Behavioural ProblemsNCT06032455
Effectiveness of Multisystemic Therapy for Adolescents From Families With Intellectual Disabilities
An observational study of Behavioural Problems, run by De Viersprong at 4 sites in Netherlands.
Trial summary
The goal of this observational study is to determine the effectiveness of a specialisation of multisystemic therapy (MST) for adolescents with severe behavioural problems from families with an intellectual disability (ID; MST-ID). To achieve this goal, a mixed method study design is used. Read more about this study
- Who is it for?
- Ages 10 to 19 years
- Conditions the study is for
- Behavioural Problems
- What is being tested?
- Multisystemic therapy and Multisystemic therapy - intellectual disabilities
- Type of treatment
- Lifestyle or therapy programme
- How many people
- 470 participants
- Where
- 4 sitesNetherlands
- Study dates
- 4 Sep 2023to Sep 2027
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 10 to 19 years
- All sexes
- No healthy volunteers
- Child, Adult
Study population: The target population consists of adolescents and their parent(s) with a known or suspected ID referred to MST-ID at one of three Dutch mental health care organisations (de Viersprong, Koraal, and Prisma) or to standard MST at one of two Dutch mental health care organisations (de Viersprong and Pactum).
Who may be able to join
- Adolescent must be 10 to 19 years old at the start of treatment;
- Adolescent presents with severe behavioural problems in at least two life areas;
- Adolescent lives with a family or there is a family the adolescent can live with, in which parent(s) have parental custody for a longer period of time;
- Parent(s) consent(s) and is/are willing to engage in treatment to prevent an out-of-home placement of the adolescent;
- Adolescent and/or parent(s) have a known or suspected intellectual disability (operationalised as an intelligence quotient [IQ] score of between 50-85 and additional deficits in adaptive functioning)
- Adolescent and/or parent(s) have sufficient knowledge of the Dutch language (as assessed by a clinician and/or researcher) in order to understand and answer the various (self-report) questionnaires.
Who cannot join
- Adolescent lives independently;
- Adolescent presents with severe problematic sexual behaviours, without presenting with other severe behavioural problems;
- Adolescent presents suicidal, psychotic, or homicidal requiring specialised treatment (such as a crisis placement in a residential facility);
- Adolescent has a severe Autism Spectrum Disorder (level 2-3 according to the Diagnostic and Statistical Manual of Mental Disorders [DSM-V] criteria) or a severe ID (IQ score <50);
- Adolescent has internalising psychiatric problems which are the primary reason for referral, or has serious psychiatric problems (similar to #3 as well as for example eating disorder.
Trial locations and contacts
4 sites in 1 country. Contact the study team or a site near you to ask about taking part.
Netherlands4 sites, 4 recruiting
- Recruiting
De Viersprong
Halsteren
Dineke J Feenstra, PhD, +31887656200
- Recruiting
Koraal
Sittard
Gaby van Helvert, +31464775252
- Recruiting
Stichting Prisma
Waalwijk
Mariska Mecking, +31629547022
- Recruiting
Pactum
Zetten
Mies Geenen, +31629673556, miesgeenen@vigogroep.nl
About this study
Official title: The Effectiveness of Multisystemic Therapy for Adolescents With Severe Behavioural Problems From Families With Intellectual Disabilities: A Mixed-Method Study
The goal of this observational study is to determine the effectiveness of a specialisation of multisystemic therapy (MST) for adolescents with severe behavioural problems from families with an intellectual disability (ID; MST-ID).
To achieve this goal, a mixed method study design is used. To this end, a quantitative and a qualitatively primary research question are formulated:
Read more
- Is MST-ID superior, when compared to standard MST, in reducing rule-breaking behaviour of adolescents (quantitative)?
- What are the experiences of adolescents and/or parents receiving MST-ID treatment (qualitative)?
Participants will be asked to complete two screeners (questionnaires delivered as a verbal interview) with a total duration of approximately 30 minutes. Other data will be collected through Routine Outcome Monitoring questionnaires that are part of standard MST procedures. To this end, five 'time points' have been identified: T0 (start of MST[-ID] treatment), T1 (end of MST[-ID] treatment), T2 (follow-up 6 month after MST[-ID] treatment), T3 (follow-up 12 month after MST[-ID] treatment), and T4 (follow-up 18 month after MST[-ID] treatment). The qualitative method used to gain insight into families' experiences is determined in consultation with the families.
