What do you do when your 16-year-old is disrespectful, aggressive, drinks, disregards curfews, and hangs around with peers who are bad influences? In other words, his life is in a downward spiral toward prison. (The first names were changed to protect the family's privacy.)
Pablo’s mother, Maria, didn’t have the answer. The Hispanic family living in rural South Carolina had always been close-knit. But since her husband left and her fiancé moved in, Pablo’s behavior had deteriorated.
After a particularly volatile incident, the boy had to be removed from the home.
He was sent to therapeutic foster care for three weeks of cooling off. Therapeutic foster care was used as temporary housing until the family could deal with the youth. Maria was adamantly against Pablo being permanently placed outside the home. She was worried he would pick up worse behavior. Despite all the problems, she wanted the best for her child.
But she needed help. The family court labeled him “incorrigible.” Pablo’s probation officer could have removed him at any time. That’s when the family was referred to Multisystemic Therapy (MST.)
After doing an assessment, the MST Therapist, Laura Fulton looked for the “fit” of Pablo’s referral behaviors. Finding the fit is the first of MST’s nine principles; the objective is to consider the factors in the youth’s environment that are contributing to the youth’s behaviors. The MST Therapist also looks for successes so that they can be leveraged in the treatment process.
Laura quickly realized that it was not only what Pablo was doing and not doing, but that Pablo and his mother were engaged in an ongoing pattern of conflict. While considering the conflict sequences between Pablo and Maria, Laura identified that there was an opportunity to increase warmth between mother and son. Pablo voiced that he didn’t feel loved and this was one factor contributing to his rebellion and acting out. The MST Therapist was able to get the mother to see that relationships matter. Once Maria realized that her actions were contributing to Pablo’s delinquency, she was able to stop taking what he did personally. She took stock of the situation and made changes in the way she approached Pablo, “If things get out of control, I count to 10. Let’s talk when we calm down, I tell him.”
As part of the MST approach, the entire family was brought into the therapy. Maria was shown ways to hold her ground and enforce consequences. She hadn’t done that before.
Laura looked for ways to make changes immediately by targeting specific and well-defined problems; another MST treatment principle. She recognized that the rest of the family had to present a united front. For example, Pablo had been getting permission from his grandmother to leave the house by telling her Maria had okayed it. Now the grandmother checked with Maria first.
After a couple of months, Pablo’s mother saw a profound difference in her son and family. She said that “Before we started MST, we didn’t have a relationship. It was all fighting. Now it’s changed. He doesn’t break his curfew. He asks before he goes out and tells me where he is going.” She and her son even go on “date nights,” just the two of them. Pablo talks about his feelings, and they spend an enjoyable time together. Before there was a wall separating them.
Pablo made such progress—no more drinking, improved grades, going to church with the family, he is even on the school’s soccer team. Because MST Therapists see families several times weekly and the treatment process is focused and intense, change is realized quickly. In four months, the family was ready to complete treatment. Though not before the family collaborated with Laura on how to continue to address Pablo and their needs. A key to long-term success and to families maintaining the changes they made in MST treatment without needing ongoing formal services.
Maria said, “I didn’t think it would be so fast. It works because it helps control the anger from both of us, we work as a family. It is not just me or him, everyone is working together. It feels good having control in my home again with Pablo.”
For Laura, it was a rewarding experience. Pablo’s turnaround was fast and dramatic, truly an MST success story.
Learn more about what makes MST such an effective intervention.
