Multisystemic therapy


Multisystemic therapy is an intense, family-focused and community-based treatment program for juveniles with serious criminal offenses and are possibly abusing substances. It is also a therapy strategy to teach their families how to foster their success in recovery.
The goals of MST are to lower rates of criminal behavior in juvenile offenders. There are several things MST therapy must include: integration of empirically based treatment to acknowledge a large variety of risk factors that may be influencing the behavior; rewards for positive changes in behavior and environment to ultimately empower caregivers; and many thorough quality assurance mechanisms that focus on completing objectives set in treatment

Medical uses

A 2017 meta-analysis of family-based treatments for serious juvenile offenders found "modest, yet long-lasting, treatment effects" in reducing antisocial behavior and improving other outcomes when compared with conventional community services. A meta-analysis of MST in 2014 reported small improvements in delinquency, psychological problems, and substance use, particularly with younger juveniles.
In 2012 a literature review compared common treatments including cognitive behavioral therapy, 12-step facilitation, multisystemic therapy, psychoeducation, and motivational interviewing in an attempt to identify the best treatments for substance-abusing adolescents with conduct problems. The authors concluded that family-based interventions produced superior outcomes, and that MST had "the most compelling evidence", noting that the providers are often well trained and supervised. A 2005 Cochrane review found inconclusive evidence as to whether MST is more effective than other services for young people.

Methods

Multisystemic therapy is a home and community based intervention for juvenile offenders. It draws upon many practices from strategic family therapy, structural family therapy, and cognitive behavior therapy in intensive interventions over four to six months. It is based in part on ecological systems theory. Treatment is individualized depending on the social systems surrounding the youth.
Although treatment is highly variable, it always includes nine core principles. Which are:
  1. The client exists within a series of systems
  2. Practitioners use existing positive systems to help client create change
  3. Interventions should include increased responsibility of family members
  4. MST is present-focused and action-oriented
  5. Each interventions targets a specific behavior
  6. MST interventions should match the developmental age of the child for which they are created
  7. Family members are needed to enact interventions
  8. Evaluation of interventions occur from multiple perspectives
  9. Each intervention is made to be used over long terms and in multiple settings

    History

The MST method was originally a collection of procedures practiced by Dr. Scott Henggeler in the 1970s. He soon brought in Charles Bourdain and Molly Brunk, two of his doctoral students, to help with the theory’s documentation. To bring their project to fruition, Henggeler, Bourdain, and Brunk combined evidence-based practice models with the positive aspects of other behavior theories, and created the calling card of MST by emphasizing family preservation and strengthening of relationships among juvenile delinquents. Since then there have been a few tweaks to the original design so in 1990 MST as it is known today was born. For being so new, MST has been tested many times in many settings, and in most it has shown to have the longest lasting positive effects for troubled youth and their families.
After the finalization of the MST method, the MST Institute was founded as a nonprofit corporation to be "responsible for setting quality assurance standards and monitoring the implementation of Multisystemic Therapy in all programs worldwide"

Use in the Juvenile Justice System

Practitioners increasingly use Multisystemic Therapy to help youth within the juvenile justice system to reintegrate into society rather than standard probation or treatment as usual. MST differs from the usual tactics in that it targets criminogenic factors related to an individual's social environment, particularly within the family system. It has been identified as a promising treatment model for juvenile offenders by the U.S. Surgeon General in reducing rates of recidivism.