Youth Services : Multisystemic Therapy® (MST®)

In 1999, Community Solutions Inc. became the first licensed provider in New England to provide Multisystemic Therapy (MST), an intensive family and community-based treatment model that addresses multiple aspects of serious antisocial behavior in adolescents. The multisystemic approach addresses the many factors that are known to contribute to delinquency across key settings, or systems, within which youth live, work and play.

MST has proven to be effective in reducing antisocial behavior among diverse populations of serious and chronic juvenile offenders. The typical duration of treatment is approximately four months, which includes approximately 60 hours of therapist-family contact with therapists being accessible to the youth and family 24 hours a day, 7 days a week. MST therapists only work with five to six families at a time and work closely with the family to promote the parent's capacity to monitor and provide effective discipline. MST can be used to prevent residential placement or as aftercare when youth are leaving a residential facility.
  • MST strives to promote behavior change in the child's natural environment, using the strengths of each system (e.g., family, peers, school, neighborhood) to facilitate change.
  • MST is a home-based therapy. This design helps overcome barriers to service, increases family retention in treatment, allows for the provision of intensive services (i.e., therapists have low caseloads), and enhances the maintenance of successful behavior change. The usual duration of MST treatment is approximately four months.
  • MST typically targets chronic, violent, or substance-abusing juvenile offenders who are at high risk of out-of-home placement away from their families.
  • Empirically-supported clinical interventions are delivered through a home-based model, including strategic family therapy, structural family therapy, behavioral parenting training, and cognitive behavioral therapy.
  • A recent study by the Washington State Institute for Public Policy estimated savings of $31,000 to $131,000 for each youth served by MST (based on MST preventing a subsequent incident requiring social or judicial services).
  • Using MST has decreased adolescent substance use, decreased adolescent psychiatric symptoms, reduced long-term rearrest rates 25 to 70 percent, and reduced long-term out-of-home placement 47 to 64 percent.
Community Solutions Inc. Home-Based Youth Services division is widely acknowledged for its strict adherence to model fidelity and successful outcomes. Community Solutions Inc. has two system supervisors qualified to provide the orientation booster trainings and consultation to Community Solutions Inc. and other organizations delivering MST.

In addition to the consultation and training provided to therapists by the MST national institute, Community Solutions Inc. runs its own multi-state meetings for therapists engaged in the MST treatment model. Community Solutions Inc. developed its own multi-phase screening, hiring and training protocols for home-based therapists, which have resulted in a very high therapist retention rate and excellent satisfaction ratings among therapists.

In recognition of Community Solutions Inc.'s success with implementing MST, we have been asked to formally work with a number of other providers to help decrease their turnover rate; has been invited to present sessions on screening, hiring and retaining therapists; and CSI protocols have been incorporated into the official training offered to MST supervisors. CSI's implementation of MST has demonstrated consistent positive outcomes for youth and families.