Cost-Benefit Analysis of Multisystemic Therapy for Problem Sexual Behavior

Introduction: Cost-beneficial treatment methods are necessary to reduce the social and financial consequences of sexual crimes by juveniles. Multisystemic therapy for problem sexual behavior (MST-PSB), a family- and community-based treatment model, has demonstrated efficacy and effectiveness in reducing both sexual and nonsexual crimes among high-risk youths through early adulthood. The economic benefits of this model, however, have not yet been evaluated. The current study will provide a cost-benefit analysis of MST-PSB versus usual community services (i.e., cognitive-behavioral group and individual treatment) using criminal arrest data from an 8.9-year follow-up of referred juvenile sexual offenders (n = 48) who participated in a randomized clinical trial.

Methods: Treatment costs of MST and usual community services (UCS) have been obtained from the budgets of treatment providers for each service. Criminal arrest data have been collected via Missouri public records. Differences in treatment costs and in sexual and nonsexual felony arrest rates in the MST-PSB versus UCS conditions will be integrated using a cost-benefit analysis model designed by the Washington State Institute for Public Policy. The economic benefits of prevented crimes will be estimated across three categories: (a) taxpayer benefits (i.e., avoided criminal justice system costs), (b) tangible benefits to victims (i.e., avoided tangible losses), and (c) intangible benefits to victims (i.e., avoided pain and suffering).

Results: It is predicted that reductions in criminality in the MST-PSB versus UCS conditions will be associated with substantial reductions in expenses to taxpayers and losses to crime victims. The costs and benefits of MST-PSB will be expressed using both (a) net benefit estimates (i.e., benefits minus costs) and (b) benefit-cost ratios (i.e., benefits divided by costs). Preliminary analyses suggest that MST-PSB resulted in cumulative benefits as high as $268,914 per juvenile sexual offender. Stated differently, this estimate suggests that every dollar spent on MST-PSB recovered up to $29.59 in savings to taxpayers and crime victims in the 8.9 years following treatment.

Conclusions: The results of this study will provide important information about the economic costs and benefits of an empirically supported treatment for juvenile sexual offenders. Preliminary findings suggest that MST-PSB resulted in substantial savings to taxpayers and crime victims by virtue of its preventive effects on future sexual and nonsexual criminal offending. Cost savings identified in this study will be important for administrators and policymakers to consider when allocating scarce financial resources to interventions for juvenile sexual offenders.