Methodological critique and meta-analysis as Trojan horse

In this article, we respond to a recent paper published in Children and Youth Services Review, in which Dr. Julia Littell concluded that multisystemic therapy (MST), a family- and evidence-based treatment of serious juvenile offenders, does not reduce rates of rearrest or incarceration and does not improve family relations. Dr. Littell's conclusion is contrasted with those of highly respected reviewers and federal entities that are entirely independent of MST developers and researchers. Moreover, we describe how Dr. Littell's conceptual and methodological analyses have misinterpreted and misrepresented MST research studies and reflect poor appreciation for the conduct of community-based research with challenging clinical populations; the distinctions between efficacy, effectiveness, and transportability research; the nuances of conducting meta-analyses; the importance of treatment fidelity to internal validity; and the fact that not all outcome studies are asking the same conceptual questions. Finally, the implications of Dr. Littell's con-tentions are noted. (c) 2005 Elsevier Ltd. All rights reserved.