Multisystemic Therapy (MST) is a dynamic, evidence-based approach designed to address complex behavioral problems in young people. At its core, MST works within the ecological systems- family, peers, school, and community - influencing a young person's life.
By working within these systems, MST can support at-risk young people. This can be particularly important when a young person is faced with a difficult transition — for example, changing schools, adapting to a blended family structure, or transitioning home from placement or foster care.
MST has evolved to include specialized adaptations and enhancements like MST-FIT (MST for Family Integrated Transitions), MST for Child Abuse and Neglect (MST-CAN and MST-BSF (MST-Building Stronger Families), each tailored to navigate unique transition periods and challenges in life and each based on core MST.
MST-FIT takes the skills learned in facility or out-of-home placement through its collaborative Integrated Treatment Model (ITM) and generalizes them at the community level when the young person transitions back home. The goals of MST-FIT are to lower recidivism, empower the caregivers to manage the child’s behaviors, connect the family with informal supports, promote pro-social behavior, and effectively improve the young person’s well-being.
MST-CAN and MST-BSF are for families who are experiencing physical abuse and/or neglect of children ages 6 to 17, Both models focus primarily on the behavior and mental health difficulties of parents (e.g., trauma, substance misuse, communication, and problem-solving difficulties) while also treating difficulties experienced by all children in the family. MST-BSF is specialized for families where at least one parent is engaging in physical abuse and/or neglect, plus serious substance misuse or addiction. The goal of both models is to keep children safely together with their families, reduce mental health difficulties in children and adults, and increase social support.
MST Foundations: How the Therapy Tackles Transition Periods
MST is an evidence-based practice that has been proven to reduce recidivism in young people who have engaged in crime. It’s referral-based, cost-effective, and is also associated with preventing mental health crises and family arrests.
The essence of MST lies in its intensive treatment model, which works within the systems that influence a child’s life, including their school, family, and community. This holistic approach is what makes it so effective.
MST can get involved and help families access:
- Family-based therapy
- Individual therapy
- Mental health support
- Substance misuse treatment
- School-based counseling
- Academic support
- Vocational support
Not every family will need all of the above services. MST works because the approach is customized depending on each family’s unique needs. This flexible approach becomes invaluable during transition periods, which are often marked by uncertainty and stress
MST can be used to support children, families, and at-risk young people during transitions like:
- Moving to a new school
- Moving to a new foster home
- Losing a close relative
- Having a close relative incarcerated
- Returning home after being placed in a detention facility
- Transitioning to young adulthood
- Parent completing alcohol or drug detoxification
- Recovery from complex trauma
MST-FIT, MST-CAN, and MST-BSF are prime examples of how MST adapts to specific family dynamics
MST-CAN and MST-BSF target family safety, positive parenting, reduction in trauma symptoms experienced by adults and children, adult substance misuse and addiction, and prevention of out-of-home placement
MST-FIT can cater to the unique challenges of young people who are transitioning from out-of-home placements (due to juvenile justice or child welfare concerns) to returning home. This is especially important as child welfare involvement and incarceration can be traumatic to the young person and their family. Providing the right support and intervention can help lower recidivism and equips the family with support that enable long-term success.
Importance of Seeing the Client as the Entire Family in MST
In MST, each family is assigned a therapist who can treat individual family members and provide family therapy. The therapist works with the young person as well as the family as a whole. By treating the family and not just the child, the therapist can help all stakeholders provide a healthy and supportive family environment for the young person that can be maintained long after treatment.
During system, out-of-home placement, or school transitions, family or caregiver support can be especially vital. This support can be helpful whether the transition directly affects the family (for example, a new baby or a blended family) or the child alone (for example, a change in schools or coping with adolescence).
MST-FIT is designed to target reuniting young people and their caregivers after an out-home placement caused by child welfare placement, youths’ mental health needs, or incarceration. MST-FIT works intensively with young people and their caregivers to ensure they are effectively working to address systemic factors (peer association, parenting practices, low social support, school enrollment, etc.) that caused the out-of-home placement.
On the other hand, MST-CAN and MST-BSF focus on developing family safety and parent-child relationships in situations where physical abuse and/or neglect has occurred. These models emphasize treatment for trauma of the child or parent and substance misuse by parents so that children can remain safely at home. It is critical to include family, extended family, and the ecology, as a great deal of social support is needed to overcome the extreme challenges the families face.
Role of MST in Different Transition Periods
MST meets families where they’re at — which is to say that it’s a versatile form of treatment that can be adjusted to a young person and family’s unique needs. This is especially important during a variety of transition periods.
In academic transitions, such as changing schools, MST supports the young person by working with educational stakeholders to create a supportive academic environment. For example, MST can partner with caregivers to engage teachers and school counselors to ensure the child is getting the support they need and any extra-mural tutoring services that can support their academic performance.
Family transitions, which can be managed under MST-FIT, are approached with sensitivity to the needs of both the child and the family unit. This can involve skill-building sessions, family therapy, mental health support, and more.
After being out of home for a period of time, a young person might struggle to re-integrate into their home and community. MST-FIT can help them overcome post-detainment challenges and can help them after a return from placements that are caused by child welfare issues and mental health needs. This MST adaptation can help care for mental health needs and cope with substance use issues, thus promoting healthy family dynamics and pro-social behavior.
MST-FIT partners with another treatment approach, the Integrated Treatment Model (ITM), which is delivered to youth while in the residential setting. The ITM is designed to enhance young people’s skills in the areas of mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. MST-FIT helps transfer these skills to the caregivers once the young person returns home. These sister programs have reaped positive results for young people and their families.
MST-CAN and MST-BSF help families transition from being under the supervision of child protection due to maltreatment to healing the family relationships and establishing safety in the family. In some cases, children have been placed out-of-home at the time of referral, and MST-CAN/MST-BSF help restore and stabilize the family.
MST is marked as an excellent aid in community transitions by connecting young people with community resources, ensuring a supportive external environment. These community resources could include vocational programs, mental health treatment services, sports programs, addiction support, and more to improve their natural supports.
Conclusion
Transition periods can be difficult at any age, but they can be particularly challenging for young people, who might still need to gain emotional regulation skills and support networks to cope with change.
MST, with its specialized programs MST-FIT, MST-CAN, and MST-BSF, offers a comprehensive support system for managing various transition periods in a young person's life and with their family. Whether it's navigating the complexities of adolescence or a traumatic childhood, adjusting to new academic environments, successfully returning children from care, or establishing sustainable safety in the family, MST's adaptive, family-focused approach stands out.
MST Therapy and its adaptations have the potential to ease these transitions; their collaborative nature and emphasis on practical, real-world solutions underscore its pivotal role in fostering resilience and positive development in at-risk young people who have experienced abuse or neglect.
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, Substance misuse Treatment, Mental Health Services, Peer Ecology Assessment and Intervention, Trauma-informed and trauma-based treatment, and Educational/ Vocational Support.
If you or someone you know is interested in learning more about Multisystemic Therapy, contact us here.
