Multisystemic Therapy (MST)

A strategy for dealing with children with severe mental illnesses, offering home-based care (rather than hospitalization) and involving the wider community (families, schools, and neighborhoods) in the health care process. This strategy was originally developed in the late 1970s to address issues with existing mental health services for serious juvenile offenders. MST posits that antisocial behavior in young people can be attributed to factors in various life domains, such as their family, their community, their peers, and their school. As such, treatment strategies that target particular aspects of the youth's behavior in an artificial setting (such as in a treatment facility or under supervised release) neglect the fundamental causes of antisocial behavior. MST targets aspects of a youth's social network that are contributing to antisocial behavior, such as improving [Page 338]caregiver discipline practices and increasing association with prosocial peers. Developers of MST argue that it has grown because, while it demands a different structure for caregiver services than is currently offered in many parts of the United States, the reorganized support for the community-based service results in improved outcomes for children with marked emotional difficulties. In addition, the cost of care delivery is reduced, relative to the alternatives, and therapists, families, and clients generally view MST positively. Various national agencies have identified MST as promising in the treatment of juvenile criminal behavior, substance abuse, and emotional disturbance. However, critics argue that insufficient independent research has been conducted to establish the effectiveness of MST. For further reading, see Schoenwald, Ward, Henggeler, and Rowland (2000).