The program breaks even when the dollars reach $0. At this point, the total benefits to participants, taxpayers, and others, are equal to the cost of the program. If the dollars are above $0, the benefits of the program exceed the initial investment.

Citations Used in the Meta-Analysis

Aos, S. (2004). Washington State’s Family Integrated Transitions program for juvenile offenders: Outcome evaluation and benefit-cost analysis (Document No: 04-12-1201). Olympia WA: Washington State Institute for Public Policy.