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Economic Value of Community-Based Services for Problematic Sexual Behaviors in Youth: A Mixed-Method Cost-Effectiveness Analysis

NCJ Number
Child Abuse & Neglect Volume: 105 Dated: July 2020
Alex R. Dopp; Peter Mundey; Jane F Silovsky; Michael Hunter; Alexandra Slemaker
Date Published
July 2020
26 pages
This study used a mixed quantitative-qualitative approach to examine the economics of the implementation of Problematic Sexual Behavior – Cognitive-Behavioral Therapy (PSB-CBT), an evidence-based treatment for problem sexual behaviors in youth.
A total of 413 youth participated in PSB-CBT at six program sites in youth service agencies across the United States. Cost-effectiveness ratios (CERs) were used to compare the direct and indirect costs of PSB-CBT to self-reported and caregiver-reported youth clinical outcomes (i.e., problem sexual behavior as well as secondary behavioral health problems). CERs represented the cost of achieving one standard unit of change on a measure. The design and interpretation of those quantitative analyses were informed by qualitative themes about program costs and benefits that were derived from interviews with 59 therapists, administrators, and stakeholders. CERs were $1,772 per youth for problem sexual behavior and ranged from $2,867 to $4,899 per youth for secondary outcomes. These quantitative results, considered alongside the qualitative perspectives of interviewees, suggested that the implementation of PSB-CBT was cost-effective. The results were robust to uncertainty in key parameters under most, but not all, conditions. These findings have important implications for decisions made by administrators, policymakers, and therapists regarding the use of community-based approaches to address problematic sexual behavior of youth. (publisher abstract modified)