Multisystemic Therapy (MST) is featured in a New York Times Magazine story about addressing the Emotional and Behavioral Disorders of children in their homes. Given it’s track record for effectiveness, it’s very nice to see the coverage in the story by Paul Raeburn.
Developed over the last 30 years by Scott Henggeler, a clinical psychologist and a professor of psychiatry at the Medical University of South Carolina, [MST] is based on the assumptions that families should remain together and that all of the causes of antisocial behavior should be attacked at once.
Taking his cues from family therapy as well as from social ecology, which emphasizes that behavior is shaped by multiple aspects of the environment, Henggeler studies the ecosystem composed by family, neighborhood, schools, peer groups and the broader community. Instead of removing children from that ecosystem, he tries to change it: solve the drug problems and the legal problems, get kids away from delinquent peers and encourage academic success.
A central idea is to focus on the parents. “We want the therapist to build the competency of the parents, because the parents are going to be there after the therapist leaves,” he says. If the parents can’t handle the job, he might ask an uncle, aunt or grandparent to fill in.
MST therapists like Towell have small caseloads â€” four to six families at a time. They visit the families every day, if necessary, and are always on call. If the police grab a child at 2 a.m., the therapist can help sort things out. Because of this intensive effort, MST isn’t cheap. It typically lasts four to five months and costs between $5,000 to $7,500 per child. To make it cost-effective, it is directed at kids at high risk of expensive out-of-home placements. If enough of them can be kept at home, the program can pay for itself â€” and even save communities money.
MST is one of only a handful of “evidence based” programs that have been shown to be effective for violent children. In a recent 14-year evaluation, kids who had been through MST programs had 54 percent fewer arrests and spent 57 percent fewer days in jail. “These programs have a higher success rate than what else is out there,” Henggeler says. The single most important piece of the treatment is getting children away from deviant peers.
Link to Mr. Raeburn’s story. Link to the MST site. Link to a review from Evidence Based Programs.