To assess the effectiveness of MST-ID, its treatment outcomes will be compared to standard MST treatment outcomes of families with ID.
Read the detailed description
Background of the study:
Over the years, a large body of research has shown that adolescents with intellectual disability are 3-4 times more likely to develop severe behaviour problems than adolescents without intellectual disability. Families in which adolescents and/or one or both parent(s) have an intellectual disability (from now on, families with ID) often deal with complex problems, putting the adolescent at an increased risk of out-of-home placement. Multisystemic therapy (MST) is an intensive home-based treatment, effective in reducing severe behaviour problems and preventing the out-of-home placement of adolescents. A specialisation of MST has been developed for families with ID: MST-ID. In MST-ID, among other alterations, simplified language and visual support is used, sessions are more structured and more time is scheduled for practicing exercises, and extra attention is paid to the generalisation of what has been learned in the sessions (with the aim of attaining long-term outcomes). Pilot studies show that when compared to standard MST, MST-ID shows similar or better treatment outcomes in families with adolescents with ID. Meanwhile, MST-ID has been disseminated more widely and the target population extended by including families in which only the parent(s) have an ID.
Objective of the study:
The aim of this study is to investigate the effectiveness of MST-ID for adolescents with severe behavioural problems from families with an intellectual disability (ID), compared to standard MST. It is hypothesised that MST-ID is more effective - in terms of fewer behavioural problems, more adolescents living at home, being in school/work, no new police contacts, less parenting stress - than standard MST. Treatment outcomes are considered both quantitatively and qualitatively.
Study design:
Quantitatively, the Propensity Score (PS) method is used to balance treatment groups and, combined with Multilevel Modelling (MLM), to estimate treatment effect over time. Qualitatively, the experiences of approximately 10 adolescents and/or parents are centralised. The qualitative research methods will be decided upon in a participatory manner with respondents (examples of potential research methods are interviews, focus group discussions, or photo elicitation).
Study population:
Adolescents (10-19y) with severe behavioural problems or delinquent behaviours, and their parent(s) receiving MST(-ID) treatment. All research participants must be from families where either the adolescent and/or parent(s) has/have ID.
Intervention:
Following standard referral procedures, families were either referred to standard MST or MST-ID treatment (i.e., non-randomly). Both standard MST and MST-ID are intensive, home-based treatments with 3-5 home visits per week, targeting the severe behavioural problems of adolescents across multiple life domains. MST-ID is tailored to the needs and skill deficits of adolescents and/or parents with ID. Concretely, more attention is paid to how therapists create engagement, implement interventions, and realise support from informal supports, in a tailored, developmentally appropriate, and simplified manner (meaning in a more structured way and using accessible language, among others), when compared to standard MST.
Research questions:
Building on the objectives, the following research questions were formulated:
Primary research questions:
- Is MST-ID superior, when compared to standard MST, in reducing rule-breaking behaviour of adolescents, according to parents?
- Is MST-ID superior, when compared to standard MST, in reducing rule-breaking behaviour of adolescents, according to adolescents? Secondary research questions:
- Is MST-ID superior, when compared to standard MST, in reducing externalising and internalising behavioural problems of adolescents, according to parents?
- Is MST-ID superior, when compared to standard MST, in reducing externalising and internalising behavioural problems of adolescents, according to adolescents?
- Is MST-ID superior, when compared to standard MST, in reducing parenting stress?
- Is MST-ID superior, when compared to standard MST, in preventing short and long term out-of-home placement, delinquency, truancy or joblessness, and addictions of adolescents?
- Is MST-ID superior, when compared to standard MST, in realising improvements on family's social networks?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome parenting skills?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome family relations?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome social support?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome adolescent success in an educational or vocational setting?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome adolescent involvement with pro-social peers?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome change in adolescent problem behaviour?
- What are the experiences of adolescents and/or parents receiving MST-ID treatment?
- Do effects across subgroups of adolescents and/or parents with ID differ?
