MST's Outcomes Depend on Building Relationships

Posted by Lori Moore

Nov 10, 2015 10:00:00 AM

Multisystemic Therapy takes more than a Coke and a smile

I remember when I was an MST supervisor, one of my therapists came into my office and said that he had finally figured it out—“Engagement in MST isn’t a Coke and a smile!” It wasn’t about having families invite him into their homes, greeting him with a smile on their faces, offering him a seat at their kitchen table and a Coke to drink. Engagement was something much more. After working in MST for several months, he had really started to understand that engagement and alignment meant a whole lot more and was critical to long-lasting success.

One of the fundamental assumptions of MST is that every family is doing the very best they can with what they have. Our job as clinicians is to help draw even more out of them. To help them figure out why their very best isn’t getting them what they want. We start this engagement process on day one—when we first walk into their lives. We take the time to meet families where they are at, to understand their unique circumstances from their perspective. We help families identify their desired outcomes. What is that theyalong with the other systems working with their young personwant to achieve, and how the MST process can help them achieve it.

Giving caregivers problem-solving skills

A unique part of our model is to come alongside the caregivers and give them the power to problem-solve what concerns them so that they have the skills, resources and supports needed to manage future challenges of raising adolescents. Therefore, a vast majority of MST clinical resources are devoted to joining with the family members to build a strong alliance, which is an essential (but not the only) step toward achieving positive outcomes in research and real-world settings.

A 2015 article published in the Journal of Family Therapy (“Sustaining change following multisystemic therapy: caregiver’s perspectives”) looks at the factors that support those favorable results, as well as sustaining them long after treatment has ended. The research suggests that overall change in family functioning and positive therapeutic alliance are key factors. These factors, among others, contributed to the caregivers’ improved relationships with their child, shifting how they viewed difficulties and solutions, and feeling strengthened and resilient. These outcomes, in turn, supported the long-term improvement after treatment.

This research supports what my therapist and many others after him came to know. Building the therapeutic alliance with caregivers in an essential step in achieving lasting results in MST.

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Topics: Multisystemic Therapy