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Governor's Office of Gang and Youth Violence Policy

Multisystemic Therapy (MST)

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Category Type Target Age Group Setting Outcomes Source of Rating
Proven Programs Delinquency & Recidivism
  • High School
  • Middle School
  • Community
  • In-Home
7.7% reduction in recidivism
  • Blueprints for Violence Prevention (Blueprints)

    The Blueprints for Violence Prevention list has been developed by a research team headed by Delbert Elliott, Ph.D. at the Center for the Study and Prevention of Violence at the University of Colorado. For Blueprints to certify a brand name program as “model,” the program must demonstrate its effects on problem behaviors with a rigorous experimental design, show that its effects persist after youth leave the program and be successfully replicated at least once. In order for a brand name program to be certified as “promising,” the program must demonstrate effects using a rigorous experimental design. The Blueprints Web site (www.colorado.edu/cspv/blueprints/) lists 11 “model” programs and 19 “promising” programs.


    Selection Criteria:
    Lasting positive effects in well designed evaluations & emphasis on replication.

    Applicability:  Excellent for crime, violence, delinquency & substance abuse.

    Reliability:  Excellent

    Currency:  Up to Date

    Advantages:  Easy to use. Plentiful peer and tech support. Predictability of outcomes.

    Limitations:  Covers only a small number of brand name programs.

    Blueprints
  • Washington State Institute for Public Policy (WSIPP)

    The Washington State Institute for Public Policy (WSIPP) uses the meta-analysis methodology to conduct evaluations of evidence-based practices, but also considers the cost of such programs and strategies to taxpayers and crime victims and weighs these costs against possible benefits (i.e., costs avoided through reduced crime). Programs and strategies are not ranked, but effect on recidivism is measured and the number of evaluations is reported. Recidivism, cost to tax payers and crime victims, and benefits are estimated using data specific to Washington State.

    For the purposes of this paper, all cost and benefit information refers to the analysis conducted by WSIPP for the State of Washington. Accordingly, the information should be considered an estimate for the potential cost and dollar benefits for California. The data used for this project can be found in the article by Elizabeth K. Drake, Steve Aos and Marna G. Miller, titled “Evidence-Based Public Policy Options to Reduce Crime and Criminal Justice Costs: Implications in Washington State” (2009), and can be downloaded from their Web site, www.wsipp.wa.gov.


    Selection Criteria:  Meta-analysis & cost-benefit analysis.

    Applicability:  Meta-analysis & cost-benefit analysis.

    Reliability:  Excellent

    Currency:  Analyses are revised every few years.

    Advantages:  Predictability of outcomes; ability to compare cost effectiveness.

    Limitations:  Costs & benefits are based on WA data.

    WSIPP

Description:

Multisystemic Therapy (MST) is an intensive family-and community-based treatment program that focuses on the entire world of chronic and violent juvenile offenders — their homes and families, schools and teachers, neighborhoods and friends.

MST works with the toughest offenders. They are adolescents, male and female, between the ages of 12 and 17, who have very long arrest histories.

  • MST clinicians go to where the child is and are on call 24 hours a day, seven days a week
  • They work intensively with parents and caregivers to put them in control
  • The therapist works with the caregivers to keep the adolescent focused on school and gaining job skills
  • The therapist and caregivers introduce the youth to sports and recreational activities as an alternative to hanging out

MST is based on evidence
This means it has been proven to work—and produce positive results—with the toughest kids. It blends the best clinical treatments—cognitive behavioral therapy, behavior management training, family therapies and community psychology to reach this population.

After 30 years of research and 18 studies, MST repeatedly has been shown to:

  • Keep kids in their home, reducing out-of-home placements up to 50 percent
  • Keep kids in school
  • Keep kids out of trouble, reducing re-arrest rates up to 70 percent
  • Improve family relations and functioning
  • Decrease adolescent psychiatric symptoms
  • Decrease adolescent drug and alcohol use

Target Population

Chronic, violent or substance abusing juvenile offenders (and their families), ages 12 to 17, at high risk of out-of-home placement

For more Information or to find Technical Assistance, visit:

MST Services
www.mstservices.com

California Institute for Mental Health
www.cimh.org

 

References and/or Published Evaluations

Something that sets MST apart from some other treatments is that it has evidence—concrete evidence—from tests and studies. There have been three decades of research that confirms MST reduces criminal activity and out-of-home placements for violent and chronic offenders.
Results Show:

  • long-term re-arrest rates reduced by 25-70 percent
  • out-of-home placements reduced by 47-64 percent
  • families functioning much better
  • decreased substance use
  • fewer mental-health problems for serious juvenile offenders

MST’s positive results are long lasting. A 14-year follow-up study by the Missouri Delinquency Project showed youths who received MST had:

  • up to 54 percent fewer re-arrests
  • up to 57 percent fewer days of incarceration
  • up to 68 percent fewer drug-related arrests
  • up to 43 percent fewer days on adult probation

MST is committed to continuing its program evaluation and has a quality assurance program that provides all MST programs around the world with tools to assess the adherence of therapists, supervisors and organizations to the MST model.

