Multisystemic Therapy - Prevention (MST-PRV) was designed in response to the unique needs of the NYC child welfare system, the Administration for Children's Services (ACS). MST Services, the purveyor of Multisystemic Therapy and its adaptations, identified the need for a service delivery that could both target challenging behaviors by the youth, while also reducing the risk of abuse or maltreatment.
Enhancing MST to Respond to Needs of the Child Welfare Prevention Services Context
In 2013, the ACS made a commitment to increase the availability of evidence-based programs in its preventive services network and selected Multisystemic Therapy (MST) to be one of the 12 models implemented in the system. Two MST treatment types were employed, MST Child Abuse and Neglect (MST-CAN) and MST Substance Abuse (MST-SA), with MST-CAN reserved for young people and their families at the highest risk. MST Services and ACS representatives collaborated on the implementation of both models and, over time, it became clear that some small changes were needed to increase the cultural relevancy of the MST-SA intervention to the child welfare preventive services context and requirements. These changes were piloted with a single MST-SA team at Children’s Village.
During the piloting process, MST Services listened to feedback from ACS partners and the provider and developed a set of enhancements that were more in alignment with the needs and goals of ACS’s child welfare portfolio. An evaluation of the enhancements was conducted in 2016 and it demonstrated that the team was able to adhere to the MST model’s standards, improve the youth’s mental health and behavioral functioning, and support the family in meeting the child welfare system’s goals. As a result, this new treatment type, labeled MST-Prevention (MST-PRV), was expanded to 14 teams in the next contract cycle.
Features of MST-PRV
One of the key features of MST-PRV is the addition of the Family Resource Caseworker (FRCW) to each team. The FRCW can address all concrete and case management needs while the therapist can focus on all clinical needs.
The enhancements included in MST-PRV heighten the MST program staff’s sensitivity and awareness to the systematic culture of child welfare prevention services, its requirements, and the way that the sensitivities of system stakeholders may be different from those of other systems such as juvenile justice. Specifically, there is an enhanced focus on assessment and interventions to increase the safety and well-being of all family members and increased resources to support the household in meeting some of the ongoing needs identified by the referring child welfare caseworker. Finally, MST-PRV monitors the treatment outcomes of each case at discharge regarding whether the target youth is living at home, in school, or working, not arrested during treatment, has improved emotional/behavioral functioning, and whether there have been new reports of maltreatment during treatment.
Growing MST-PRV
Last year, the New York Foundling was awarded contracts to implement MST-PRV teams in Queens, Brooklyn, Manhattan, and Staten Island. Taking on the program development process while also managing the COVID-19 pandemic's effect in NYC was challenging. However, through constant communication, close collaboration with MSTS, and the "Whatever It Takes" spirit, they were able to get this program up and running in all boroughs.
Laura Valencia, a Family Resource Caseworker on the MST-PRV team in Manhattan, shared why she enjoys working with a prevention team. “I love being a part of the MST team, especially as a caseworker because I am getting firsthand knowledge about Multisystemic Therapy and seeing the positive outcomes it can generate without having my license for social work yet. I have to admit, I give a lot of credit to the therapists on the team for implementing MST in their everyday work. I am so thankful to be able to collaborate with the therapists on my team and use the MST model in my caseworker role. All the MST pieces of training have taught me something new and I’ve been able to apply a lot of it to not only my job but my personal life!”
Since accepting their first cases in May of 2020, the MST-PRV teams in New York have now collectively served over 100 families across the 4 boroughs. Although ACS is a primary referral source, the teams have also had the opportunity to engage various community partners and educate them on the value and impact of MST-PRV. Some of these community partners include the Youth Community program of the NYPD, local schools, outpatient clinics, and hospitals. Through these partnerships, the NY Foundling can truly be a preventive program: working with families who are at risk of, but not yet had, child welfare involvement.
Multisystemic Therapy (MST) is an evidence-based alternative to incarceration. MST effectively treats troubled youth and their families by utilizing a built-in suite of services within the home, school, and community settings. For more information about Multisystemic Therapy, click here.