MST-ID is expected to be superior in achieving the aforementioned outcomes (#1-13) when compared to standard MST. Research questions #14-15 will be assessed exploratively, therefore no hypotheses have been formulated.
- Conditions
- Behavioural Problems
- Being tested
- Multisystemic therapy, Multisystemic therapy - intellectual disabilities
- Keywords
- multisystemic therapy, intellectual disability, adolescent behavioural problems, family functioning
- Medical subject headings
- Mental Disorders, Intellectual Disability
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Multisystemic therapyBehavioural
Also called MST
Multisystemic Therapy (MST) is an intensive, evidence-based treatment aimed at preventing out-of-home placement of adolescents with severe behavioural problems. The intervention is home-based and focuses not only on the adolescent, but also on the various systems surrounding the adolescent, such as the family, neighbourhood, school, and friends. MST helps parents increase their parenting competencies such as parental monitoring and find (more) social support in their environment. MST also helps adolescents improve their relationship with their parents, school participation, and social activities, and promotes contact with pro-social peers. These goals are achieved by working together with key figures in the family's environment. MST treatment duration is three to five months. In MST, a family can contact a therapist 24/7.
Multisystemic therapy - intellectual disabilitiesBehavioural
Also called MST-ID
Multisystemic therapy - intellectual disabilities (MST-ID) is a specialisation of standard MST (see above), tailored to the needs and skill deficits of families in which the adolescent and/or parent(s) has/have a known or suspected ID. In MST-ID, among others, simplified language and visual support are used, and extra attention is paid to the generalisation of what has been learned in the treatment sessions.
| Study group | Role | What they receive |
|---|---|---|
| Families receiving standard MST | Families in which the adolescent and/or parent(s) has/have an ID receiving standard MST treatment Receives: Behavioral: Multisystemic therapy | |
| Families receiving MST-ID | Families in which the adolescent and/or parent(s) has/have an ID receiving MST-ID treatment Receives: Behavioral: Multisystemic therapy - intellectual disabilities |
What is being measured
The primary outcome is the main question the study is designed to answer.
Rule-breaking behaviour of adolescents - parents
Rule-breaking behaviour of adolescents according to parents will be assessed using the Child Behavior Check List (CBCL). The CBCL consists of 118 questions rated on a 3-point scale from 0 (absent) to 2 (occurs often). Higher scores indicate that adolescents experience more problems.
Measured: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Rule-breaking behaviour of adolescents - adolescents
Rule-breaking behaviour of adolescents according to parents will be assessed using the Youth Self Report (YSR). The YSR consists of 112 questions rated on a 3-point scale from 0 (absent) to 2 (occurs often). Higher scores indicate that adolescents experience more problems.
Measured: Start (T0) and end (T1) of MST(-ID) treatment, an average of 4 months in between
Secondary outcomes (14)
Externalising and internalising behavioural problems of adolescents - parents
Externalising and internalising behavioural problems of adolescents will be assessed using the Child Behavior Check List (CBCL). The CBCL consists of 118 questions rated on a 3-point scale from 0 (absent) to 2 (occurs often). Higher scores indicate that adolescents experience more problems.
Measured: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Externalising and internalising behavioural problems of adolescents - adolescents
Externalising and internalising behavioural problems of adolescents according to adolescents will be assessed using the Youth Self Report (YSR). The YSR consists of 112 questions rated on a 3-point scale from 0 (absent) to 2 (occurs often). Higher scores indicate that adolescents experience more problems.
Measured: Start (T0) and end (T1) of MST(-ID) treatment, an average of 4 months in between
Parenting stress
Parenting stress will be assessed using the Parenting Stress Questionnaire (PSQ), which is the English version of the Dutch Opvoedingsbelasting Vragenlijst (OBVL). The PSQ consists of 34 questions rated on a 4-point scale from 1 (not true) to 4 (very true). Higher scores indicate more parenting stress.
Measured: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Out-of-home placement
Out-of-home placement of adolescents will be assessed using the Social Demographic Information 3.0 questionnaire (SDI 3.0).
Measured: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Delinquency
Delinquency of adolescents is operationalized as police contact and will be assessed using the SDI 3.0.
