Multisystemic Therapy (MST) is a family-oriented, home-based program that targets chronically violent, substance-abusing juvenile offenders 12 to 17 years old. It uses methods that promote positive social behavior and decrease antisocial behavior, including substance use, to change how youth function in their natural settings (e.g., home, school, and neighborhood). The primary goals of MST are to:
- Reduce youth criminal activity.
- Reduce antisocial behavior, including substance abuse.
- Achieve these outcomes at a cost savings by decreasing incarceration and out-of-home placement rates.
Delivered across a flexible series of 12 to 16 weekly or twice weekly 60- to 90-minute sessions, the program is a manual-driven intervention with specific assessment and treatment modules that target four areas of social interaction: (1) the youth's interpersonal functioning with parents and peers, (2) the parents' parenting practices and level of adult functioning independent of their parenting role, (3) parent-adolescent interactions in therapy sessions, and (4) communication between family members and key social systems (e.g., school, child welfare, mental health, juvenile justice).
MST has been demonstrated to be an effective treatment for multiple problems of serious and violent juvenile offenders in different settings. It also has proved to be cost-beneficial.
Belief in physical aggression to resolve disagreements and violent tendencies
Developmental trauma exposure
Early dating/sexual activity/fatherhood
Exposure to firearm violence
Gang involvement in adolescence
General delinquency involvement
High alcohol/drug use
High drug dealing
Illegal gun ownership/carrying
Lack of guilt and empathy
Makes excuses for delinquent behavior (neutralization)
Mental health problems
Father’s gang membership (for males only, but only with frequent contacts and maltreatment)
Foster care placement
Growing up in foster care
Jailing or imprisonment of a household member
Lack of orderly and structured activities within the family
Low parental education
Mother’s gang membership (for females only)
Parental use of physical punishment/harsh and/or erratic discipline practices
Poor parental supervision (control, monitoring, and child management)
Frequent school transitions
Frequent truancy/absences/suspensions; expelled from school; dropping out of school
Low academic aspirations
Low parent college expectations for child
Low school attachment/bonding/motivation/commitment to school
Non-normative school transitions (i.e., changes due to residential moves or mid-year transfers)
Performance on standardized math assessments in the 6th and 10th grades
Poor school attitude/performance; academic failure
Feeling unsafe in the neighborhood
Neighborhood youth in trouble
Association with antisocial/aggressive/delinquent peers; high peer delinquency
Leading peers in antisocial behavior and committing crimes for peer status or revenge
Peer alcohol/drug use
Model Programs Guide: Effective
National Registry of Evidence-based Programs and Practices: Legacy program
University of Colorado Blueprints: Model program
Web site: https://msti.org/mstinstitute/
Curtis, N. M., and Ronan, K. R. (2004). “Multisystemic Treatment: A Meta-Analysis of Outcome Studies.” Journal of Family Psychology, 18(3):411–19.
Henggeler, S. W.; Mihalic, S. F.; Rone, L.; Thomas, C. R.; and Timmons-Mitchell, J. (1998). Blueprints For Violence Prevention, Book Six: Multisystemic Therapy. Boulder, Colorado: Center for the Study and Prevention of Violence.
Henggeler, S. W.; Schoenwald, S. K.; Borduin, C. M.; Rowland, M. D.; and Cunningham, P. B.. (2009). Multisystemic Treatment of Antisocial Behavior in Children and Adolescents (2nd ed.). New York: Guilford Press.
Ogden, T., and Hagen, K. A. (2006). “Multisystemic Therapy of Serious Behavior Problems in Youth: Sustainability of Therapy Effectiveness Two Years After Intake.” Child & Adolescent Mental Health, 11(3):142–149.
Ogden, T., and Halliday-Boykins, C. A. (2004). “Multisystemic Treatment of Antisocial Adolescents in Norway: Replication of Clinical Outcomes Outside of the U.S.” Child & Adolescent Mental Health, 9(2):77–83.
Schaeffer, C. M., and Borduin, C. M. (2005). “Long-Term Follow-Up to a Randomized Clinical Trial of Multisystemic Therapy With Serious and Violent Juvenile Offenders.” Journal of Consulting and Clinical Psychology, 73(3):445–453.
Timmons-Mitchell, J.; Bender, M. B.; Kishna, M. A.; and Mitchell, C. C. (2006). “An Independent Effectiveness Trial of Multisystemic Therapy With Juvenile Justice Youth.” Journal of Clinical Child and Adolescent Psychology, 35(2):227–236.
Asscher, J. J., Deković, M., Manders, W. A., van der Laan, P. H., Prins, P. J. M., & the Dutch MST Cost-Effectiveness Study Group 4. (2013). A randomized controlled trial of the effectiveness of Multisystemic Therapy in the Netherlands: Post-treatment changes and moderator effects. Journal of Experimental Criminology, 9, 169-187.
Letourneau, E.J., Henggeler, S.W., Borduin, C.M., Schewe, P.A., McCart, M.R., Chapman, J.E., & Saldana, L. (2009). Multisystemic Therapy for juvenile sexual offenders: 1-year results from a randomized effectiveness trial. Journal of Family Psychology, 23, 89-102.