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Updated on September 27, 2022

Multisystemic Therapy

What is Multisystemic Therapy (MST)?

Multisystemic Therapy (MST) is a family and community-based approach to treating high-risk youth.

It addresses all aspects of their lives, including home, family functioning, school, community, and peers. 

MST clinicians:

  • Spend time in the patient’s environment 
  • Are on-call 24/7
  • Empower parents, extended family, and other caregivers
  • Focus on helping the patient succeed in school and gain job skills
  • Introduce alternative recreational activities

The goal of MST is to reduce youth criminal behavior. This is achieved through intense involvement and contact with the patient and their family and support system. 

MST services uncover and assess the origins of the issues experienced by chronic youth offenders. Together, the patient and their support system work to to improve their conduct and reduce behavior problems.

Strategies include:

  • Individual therapy
  • Family therapy
  • Cognitive-behavioral therapy
  • Treatment for drug use or other substance use
  • Tools to promote behavior change
  • Follow-up when issues arise 
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Is MST Effective?

Across multiple studies, MST decreases youth re-arrest and incarceration of between 42-54%. It's also effective in reducing emotional disorders, substance abuse, and delinquency.3

Is Multisystemic Therapy Evidence Based?

MST is an evidence-based therapy developed by the Medical University of South Carolina’s Family Services Research Center. The goal was to provide mental health services to delinquent youth and offer their families support.

As part of treatment, patients and their therapists set specific, tailored, and measurable goals.

The therapist’s goal is to keep the patient safe and out of trouble with the law.

Success is not measured by the length of time the youth or their family is in the program.

When a patient is released from the program, therapists consider:

  • Is the patient still living at home?
  • Is the patient still attending school or working?
  • Was the patient arrested during treatment?

Case studies of MST show it reduces youth recidivism rates by about 20 percent. Participants spend less time incarcerated, and if they do commit crimes, they're generally less severe.7

Therapists work with everyone in the patient’s life. They let the family set treatment goals and help them develop a plan to get there.

MST participants also show higher family cohesion and less peer aggression.

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How Does MST Work?

MST programs address patient, family, and community together. A highly-trained therapist is placed and works within the patient's home, school, and community.

Patients see their therapists several times a week for intensive treatment. Programs usually last about three to five months. Therapists are also on call for crises.

Who Benefits From MST?

The primary participants in MST are those between 12 to 17 years of age with behavior issues. Many MST members also experience mental illness.

Most serious juvenile offenders crimes might exhibit the following:

  • Problems at school, including truancy
  • Disrespectful or disobedient behavior
  • Aggressiveness
  • Drug or alcohol problems
  • Criminal behavior
  • Running away from home

Patients in the program benefit, but so do their families and wider community.

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How Is Success Measured With MST?

The success of MST depends on the specific goals for each case. These goals are set by the participant's family and the therapist develops a plan to implement them.

Throughout MST treatment, several adherence measures are tracked. The primary caregiver reports how efficiently the therapist is following MST’s treatment principles.

MST’s primary outcomes are to keep young people at home, in school, or working, and out of trouble with the law. Success is not measured by the amount of time a family has spent in treatment.

How Does MST Assess Fidelity and Quality Assurance?

Additionally, the MST team's clinicians report how successfully the therapists, supervisors, and consultants adhere to the treatment model.

Sticking to the model is essential as research shows that precise adherence and supervision lead to a 64 percent reduction in incarceration during and post-treatment.8 MST providers use the website MSTI.org to track case-level outcome data.

How Much is MST Counseling?

MST counseling costs approximately $5,500 per family.

While this may seem expensive, consider that a single night in the hospital for psychiatric treatment is anywhere from $700-$1000.

When considered in light of this fact, and that the average hospital stay for adolescents is eleven nights, the price of MST is relatively modest.

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Resources

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  1. Multisystemic Therapy (MST) | Youth.Gov.” Youth.Gov, 2019.
  2. Cohen, Lori. “Multisystemic Therapy (MST) Shown to Reduce the High Cost of Crime.” Info.Mstservices.Com.
  3. Swenson, Cynthia Cupit et al. “Multisystemic Therapy for Child Abuse and Neglect: a randomized effectiveness trial.” Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43) vol. 24,4 : 497-507. doi:10.1037/a0020324.
  4. Zajac, Kristyn et al. “Multisystemic Therapy for Externalizing Youth.” Child and adolescent psychiatric clinics of North America vol. 24,3 : 601-16. doi:10.1016/j.chc.2015.02.007.
  5. Eeren, Hester V et al. “Multisystemic Therapy and Functional Family Therapy Compared on their Effectiveness Using the Propensity Score Method.” Journal of abnormal child psychology vol. 46,5 : 1037-1050. doi:10.1007/s10802-017-0392-4.
  6. Pane, Heather T et al. “Multisystemic therapy for child non-externalizing psychological and health problems: a preliminary review.” Clinical child and family psychology review vol. 16,1 : 81-99. doi:10.1007/s10567-012-0127-6.
  7. Practices, CDC Promising. “Multisystemic Therapy (MST) for Juvenile Offenders.” CDC Promising Practices :: Promising Practices :: Multisystemic Therapy (MST) for Juvenile Offenders, 2005.
  8. Care, Empower Community. “Multisystemic Therapy FAQ: MST Services.” Multisystemic Therapy FAQ | MST Services.

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