Measured: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
School going or work
The adolescent's school going or work is operationalised as "school going that meets the expectations of the school or public education law officer or work that meets the expectations of caregivers and the referring agent" and will be assessed using the SDI 3.0.
Measured: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Addictions
Addictions of adolescents are operationalised as "adolescent drug misuse/abuse, screen or game dependency that has resulted in addiction, and/or other addictions" and will be assessed using the SDI 3.0.
Measured: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Social network
Social network is operationalised as "forms of social network available to a family and number of supports (read: individuals) that are available to the family" and will be assessed using the SDI 3.0.
Measured: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
IO Percentage of families with improved parenting skills
MST's so called "instrumental outcomes" (IOs) identify skills which are instrumental to achieving positive treatment outcomes and are reported by therapists. The first IO assesses whether or not families show improved parenting skills, answered 'yes' or 'no'.
Measured: End of MST(-ID) treatment, an average of 4 months after start of treatment
IO Percentage of families with improved family relations
MST's so called "instrumental outcomes" (IOs) identify skills which are instrumental to achieving positive treatment outcomes and are reported by therapists. The second IO assesses whether or not families show improved family relations, answered 'yes' or 'no'.
Measured: End of MST(-ID) treatment, an average of 4 months after start of treatment
IO Percentage of families with improved social support
MST's so called "instrumental outcomes" (IOs) identify skills which are instrumental to achieving positive treatment outcomes and are reported by therapists. The third IO assesses whether or not families show improved social support, answered 'yes' or 'no'.
Measured: End of MST(-ID) treatment, an average of 4 months after start of treatment
IO Percentage of families with adolescent success in an educational or vocational setting
MST's so called "instrumental outcomes" (IOs) identify skills which are instrumental to achieving positive treatment outcomes and are reported by therapists. The fourth IO assesses whether or not the adolescent obtained success in an educational or vocational setting, answered 'yes' or 'no'.
Measured: End of MST(-ID) treatment, an average of 4 months after start of treatment
IO Percentage of families with adolescent involvement with pro-social peers
MST's so called "instrumental outcomes" (IOs) identify skills which are instrumental to achieving positive treatment outcomes and are reported by therapists. The fifth IO assesses whether or not the adolescent is involved with pro-social peers, answered 'yes' or 'no'.
Measured: End of MST(-ID) treatment, an average of 4 months after start of treatment
IO Percentage of families with change in adolescent problem behaviour
MST's so called "instrumental outcomes" (IOs) identify skills which are instrumental to achieving positive treatment outcomes and are reported by therapists. The sixth IO assesses whether or not the adolescent obtained changes in problem behaviour that were sustained for 3-4 weeks, answered 'yes' or 'no'.
Measured: End of MST(-ID) treatment, an average of 4 months after start of treatment
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Sep 2023
- Study start4 Sep 2023
- Primary completionSep 2027 (estimated)
- Study completionSep 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for Behavioural ProblemsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Prospective
- Enrolment
- 470 participants (estimated)
Sponsor and investigators
- Lead sponsor
- De Viersprong
- Sponsor type
- University, hospital or other
- Collaborators
- Stichting tot Steun, Koraal, Prisma, MST-Netherlands/Belgium, Radboud University Medical Center, Pactum
- Responsible party
- Sponsor
- Investigators
- Dineke Feenstra, PhD, Principal investigator, De Viersprong
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06032455
- Sponsor's protocol ID
- 303
- Status last verified
- Feb 2026
- First submitted
- 25 Jul 2023
- Last updated
- 13 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Emerson E, Einfeld S, Stancliffe RJ. Predictors of the persistence of conduct difficulties in children with cognitive delay. J Child Psychol Psychiatry. 2011 Nov;52(11):1184-94. doi: 10.1111/j.1469-7610.2011.02413.x. Epub 2011 Apr 19.
PubMed 21501168Blankestein A, van der Rijken R, Eeren HV, Lange A, Scholte R, Moonen X, De Vuyst K, Leunissen J, Didden R. Evaluating the effects of multisystemic therapy for adolescents with intellectual disabilities and antisocial or delinquent behaviour and their parents. J Appl Res Intellect Disabil. 2019 May;32(3):575-590. doi: 10.1111/jar.12551. Epub 2019 Jan 8.
