Multisystemic Therapy Helps Troubled Youth with Family Therapy

Posted by Julianna Ohler

Jul 14, 2015 10:00:00 AM

Troubled Youth Goes From Hating to Loving School

(For the sake of confidentiality, the client is called “Joe” in the story.) 

Many times, the behaviors and circumstances surrounding cases referred to Multisystemic Therapy (MST) seem insurmountable. In Joe’s case, years of school refusal (since kindergarten), academic struggles and defiance made it seem as though finding the solution was akin to the proverbial needle in a haystack. However, the family, referral source and school had pinned their hopes on MST since it is designed to work with such intensive behavior. Despite the challenging task ahead of Catherine Cook, the MST therapist, she helped the family retrieve the missing needle that positively contributed to the family’s success of getting a 16-year-old boy back to a school and what’s more, a school where he has thrived academically and enjoyed attending.

Joe, like most MST cases, comes from a trying history including trauma, ongoing truancy issues, school failure, caregiver mental health and family conflict. Despite these challenges, Joe is polite, smart and loves being outside and connecting with nature, interests that would later prove to be crucial to his success. At the time of referral, Joe had been transitioned to living with his grandparents due to the intensity of his behavior. Joe’s immigrant grandparents were struggling to overcome language and cultural barriers that made their own lives challenging. They, too, were at their breaking point with all the effort it took to get Joe to school every day.

Why was Joe refusing to go to school?

The treatment process began by gathering sequences of Joe’s pattern of refusing to go to school, and getting his grandparents and mother to assess what ecological drivers were contributing to this problem behavior pattern. The family was adamant that they had tried everything and that they were preparing for Joe to go to placement since he had no desire to complete his schoolwork or even follow through with homeschooling. Despite their doubts, the therapist engaged the family in working to solidify their evening and morning routines, including clearly defining each person’s role in getting Joe up in the morning since this was when there was the most conflict in the home. 

Catherine assisted Joe’s grandmother in taking advantage of her warm relationship with the boy in the morning while his grandfather and mother remained in the background as supports. After limited success, Catherine then looked to some materials from her MST training for ideas about what other system factors could be contributing to Joe’s pattern of not going to school. Using these resources, the family and therapist worked together to identify a driver that the family had not been able to successfully work on: Joe’s dislike and general lack of connection with school. This was a turning point in the treatment.

The needle was in the woods, not a haystack

Remember, Joe struggled with attendance issues since kindergarten despite trying public school, cyber school and even home tutoring. It seemed as though no matter what the setting, the boy simply did not like school. To target this barrier, the family, school district and therapist looked for a new school in the same general area. As a trained MST therapist, Catherine hoped to find a setting where they could leverage his skills and interests to achieve the desired change. With some great timing, research and good fortune, they located a school that seemed created for kids exactly like Joe. Nestled in the woods, it was brand new with very small class sizes and a curriculum geared toward nature. The taxidermy projects and opportunities to help the game commissioner were a great match for his interests.

The director of the school and the family were able to quickly establish a strong collaborative relationship with frequent communication and the shared goal of Joe’s success. With the family’s daily effort of running their plans to get Joe to school, he now loves school. (The word “loves” is not a typo. That was Joe’s word). He has had positive school attendance for the past six weeks and has all A’s. He even received 130 percent on a test where he elected to complete extra credit.

This case is truly is a testament to the statement “It takes a village to raise a child.” It also shows that sometimes all it takes is intervening on the right driver and capitalizing on strengths, or in this case, finding the missing needle in a haystack.

Julianna Ohler is an MST Supervisor at Adelphoi Village. 

To learn more about the effectiveness of MST download the report: MST Works for Juvenile Offenders and their Siblings. 

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Topics: MST Success Stories