Multisystemic therapy (MST) is an intensive, family-focused and community-based treatment program for chronically violent youth.
Contents
Reviews of clinical studies have been unable to establish a consensus as to its effectiveness in comparison to other interventions. There is no evidence of harm.
Method
Multisystemic therapy (MST) is a home and community based intervention for families of youth with severe psychosocial and behavioral problems that assembles practices from strategic family therapy, structural family therapy, and cognitive behavior therapy in intensive interventions over four to six months. It is based in part on ecological systems theory. Treatment is individualized.
Effectiveness
A 2005 systematic review by the Cochrane Collaboration found that there was no evidence to suggest that MST is any more effective than other services for youth. Another meta-analysis, published in the Clinical Psychology Review in 2014, reported small improvements in delinquency, psychological problems, and substance use.
Adverse effects
There is no evidence of harm resulting from MST.
History
The MST method was developed at the Family Services Research Center (FSRC) of the Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina. FSRC members were interested in improving mental health services for young criminals. They evaluated the literature for evidence-based practices and assembled the best ones into the MST method. As of 2002, FSRC had conducted most of the research and dissemination of the method. The first multi-center clinical trial of the method by FSRC showed that quality of the training of those implementing MST, and their supervision by experts, had an "extremely weak but significant" effect on the effectiveness of the method; the study was designed in part to test whether that was true.
In 1996, MST Services, a private for-profit corporation, was formed to oversee dissemination of the method and provide supervision. At the same time, MST Institute, a nonprofit corporation, was formed, to be "responsible for setting quality assurance standards and monitoring the implementation of Multisystemic Therapy in all programs worldwide. Its information system is designed to provide policy makers and other stakeholders with the data necessary to assess the effectiveness of their MST programs and improve services to families and youth in their communities." MST Services has an exclusive license from the Medical University of South Carolina for intellectual property covering the assessment instruments, and the protocols used in MST. MST Services in turn grants sublicenses and trains teams to practice MST; as of 2008 there were about 250 such teams in North America and Europe. MST Group LLC (which does business as MST Services) owns the "Multisystemic Therapy" trademark.