PubMed 30620111Blankestein A, Lange A, van der Rijken R, Scholte R, Moonen X, Didden R. Brief report: Follow-up outcomes of multisystemic therapy for adolescents with an intellectual disability and the relation with parental intellectual disability. J Appl Res Intellect Disabil. 2020 May;33(3):618-624. doi: 10.1111/jar.12691. Epub 2019 Dec 28.
PubMed 31883357De Ruiter KP, Dekker MC, Douma JCH, Verhulst FC, Koot HM. Development of parent- and teacher-reported emotional and behavioural problems in young people with intellectual disabilities: Does level of intellectual disability matter? J Appl Res Intellect Disabil. 2008; 21(1): 70-80.
Wallander JL, Dekker MC, Koot HM. Psychopathology in children and adolescents with intellectual disability: Measurement, prevalence, course, and risk. International Review of Research in Mental Retardation. 2003; 26: 93-134.
Blankestein A, Van der Rijken R, De Vuyst K, De Bruijn J, Moonen X, Leunissen J, Didden R. Multisysteemtherapie voor jongeren met een licht verstandelijke beperking en hun ouders: Een onderzoek naar de effectiviteit van een ambulante systeemgerichte interventie. Directieve Therapie. 2016; 36(3): 204-219. Dutch.
Dekker MC. Short Review: Psychopathology in young people with mild ID or borderline intellectual functioning: Research findings from representative (clinical) samples & future needs. Academische Werkplaats Kajak. 2019.
Henggeler SW, Schoenwald SK, Borduin CM, Rowland MD, Cunningham PB. Multisystemic therapy for antisocial behavior in children and adolescents. 2nd ed. New York: The Guilford Press; 2009.
Kaal HL, Overvest N, Boertjes MJ. Beperkt in de keten: Mensen met een licht verstandelijke beperking in de strafrechtsketen [People with mild intellectual disability in the justice system]. 2nd ed. Amsterdam: Boom Lemma; 2014.
Study at a glance
From the registry record, last updated by the sponsor on 13 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- The Effectiveness of Multisystemic Therapy for Adolescents With Severe Behavioural Problems From Families With Intellectual Disabilities: A Mixed-Method Study
- ClinicalTrials.gov ID
- NCT06032455
- Acronym / sponsor ID
- 303
- Conditions
- Behavioural Problems
- Keywords
- multisystemic therapy, intellectual disability, adolescent behavioural problems, family functioning
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 470 participants (estimated)
- Lead sponsor
- De ViersprongUniversity, hospital or other
- Collaborators
- Stichting tot Steun, Koraal, Prisma, MST-Netherlands/Belgium, Radboud University Medical Center, Pactum
- Study start
- 4 Sep 2023 (actual)
- Primary completion
- Sep 2027 (estimated)
- Study completion
- Sep 2027 (estimated)
- First posted
- 13 Sep 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The goal of this observational study is to determine the effectiveness of a specialisation of multisystemic therapy (MST) for adolescents with severe behavioural problems from families with an intellectual disability (ID; MST-ID).
To achieve this goal, a mixed method study design is used. To this end, a quantitative and a qualitatively primary research question are formulated:
- Is MST-ID superior, when compared to standard MST, in reducing rule-breaking behaviour of adolescents (quantitative)?
- What are the experiences of adolescents and/or parents receiving MST-ID treatment (qualitative)?
Participants will be asked to complete two screeners (questionnaires delivered as a verbal interview) with a total duration of approximately 30 minutes. Other data will be collected through Routine Outcome Monitoring questionnaires that are part of standard MST procedures. To this end, five 'time points' have been identified: T0 (start of MST[-ID] treatment), T1 (end of MST[-ID] treatment), T2 (follow-up 6 month after MST[-ID] treatment), T3 (follow-up 12 month after MST[-ID] treatment), and T4 (follow-up 18 month after MST[-ID] treatment). The qualitative method used to gain insight into families' experiences is determined in consultation with the families.
To assess the effectiveness of MST-ID, its treatment outcomes will be compared to standard MST treatment outcomes of families with ID.
