For decades, the U.S. child welfare system has primarily operated in reactive mode, intervening only after harm occurs, often through out-of-home placements. The Family First Prevention Services Act (FFPSA), enacted in 2018, marked a turning point in this reactive approach. It redirected federal priorities toward prevention, empowering states to invest in services that strengthen families before a crisis demands removal.
At the heart of FFPSA implementation is a shift from institutional care to family-based, prevention-focused services. Rather than defaulting to foster care or congregate living, the act encourages agencies to support families with tools that are trauma-informed and proven to work. These are evidence-based child welfare programs designed to safely keep young people at home and connected to their communities.
This blog explores how FFPSA reshapes the child welfare landscape and highlights one intervention in particular: Multisystemic Therapy (MST). MST is a well-researched model that meets FFPSA's standards while addressing the complex, interconnected challenges many families face. As more states adopt FFPSA programs, understanding the multisystemic approach can illuminate a path forward—a path where prevention, not placement, becomes the norm.
Understanding the FFPSA and Its Goals
As mentioned, the FFPSA was signed into law in 2018 as part of the Bipartisan Budget Act; however, its roots date back decades. It was born out of a growing awareness that the child welfare system too often intervenes too late. Instead of waiting for children to enter foster care, FFPSA implementation flips the script by putting prevention first.
At its core, FFPSA programs aim to reduce reliance on congregate care by offering families the support they need before crises escalate. Through FFPSA implementation, states can now utilize Title IV-E funding to provide mental health treatment, substance use prevention, and in-home parenting support. These are tailored services backed by research we can weave into the fabric of everyday family life. They reflect a multisystemic approach to care: one that recognizes that home, school, peers, and community all play a role in a child's well-being.
A key requirement of FFPSA programs is that funded services must be trauma-informed and rated as "promising," "supported," or "well-supported" by the Title IV-E Prevention Services Clearinghouse, ensuring a focus on evidence-based child welfare programs that deliver real results.
As the FFPSA implementation process unfolds across states, the act continues to reshape child welfare programs from a reactive system into one that strengthens families and builds resilience. It's a bold reimagining of what support can (and should) look like for children and their caregivers.
Real-World Examples of Successful State-Wide FFPSA Implementation
While FFPSA implementation is federal in scope, its true impact is unfolding at the state level, where policies are being rewritten, budgets are being reallocated, and new partnerships are being formed to strengthen family-based care.
Take Georgia, for example. The state allocated funding to upgrade its child welfare information systems and support a project management team dedicated to FFPSA implementation, ensuring that efforts remain on track and data driven. In Colorado, leaders expanded the legal definition of "kin" to broaden eligibility for prevention services, guaranteeing families could access support before children were placed in foster care.
In several states, FFPSA programs that incorporate intensive, family-centered interventions have already begun to demonstrate success. From measurable reductions in out-of-home placements to improved functioning in youth with serious behavioral health needs, the results point to progress.
A key component of that success is the adoption of Multisystemic Therapy (MST). Rated as "well-supported" by the Title IV-E Prevention Services Clearinghouse, MST is being used as a multisystemic approach in numerous states to meet the rigorous standards of FFPSA implementation. By intervening across the family, school, and community systems, the multisystemic approach of MST helps address the root causes of behavior and promotes lasting change.
According to Casey Family Programs' state inventory of interventions, MST appears consistently in state prevention plans as a top evidence-based child welfare program of choice. Its trauma-informed, in-home model makes it not only compatible with FFPSA goals—but essential to realizing them.
As more states adopt these forward-thinking strategies, it becomes clear that the success of FFPSA programs hinges on more than compliance. It requires a commitment to high-quality, research-backed interventions that empower families from within.
The Role of MST in FFPSA Implementation
For FFPSA implementation to succeed, states need interventions that are as comprehensive as the challenges families face. That's where MST shines. This intensive, home-based, and trauma-informed treatment model is grounded in decades of research and built around the very goals that the FFPSA was designed to achieve.
MST is a multisystemic approach that works across all the domains influencing a young person's life: family, peers, school, and the greater community. Rather than isolating issues or individuals, MST recognizes that behavioral challenges rarely occur in a vacuum. MST treatment addresses root causes like mental health issues, exposure to violence, peer pressure, and family conflict by delivering therapy directly in the home and tailoring it to each family's unique circumstances.
This model is a direct fit for FFPSA programs, which prioritize services that strengthen families before out-of-home placement becomes necessary. MST therapists maintain small caseloads, offer support 24/7, and stay with a family for several months. And it works: studies show that MST reduces youth recidivism by up to 70%, improves family cohesion, and significantly lowers the likelihood of future placements in the juvenile justice or child welfare systems.
As a result, MST is rated "well-supported" by the Title IV-E Prevention Services Clearinghouse, making it an ideal evidence-based child welfare program under FFPSA program guidelines. This distinction matters for funding purposes, of course, but also because it affirms MST's status as a trusted and proven intervention for families in crisis.
The multisystemic approach yields strong results, offering a flexible, family-first solution that supports long-term well-being while helping agencies meet federal requirements. For states aiming to deliver on the promise of FFPSA, a multisystemic approach offers both the evidence and the ability to make it happen.
MST Is Key to Successful FFPSA Implementation and Family-Based Reform
When done right, FFPSA implementation goes beyond a mere policy shift by offering a pathway to stronger families, safer communities, and a more responsive child welfare system. But this transformation hinges on selecting the right tools for the job.
MST offers one of the most effective, scalable solutions available. As a multisystemic approach, it aligns perfectly with the goals of FFPSA programs: keeping families together, addressing challenges before they escalate, and improving long-term outcomes for children and caregivers. It's a proven, evidence-based child welfare program with real-world results. And it's helping agencies turn the promise of reform into everyday reality.
For decision-makers, the message is clear: if we want FFPSA implementation to fulfill its potential, we must prioritize high-impact, community-driven interventions, such as MST. Families are ready. The tools are here. Now it's time to act. Become an MST provider today.
MST is an evidence-based alternative to incarceration or severe system consequences due to serious externalizing, anti-social, and/or criminal behaviors. MST effectively treats young people and their families by utilizing a built-in suite of interventions within the home, school, and community settings. Treatment is tailored to the family and their individual strengths and needs, which could include but is not limited to the following types of therapies: Family Therapy, Cognitive Behavioral Therapy, Drug and Alcohol Treatment, Mental Health Services, Peer Ecology Assessment and Intervention, Trauma-informed treatment, and Educational/ Vocational Support. If you or someone you know is interested in learning more about Multisystemic Therapy, contact us here.