Click here to see a complete list of MST Outcome Studies

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Additional Information

Provided by www.mstservices.com, September 2010

  • Has this program been replicated at other sites? If so, how many and where are they?
    MST currently operates in 31 States, the District of Columbia and 12 countries including: Alabama, Arizona, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Illinois, Louisiana, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, North Carolina, Nebraska, New Jersey, New Mexico, Nevada, New York, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Texas, Virginia, and Washington, the District of Columbia, Norway, Australia, Canada, Denmark, Northern Ireland, England, Scotland, Sweden, Switzerland, the Netherlands, New Zealand and Iceland.
  • Is there a formal curriculum or program guidelines in place? What is the approximate cost for these materials?
    In 1996, MST Services was formed, a university licensed organization for the dissemination of MST. MST Services offers comprehensive assistance with the full development of MST programs by providing program start-up assistance, initial and ongoing clinical training and program quality assurance support services. MST Services grants license agreements to MST programs and provides program development and training services in MST worldwide. Cost information is variable. For detailed and up-to-date cost information, please contact either www.mstservices.com or www.cimh.org.
  • What kind of training and technical assistance is available for this program?
    In order to keep true to the MST treatment model so that the best results can be reached for youth and their families, rigorous and continual training is needed.

    MST Services provides ongoing instruction, workshops, Webinars and conferences. Online registration is available for most of these sessions.

    • 5-Day Orientation
      All new MST therapists, supervisors, and some other MST program staff receive five days of training to be introduced to the theory and techniques of the treatment model. The training includes didactic teaching, role-playing and other exercises designed to stimulate critical thinking about the treatment process. This orientation is designed to prepare MST teams to begin working with youth and their families.

    • Supervisor Orientation Workshop
      Supervisor orientation is a two-day training for new MST supervisors, typically attended during the first six months on the job as supervisor. It is designed to introduce MST supervisors to their core job tasks in the following areas:

      The orientation is also designed to allow supervisors to start identifying their strengths and needs in each of these areas and to create supervisor development plans. The training is highly interactive and experiential with multiple opportunities to practice implementing the various job tasks.

      • MST group supervision
      • Clinician development
      • Continuous quality improvement
      • Community collaboration
      • Therapist hiring

    • Advanced Supervisor Workshop
      The advanced supervisor workshop occurs once every year in Charleston, SC. It is designed for MST clinical supervisors from licensed MST programs who have been in the MST supervisor position for six (6) months or more. MST supervisors can attend the workshop every year if they desire. The workshop is also open to MST program managers from licensed MST programs, as relevant.

    • Conferences

    • Webinars
  • Once the program has been implemented, can an organization obtain assistance with fidelity monitoring or quality assurance?
    Thirty years of study have proven that MST works in keeping chronic and violent youths at home, in school and out of trouble. For MST interventions to achieve the best results, its therapeutic principals and processes must be followed.

    Putting MST into practice is much like a doctor performing exactly and precisely the steps of a bypass surgery, from prep to patient recovery. Similarly, MST involves steps that must be followed with fidelity if the positive outcomes shown in studies and rigorous tests over three decades are to be achieved.

    MST Services’ quality-assurance system provides multiple layers of clinical and program support and ongoing feedback to ensure that providers faithfully implement MST.

    Short cuts just don’t work. They deteriorate the success rate. For example, caseloads must be kept low so that teams and supervisors can devote all the time necessary to each youth and family. Adding more cases dilutes that time, and everyone loses. Ongoing training is also a critical component to staying true to the model. And only youths who are in the MST target population—hard-core offenders—should be included in treatment.

    In randomized trials of MST, greater therapist adherence predicted reductions in:
    • youth arrests
    • days incarcerated
    • soft drug use
    • aggression

    And improvements in:
    • family functioning
    • parenting practices

    These findings held up across 45 sites in the MST Transportability Study. That study also showed links between consultant adherence, supervisor adherence, therapist adherence, and youth outcomes. There is solid evidence that MST is highly effective—if it is followed with fidelity.

    Download a detailed version of MST's quality assurance program.
  • Can an organization obtain assistance with data collection or measurement of outcomes?
    The MST Institute is a non-profit organization founded in 1996 to provide web based information and quality assurance tools to programs implementing MST. The MST Institute web site (www.mstinstitute.org) provides information about the measures and procedures used in the quality assurance activities supporting fidelity and adherence to the nine principles of the MST treatment model. In addition, the site provides data collection, monitoring and reporting tools to licensed MST programs, their funders and MST experts for use in continuous quality improvement.
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