Detailed description
Background of the study:
Over the years, a large body of research has shown that adolescents with intellectual disability are 3-4 times more likely to develop severe behaviour problems than adolescents without intellectual disability. Families in which adolescents and/or one or both parent(s) have an intellectual disability (from now on, families with ID) often deal with complex problems, putting the adolescent at an increased risk of out-of-home placement. Multisystemic therapy (MST) is an intensive home-based treatment, effective in reducing severe behaviour problems and preventing the out-of-home placement of adolescents. A specialisation of MST has been developed for families with ID: MST-ID. In MST-ID, among other alterations, simplified language and visual support is used, sessions are more structured and more time is scheduled for practicing exercises, and extra attention is paid to the generalisation of what has been learned in the sessions (with the aim of attaining long-term outcomes). Pilot studies show that when compared to standard MST, MST-ID shows similar or better treatment outcomes in families with adolescents with ID. Meanwhile, MST-ID has been disseminated more widely and the target population extended by including families in which only the parent(s) have an ID.
Objective of the study:
The aim of this study is to investigate the effectiveness of MST-ID for adolescents with severe behavioural problems from families with an intellectual disability (ID), compared to standard MST. It is hypothesised that MST-ID is more effective - in terms of fewer behavioural problems, more adolescents living at home, being in school/work, no new police contacts, less parenting stress - than standard MST. Treatment outcomes are considered both quantitatively and qualitatively.
Study design:
Quantitatively, the Propensity Score (PS) method is used to balance treatment groups and, combined with Multilevel Modelling (MLM), to estimate treatment effect over time. Qualitatively, the experiences of approximately 10 adolescents and/or parents are centralised. The qualitative research methods will be decided upon in a participatory manner with respondents (examples of potential research methods are interviews, focus group discussions, or photo elicitation).
Study population:
Adolescents (10-19y) with severe behavioural problems or delinquent behaviours, and their parent(s) receiving MST(-ID) treatment. All research participants must be from families where either the adolescent and/or parent(s) has/have ID.
Intervention:
Following standard referral procedures, families were either referred to standard MST or MST-ID treatment (i.e., non-randomly). Both standard MST and MST-ID are intensive, home-based treatments with 3-5 home visits per week, targeting the severe behavioural problems of adolescents across multiple life domains. MST-ID is tailored to the needs and skill deficits of adolescents and/or parents with ID. Concretely, more attention is paid to how therapists create engagement, implement interventions, and realise support from informal supports, in a tailored, developmentally appropriate, and simplified manner (meaning in a more structured way and using accessible language, among others), when compared to standard MST.
Research questions:
Building on the objectives, the following research questions were formulated:
Primary research questions:
- Is MST-ID superior, when compared to standard MST, in reducing rule-breaking behaviour of adolescents, according to parents?
- Is MST-ID superior, when compared to standard MST, in reducing rule-breaking behaviour of adolescents, according to adolescents? Secondary research questions:
- Is MST-ID superior, when compared to standard MST, in reducing externalising and internalising behavioural problems of adolescents, according to parents?
- Is MST-ID superior, when compared to standard MST, in reducing externalising and internalising behavioural problems of adolescents, according to adolescents?
- Is MST-ID superior, when compared to standard MST, in reducing parenting stress?
- Is MST-ID superior, when compared to standard MST, in preventing short and long term out-of-home placement, delinquency, truancy or joblessness, and addictions of adolescents?
- Is MST-ID superior, when compared to standard MST, in realising improvements on family's social networks?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome parenting skills?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome family relations?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome social support?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome adolescent success in an educational or vocational setting?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome adolescent involvement with pro-social peers?
- Is MST-ID superior, when compared to standard MST, in improving the instrumental outcome change in adolescent problem behaviour?
- What are the experiences of adolescents and/or parents receiving MST-ID treatment?
- Do effects across subgroups of adolescents and/or parents with ID differ?
MST-ID is expected to be superior in achieving the aforementioned outcomes (#1-13) when compared to standard MST. Research questions #14-15 will be assessed exploratively, therefore no hypotheses have been formulated.
