Multisystemic therapy

Multisystemic therapy (MST) is an intensive, family-focused and community-based treatment program for chronically violent youth.

Since a 2005 Cochran review found no conclusive evidence of MST performing better than other therapies, later reviews have consistently reported that MST and other family-based treatments produce varying levels of reductions in antisocial behavior and other desirable outcomes.[1][2][3][4] There is no evidence of harm.[1]

Medical uses

A 2005 Cochrane review found inconclusive evidence as to whether MST is more effective than other services for young people.[1] A meta-analysis of MST in 2014 reported small improvements in delinquency, psychological problems, and substance use, particularly with younger juveniles.[2] A 2017 meta-analysis of family-based treatments for serious juvenile offenders found "modest, yet long-lasting, treatment effects" in reducing antisocial behavior and improving other outcomes when compared with conventional community services.[5]

In 2012 a literature review compared common treatments including cognitive behavioral therapy, 12-step facilitation, multisystemic therapy, psychoeducation, and motivational interviewing in an attempt to identify the best treatments for substance-abusing adolescents with conduct problems. The authors concluded that family-based interventions produced superior outcomes, and that MST had "the most compelling evidence", noting that the providers are often well trained and supervised.[4]

Adverse effects

There is no evidence of harm resulting from MST.[1]

Method

Multisystemic therapy (MST) is a home and community based intervention for families of youth with severe psychosocial and behavioral problems that assembles practices from strategic family therapy, structural family therapy, and cognitive behavior therapy in intensive interventions over four to six months. It is based in part on ecological systems theory. Treatment is individualized.[1]

History

The MST method was developed at the Family Services Research Center (FSRC) of the Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina.[6]:110 FSRC members were interested in improving mental health services for young criminals. They evaluated the literature for evidence-based practices and assembled the best ones into the MST method. As of 2002, FSRC had conducted most of the research and dissemination of the method.[6]:110 The first multi-center clinical trial of the method by FSRC showed that quality of the training of those implementing MST, and their supervision by experts, had an "extremely weak but significant" effect on the effectiveness of the method; the study was designed in part to test whether that was true.[6]:113–114

In 1996, MST Services, a private for-profit corporation, was formed to oversee dissemination of the method and provide supervision.[6]:118 At the same time, MST Institute, a nonprofit corporation, was formed, to be "responsible for setting quality assurance standards and monitoring the implementation of Multisystemic Therapy in all programs worldwide. Its information system is designed to provide policy makers and other stakeholders with the data necessary to assess the effectiveness of their MST programs and improve services to families and youth in their communities."[7] MST Services has an exclusive license from the Medical University of South Carolina for intellectual property[8] covering the assessment instruments, and the protocols used in MST.[1][9] MST Services in turn grants sublicenses and trains teams to practice MST; as of 2008 there were about 250 such teams in North America and Europe.[1] MST Group LLC (which does business as MST Services) owns the "Multisystemic Therapy" trademark.[10]

References

  1. 1 2 3 4 5 6 7 Littell, JH; Popa, M; Forsythe, B (October 19, 2005). "Multisystemic Therapy for social, emotional, and behavioral problems in youth aged 10-17". The Cochrane Database of Systematic Reviews (4): CD004797. doi:10.1002/14651858.CD004797.pub4. PMID 16235382.
  2. 1 2 van der Stouwe, Trudy; Asscher, Jessica J; Stams, Geert Jan JM; Deković, Maja; van der Laan, Peter H (August 2014). "The effectiveness of Multisystemic Therapy (MST): A meta-analysis". Clinical Psychology Review. 34 (6): 468–81. doi:10.1016/j.cpr.2014.06.006. PMID 25047448.
  3. ↑ Baldwin, SA; Christian, S; Berkeljon, A; Shadish, WR (January 2012). "The effects of family therapies for adolescent delinquency and substance abuse: a meta-analysis". Journal of marital and family therapy. 38 (1): 281–304. doi:10.1111/j.1752-0606.2011.00248.x. PMID 22283391.
  4. 1 2 Spas, J; Ramsey, S; Paiva, AL; