Economic Impact of the Statewide Implementation of an Evidence-Based Treatment: Multisystemic Therapy in New Mexico

Several states have made considerable investments into large-scale implementation of evidence-based treatments (EBTs), yet little is known about key success indicators for these implementation efforts such as cost and sustainability. To that end, the present study examined the economic impact of statewide implementation of multisystemic therapy (MST; Henggeler, Schoenwald, Borduin, Rowland, & Cuningham, 2009), a family- and community-based behavioral EBT for serious juvenile offenders in New Mexico. Participants were 1,869 youth who received MST across 23 teams during the study period. We conducted a cost-benefit analysis using metrics from state data sources that compared the cost of MST to its benefits (i.e., avoided expenses from pre- to posttreatment) in two domains: (a) behavioral health services (i.e., Medicaid claims) and (b) juvenile crime (i.e., taxpayer expenses, tangible and intangible expenses to crime victims). MST costs were based on Medicaid claims, which were reimbursed at an enhanced billing rate that was intended to cover expenses for both clinical and implementation (e.g., training, quality assurance) activities. Results suggest that implementation of MST in New Mexico over the 7-year study period may have produced net benefits, through 2 years posttreatment, of more than $4,643 per youth in avoided behavioral health claims and $15,019 per youth through reductions in juvenile crime. Stated differently, every dollar that New Mexico spent on MST appeared to have returned $3.34 for a total benefit of $64.2 million over the course of the study. We discuss implications of these findings for policymakers, administrators, and researchers who are interested in increasing the sustainability of complex EBTs in community settings.     

Juveniles' understanding of trial-related information: are they competent defendants?

There exists a national trend lowering the age to transfer children facing serious charges to adult court for trial. This study examined juvenile offenders' understanding of factual information about trials. Juveniles ages 11 through 16 experiencing their first institutional placement were administered a competence to stand trial screening measure, shown an educational videotape, and readmin- istered the measure. Findings suggest that a majority do not have sufficient understanding for meaningful participation in their trials. Special care appears warranted with juveniles ages 13 and under, and juveniles with low average or below average IQ scores. Further, substantial training may be necessary for some juvenile offenders. ©1997 John Wiley & Sons, Ltd.     

Vengeance: Effects of gender,age, and religious background

Vengeance can be commonly defined as the infliction of harm in return for perceived injury or insult or as simply getting back at another person. Three hundred fifty‐three participants responded to eight hypothetical scenarios that may elicit vengeful behavior in which the offending party was either a romantic partner, a friend, a coworker, or a stranger. Participants also completed a vengeance scale and a measure of biblical literalism. Participants were most vengeful toward coworkers and least vengeful toward romantic partners. Age, religious conservatism, and gender were significant predictors of attitudes toward vengeance. Although men were more likely than women to be accepting of vengeful attitudes as measured by the vengeance scale, only age was a significant predictor of behavior in the vengeance scenarios. The current research provides a basis for a systematic investigation of vengeance within the structure of human relationships and interactions. Aggr. Behav. 27:343–350, 2001. © 2001 Wiley‐Liss, Inc.     

Emotional selection in memes: the case of urban legends.

This article explores how much memes like urban legends succeed on the basis of informational selection (i.e., truth or a moral lesson) and emotional selection (i.e., the ability to evoke emotions like anger, fear, or disgust). The article focuses on disgust because its elicitors have been precisely described. In Study 1, with controls for informational factors like truth, people were more willing to pass along stories that elicited stronger disgust. Study 2 randomly sampled legends and created versions that varied in disgust; people preferred to pass along versions that produced the highest level of disgust. Study 3 coded legends for specific story motifs that produce disgust (e.g., ingestion of a contaminated substance) and found that legends that contained more disgust motifs were distributed more widely on urban legend Web sites. The conclusion discusses implications of emotional selection for the social marketplace of ideas.     

Facilitating Interorganizational Collaboration: The Contributions of Interorganizational Alliances

In an attempt to promote service delivery integration and improve interorganizational collaboration, many recent human service delivery initiatives have included the development of interorganizational alliances such as coalitions and coordinating councils. Despite their popularity, little is known about how these alliances influence interorganizational collaboration, specifically the extent to which they alter the interactions among human service delivery organizations. The present study examined the interorganizational interactions, specifically the exchange relationships, within one county that was implementing two interorganizational alliances—a countywide coordinating council and interagency service delivery teams. Membership on both alliances was associated with broader interorganizational exchange networks. Organizations involved in a coordinating council were more likely to be included in client, information, and resource exchanges, and participate in joint ventures with a broader range of organizations. Providers involved in interagency teams also exchanged clients and information with a broader sector of service delivery organizations than nonparticipating providers. Observational data suggested that both alliances created structures and processes intended to facilitate interorganizational exchanges. Together, these results suggest that the development of opportunities for and encouragement of staff and leader involvement in these types of alliances may be an important part of our attempt to create a more integrated social service delivery system. The implications of these findings for researchers and practitioners are discussed.     

The preparation of reach to grasp movements in adults with Down syndrome.

The aim of this study was to determine the extent to which adults with Down syndrome (DS) are able to utilise advance information to prepare reach to grasp movements. The study comprised ten adults with DS; ten children matched to an individual in the group with DS on the basis of their intellectual ability, and twelve adult controls. The participants used their right hand to reach out and grasp illuminated perspex blocks. Four target blocks were positioned on a table surface, two to each side of the midsagittal plane. In the complete precue condition, participants were provided with information specifying the location of the target. In the partial precue condition, participants were given advance information indicating the location of the object relative to the midsagittal plane (left or right). In the null condition, advance information concerning the position of the target object was entirely ambiguous. It was found that both reaction times and movement times were greater for the participants with DS than for the adults without DS. The reaction times exhibited by individuals with DS in the complete precue condition were lower than those observed in the null condition, indicating that they had utilised advance information to prepare their movements. In the group with DS, when advance information specified only the location of the target object relative to the midline, reaction times were equivalent to those obtained when ambiguous information was given. In contrast, the adults without DS exhibited reaction times that were lower in both the complete and partial precue conditions when compared to the null condition. The pattern of results exhibited by the children was similar to that of the adults without DS. The movement times exhibited by all groups were not influenced by the precue condition. In summary, our findings indicate that individuals with DS are able to use advance information if it specifies precisely the location of the target object in order to prepare a reach to grasp movement. The group with DS were unable, however, to obtain the normal advantage of advance information specifying only one dimension of the movement goal (i.e., the position of an object relative to the body midline).