Study design
- Observational model
- Case-control
- Time perspective
- Prospective
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Families receiving standard MST | – | Behavioral: Multisystemic therapyFamilies in which the adolescent and/or parent(s) has/have an ID receiving standard MST treatment |
| Families receiving MST-ID | – | Behavioral: Multisystemic therapy - intellectual disabilitiesFamilies in which the adolescent and/or parent(s) has/have an ID receiving MST-ID treatment |
Who may qualify
- Ages
- 10 to 19 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
- Study population
- The target population consists of adolescents and their parent(s) with a known or suspected ID referred to MST-ID at one of three Dutch mental health care organisations (de Viersprong, Koraal, and Prisma) or to standard MST at one of two Dutch mental health care organisations (de Viersprong and Pactum).
Key inclusion criteria (6 listed)
- Adolescent must be 10 to 19 years old at the start of treatment;
- Adolescent presents with severe behavioural problems in at least two life areas;
- Adolescent lives with a family or there is a family the adolescent can live with, in which parent(s) have parental custody for a longer period of time;
- Parent(s) consent(s) and is/are willing to engage in treatment to prevent an out-of-home placement of the adolescent;
- Adolescent and/or parent(s) have a known or suspected intellectual disability (operationalised as an intelligence quotient [IQ] score of between 50-85 and additional deficits in adaptive functioning)
Key exclusion criteria (5 listed)
- Adolescent lives independently;
- Adolescent presents with severe problematic sexual behaviours, without presenting with other severe behavioural problems;
- Adolescent presents suicidal, psychotic, or homicidal requiring specialised treatment (such as a crisis placement in a residential facility);
- Adolescent has a severe Autism Spectrum Disorder (level 2-3 according to the Diagnostic and Statistical Manual of Mental Disorders [DSM-V] criteria) or a severe ID (IQ score <50);
- Adolescent has internalising psychiatric problems which are the primary reason for referral, or has serious psychiatric problems (similar to #3 as well as for example eating disorder.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Multisystemic therapyAlso: MSTMultisystemic Therapy (MST) is an intensive, evidence-based treatment aimed at preventing out-of-home placement of adolescents with severe behavioural problems. The intervention is home-based and focuses not only on the adolescent, but also on the various systems surrounding the adolescent, such as the family, neighbourhood, school, and friends. MST helps parents increase their parenting competencies such as parental monitoring and find (more) social support in their environment. MST also helps adolescents improve their relationship with their parents, school participation, and social activities, and promotes contact with pro-social peers. These goals are achieved by working together with key figures in the family's environment. MST treatment duration is three to five months. In MST, a family can contact a therapist 24/7. | Behavioural | Families receiving standard MST |
| Multisystemic therapy - intellectual disabilitiesAlso: MST-IDMultisystemic therapy - intellectual disabilities (MST-ID) is a specialisation of standard MST (see above), tailored to the needs and skill deficits of families in which the adolescent and/or parent(s) has/have a known or suspected ID. In MST-ID, among others, simplified language and visual support are used, and extra attention is paid to the generalisation of what has been learned in the treatment sessions. | Behavioural | Families receiving MST-ID |
Primary outcome
Rule-breaking behaviour of adolescents - parents
Time frame: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Rule-breaking behaviour of adolescents according to parents will be assessed using the Child Behavior Check List (CBCL). The CBCL consists of 118 questions rated on a 3-point scale from 0 (absent) to 2 (occurs often). Higher scores indicate that adolescents experience more problems.
Rule-breaking behaviour of adolescents - adolescents
Time frame: Start (T0) and end (T1) of MST(-ID) treatment, an average of 4 months in between
Rule-breaking behaviour of adolescents according to parents will be assessed using the Youth Self Report (YSR). The YSR consists of 112 questions rated on a 3-point scale from 0 (absent) to 2 (occurs often). Higher scores indicate that adolescents experience more problems.
