Blueprints
Model Programs
Multisystemic Therapy (MST)
This program was part of a cost-benefit
analysis completed by the Washington
State Institute for Public Policy on several violence
prevention and reduction programs, including six Blueprints
programs:
Watching
the Bottom Line: Cost-Effective Interventions for Reducing
Crime in Washington.
Program
Summary
Multisystemic Therapy (MST) is an
intensive family- and community-based treatment that
addresses the multiple determinants of serious antisocial
behavior in juvenile offenders. The multisystemic
approach views individuals as being nested within
a complex network of interconnected systems that encompass
individual, family, and extrafamilial (peer, school,
neighborhood) factors. Intervention may be necessary
in any one or a combination of these systems.
Program Targets:
MST targets chronic, violent, or substance abusing
male or female juvenile offenders, ages 12 to 17,
at high risk of out-of-home placement, and the offenders'
families.
Program Content:
MST addresses the multiple factors known to be related
to delinquency across the key settings, or systems,
within which youth are embedded. MST strives to promote
behavior change in the youth's natural environment,
using the strengths of each system (e.g., family,
peers, school, neighborhood, indigenous support network)
to facilitate change.
The major goal of MST is to empower parents with
the skills and resources needed to independently address
the difficulties that arise in raising teenagers and
to empower youth to cope with family, peer, school,
and neighborhood problems. Within a context of support
and skill building, the therapist places developmentally
appropriate demands on the adolescent and family for
responsible behavior. Intervention strategies are
integrated into a social ecological context and include
strategic family therapy, structural family therapy,
behavioral parent training, and cognitive behavior
therapies.
MST is provided using a home-based model of services
delivery. This model helps to overcome barriers to
service access, increases family retention in treatment,
allows for the provision of intensive services (i.e.,
therapists have low caseloads), and enhances the maintenance
of treatment gains. The usual duration of MST treatment
is approximately 60 hours of contact over four months,
but frequency and duration of sessions are determined
by family need.
Program Outcomes:
Evaluations of MST have demonstrated for serious juvenile
offenders:
- reductions of 25-70% in long-term rates of rearrest,
- reductions of 47-64% in out-of-home placements,
- extensive improvements in family functioning,
and
- decreased mental health problems for serious
juvenile offenders.
Program Costs:
MST has achieved favorable outcomes at cost saving
in comparison with usual mental health and juvenile
justice services, such as incarceration and residential
treatment. At a cost of $4,500 per youth, a recent
policy report concluded that MST was the most cost-effective
of a wide range of intervention programs aimed at
serious juvenile offenders.
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