Multisystemic Therapy

Multisystemic Therapy (MST) is an intensive family- and community-based treatment that addresses the multiple determinants of serious antisocial behavior in juvenile offenders.

MST Eligibility

• Identified client must be between the ages of 11-17
• Youth is living at home or will soon return home
• Multiple systems need to be involved
• Repeated failure with other treatment compliance
• Multiple family members (including siblings and/or parents) are in need of therapeutic services
• Requires higher service intensity
• Client has serious drug abuse or dependency issues
• Participation with MST may be used as an alternative to detention or out of home placement
• Has Medicaid (or is eligible for flex funds)

MST Exclusionary Criteria

• Youth is living independently, or youth for whom a primary caregiver cannot be identified despite extensive efforts to locate all extended family, adult friends and other potential surrogate caregivers
• Youth referred primarily due to concerns related to suicidal, homicidal or psychotic behaviors
• Juvenile sex offenders (sex offending in the absence of other delinquent or anti-social behavior)
• Autistic youth
• Youth is enrolled in Juvenile drug court
• Youth continues with individual therapy
• Does not have Medicaid

Program Targets
MST targets chronic, violent or substance abusing male and female juvenile offenders at risk of out-of-home placement. Thus, a “typical” MST youth:

• lives in a single-parent home characterized by multiple needs and problems.
• has multiple arrests/Is a chronic offender.
• is deeply involved with delinquent peers.
• is experiencing problems at school or doesn’t attend at all.
• abuses substances (pot, alcohol, cocaine).

Program Characteristics
MST delivers intensive home-based services via therapists fully trained in MST and supported through weekly supervision and telephone consultation with an MST expert. Therapists carry a small (but demanding) caseload, and length of treatment averages two to five months. Within the MST model, therapists:

• conduct comprehensive functional assessments of youth in the context of their families, peer group, school and neighborhood.
• seek to understand the “fit” between the youth’s problems and the factors which contribute to them.
• empower parents to address the needs of youth (i.e., structure, support) more effectively.
• focus on helping parents build supportive social networks in their community.
• emphasize long-term changes that families can maintain after their involvement in MST ends.

Program Goals
MST “empowers parents with the skills and resources needed to independently address the difficulties that arise in raising teenagers and empowers youth to cope with family, peer, school and neighborhood problems.” Within a context of support and skill-building, the therapist places developmentally appropriate demands on the adolescent and family for responsible behavior.