14 secondary outcomes
Externalising and internalising behavioural problems of adolescents - parents
Time frame: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Externalising and internalising behavioural problems of adolescents - adolescents
Time frame: Start (T0) and end (T1) of MST(-ID) treatment, an average of 4 months in between
Parenting stress
Time frame: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Out-of-home placement
Time frame: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Delinquency
Time frame: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
School going or work
Time frame: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Addictions
Time frame: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
Social network
Time frame: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)
IO Percentage of families with improved parenting skills
Time frame: End of MST(-ID) treatment, an average of 4 months after start of treatment
IO Percentage of families with improved family relations
Time frame: End of MST(-ID) treatment, an average of 4 months after start of treatment
IO Percentage of families with improved social support
Time frame: End of MST(-ID) treatment, an average of 4 months after start of treatment
IO Percentage of families with adolescent success in an educational or vocational setting
Time frame: End of MST(-ID) treatment, an average of 4 months after start of treatment
IO Percentage of families with adolescent involvement with pro-social peers
Time frame: End of MST(-ID) treatment, an average of 4 months after start of treatment
IO Percentage of families with change in adolescent problem behaviour
Time frame: End of MST(-ID) treatment, an average of 4 months after start of treatment
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 13 Apr 2026.
- Background: PubMed 21501168Emerson E, Einfeld S, Stancliffe RJ. Predictors of the persistence of conduct difficulties in children with cognitive delay. J Child Psychol Psychiatry. 2011 Nov;52(11):1184-94. doi: 10.1111/j.1469-7610.2011.02413.x. Epub 2011 Apr 19.
- Background: PubMed 30620111Blankestein A, van der Rijken R, Eeren HV, Lange A, Scholte R, Moonen X, De Vuyst K, Leunissen J, Didden R. Evaluating the effects of multisystemic therapy for adolescents with intellectual disabilities and antisocial or delinquent behaviour and their parents. J Appl Res Intellect Disabil. 2019 May;32(3):575-590. doi: 10.1111/jar.12551. Epub 2019 Jan 8.
- Background: PubMed 31883357Blankestein A, Lange A, van der Rijken R, Scholte R, Moonen X, Didden R. Brief report: Follow-up outcomes of multisystemic therapy for adolescents with an intellectual disability and the relation with parental intellectual disability. J Appl Res Intellect Disabil. 2020 May;33(3):618-624. doi: 10.1111/jar.12691. Epub 2019 Dec 28.
- BackgroundDe Ruiter KP, Dekker MC, Douma JCH, Verhulst FC, Koot HM. Development of parent- and teacher-reported emotional and behavioural problems in young people with intellectual disabilities: Does level of intellectual disability matter? J Appl Res Intellect Disabil. 2008; 21(1): 70-80.
- BackgroundWallander JL, Dekker MC, Koot HM. Psychopathology in children and adolescents with intellectual disability: Measurement, prevalence, course, and risk. International Review of Research in Mental Retardation. 2003; 26: 93-134.
- BackgroundBlankestein A, Van der Rijken R, De Vuyst K, De Bruijn J, Moonen X, Leunissen J, Didden R. Multisysteemtherapie voor jongeren met een licht verstandelijke beperking en hun ouders: Een onderzoek naar de effectiviteit van een ambulante systeemgerichte interventie. Directieve Therapie. 2016; 36(3): 204-219. Dutch.
- BackgroundDekker MC. Short Review: Psychopathology in young people with mild ID or borderline intellectual functioning: Research findings from representative (clinical) samples & future needs. Academische Werkplaats Kajak. 2019.
- BackgroundHenggeler SW, Schoenwald SK, Borduin CM, Rowland MD, Cunningham PB. Multisystemic therapy for antisocial behavior in children and adolescents. 2nd ed. New York: The Guilford Press; 2009.
- BackgroundKaal HL, Overvest N, Boertjes MJ. Beperkt in de keten: Mensen met een licht verstandelijke beperking in de strafrechtsketen [People with mild intellectual disability in the justice system]. 2nd ed. Amsterdam: Boom Lemma; 2014.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Dineke Feenstra, PhD principal investigator
De Viersprong
4 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Behavioural Problems, run by De Viersprong at 4 sites in Netherlands.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 13 Apr 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 4 sites in Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Annemarieke Blankestein, PhD (+31629392787, annemarieke.blankestein@deviersprong.nl), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Rule-breaking behaviour of adolescents - parents (time frame: Start of MST(-ID) treatment (T0) until 18-month follow up (T4)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06032455, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Apr 2026.