Two different evidence-based programs each have unique pros
SHIELDS for Families has been using both Multisystemic Therapy (MST) and Functional Family Therapy (FFT) off and on since 2004. Some might ask why not one or the other? They both are evidence-based models and work with the whole family and the offender—with good results.
Before going further, it should be said that at my agency, SHIELDS, they are used quite differently. MST deals with youths who are repeat violent offenders having committed several serious crimes. Many can be characterized as hard core and will very likely end up incarcerated. FFT works with high-risk juveniles who might have committed lesser crimes.
Another difference is FFT is an intervention which works with less contract time with families, generally about 20 to 30 hours in total time with any family. MST is intensive, 3-5 months with session frequency determined by clinical need, with therapists on call 24 hours a day, seven days a week, ready to go to the offender’s home whenever needed. This treatment on average lasts 60 hours over four months. With the SHIELDS mission to keep families together and children out of jail, we saw the powerful advantages and results of each approach.
Different treatments for different people
What was also important to SHIELDS was taking advantage of the strengths of our staff.
Some preferred FFT because of a perceived flexibility in treatment. The staff member could be sitting with a family and sense a theme. Realizing a particular intervention might be effective, the therapist would implement it on the spot. This model was not the easiest to master.
Then there were those who felt more comfortable and better able to produce beneficial results using MST. When working with an MST case top clinical concerns are zeroed in on. This works well for concrete thinkers who prefer a more defined course of treatment. FFT is better for those who like interpreting behaviors and working with the ever-changing dynamics of each family session.
Since we have run MST and FFT teams for such a long time, we are able to recognize when one model might be more beneficial than the other. For example, when a youth is resistant and disengaged, we have opted for MST. As the therapist works with the parents, there is an increased buy-in by the youth.
In some situations, there was so much negativity and blame within the family, FFT seemed the better match. In such cases, the therapist worked to build an alliance and help the family get beyond adverse thoughts and statements. There have been a few cases where, for whatever reason, the client/family was not progressing in, say, FFT, such that we opted to provide services under MST. This has only occurred a few times over the years that we have been using these models.
For both our MST and FFT programs, we feel that our staff have developed advanced skills for engaging families, empowering parents, getting the juvenile involved and applying efficient treatment practices. The programs inherently complement each other in many ways, and there has been a natural camaraderie developed between our staff in both programs.
Overall, it can be noted that the having FFT and MST has positively impacted our mental-health departments, and the programs help to round out the broad range of services provided at SHIELDS.
Katherine Erickson, LCSW, is the Mental Health Director for SHIELDS for Families
The SHIELDS MST Team is pictured above. From left to right: David De Aragon, Rebecca Moreno, Nicholas Nunez, Shalonda Body, Manuela Castellanos, Articela Vega, Lucia Contreras.
To learn more about the cost-effectiveness of Multisystemic Therapy, download this white paper.
