Updated on April 4, 2024
4 min read

Multisystemic Therapy

What is Multisystemic Therapy (MST)?

Our problems don't happen in a vacuum. They're influenced by many things⁠—family, friends, school, and more. Multisystemic Therapy (MST) understands this. It tackles the whole picture to help at-risk youth turn their lives around, addressing behavior problems and even substance abuse.

MST requires community collaboration. It involves the home, school, and everything in between to support positive change and reduce youth criminal behavior.

What Strategies Does MST Use?

MST aims to have a holistic understanding of how a young person's home and relationships contribute to their issues or behavior. The goal isn't just to fix the surface issues, it's about changing how the whole system works.

The young person and their support network get hands-on help to make positive changes. This is achieved through various strategies, which 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 

How Does MST Work?

MST programs address the young person, their family, and the community together. Therapists don't just work in an office⁠—they get out into the teen's environment, whether it's home, school, or the neighborhood.

Here are some of the things that MST provides to support for adolescents: 

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

Children and teens see their therapists several times a week for intensive treatment, which usually lasts three to five months. These therapists are also on call for crises.

Who Benefits From MST?

MST is designed for teens and young people between 12 to 17 who are going through behavioral issues. These kids may exhibit the following behaviors:

  • Problems at school
  • Getting into fights
  • Skipping school
  • Disrespectful or disobedient behavior
  • Aggressiveness
  • Alcohol and drug abuse
  • Criminal behavior
  • Running away from home

The good news is MST doesn't just help the young person⁠—families can benefit too, and the positive impact can ripple throughout the whole community.


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How is MST Integrated Into Addiction Treatment?

MST for substance abuse (MST-SA) is a specialized version all about helping teens break free from addiction. It integrates several components of substance abuse treatment, including:

  • Contingency management (CM): Rewards kids to encourage healthy choices and staying substance-free
  • Family & community focus: Involves mending family relationships, building parenting skills, and even getting schools and friends involved for strong support
  • Intensive treatment: Involves frequent sessions with therapists and families over several months for deep, lasting change

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How Much is MST Counseling?

On average, MST counseling runs about $5,500 per family. Keep in mind that this can change a bit based on where you live and how long the treatment lasts.

That number might sound hefty at first, but compare it to other types of care. A single night in the hospital for psychiatric care can cost $700 to $1000. A typical 3-day stay is around $30,000.9

Considering that, MST comes out a lot more affordable, especially since the average hospital stay for teens is eleven nights.

Is MST Effective?

MST can be a game-changer for young people facing serious challenges, including substance abuse. Studies show that MST significantly reduces re-arrest and incarceration rates by 42 to 54%.3

It's not just about keeping kids out of trouble. Case studies reveal that MST also reduces repeat offenses by about 20%. Those who complete MST tend to spend less time locked up, and if they do slip up, the offenses are usually less severe.7

Beyond the legal aspects, MST tackles emotional disorders, substance abuse, and delinquency.3 Even respected organizations like the National Institute for Health and Clinical Excellence (NICE) recommend MST for dealing with conduct disorders.8

Is Multisystemic Therapy Evidence-Based?

MST is an evidence-based therapy developed by the Medical University of South Carolina’s Family Services Research Center. It's specifically designed to provide mental health services to delinquent youth and their families.

MST doesn't use a one-size-fits-all approach. Therapists work with the teen and their family to set clear, measurable goals focused on safety and staying out of trouble.

The whole process is collaborative, with everyone working together on a treatment plan. MST participants have stronger family bonds and less aggression towards their peers.

How Is Success Measured With MST?

Success in MST isn't one-size-fits-all. It depends on the goals you set with your therapist and family. But generally, success is when the young person is safe and on the right track.

Success isn’t measured by how long you and your family stay in the program. Here's what therapists look at when deciding if things are successful:

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

How Does MST Assess Fidelity and Quality Assurance?

With MST, there's a whole system of checks and balances to ensure the program remains effective. Throughout treatment, everyone keeps track of how the teen is doing.

Therapists, supervisors, and everyone involved also report how closely they stick to the MST model. Why? Studies show that following the plan closely leads to the best outcomes⁠—even a 64% reduction in teen incarceration.8MST providers use a special website (MSTI.org) to keep tabs on results for each case. This way, MST doesn't just help teens, it constantly improves itself.

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Updated on April 4, 2024
8 sources cited
Updated on April 4, 2024
  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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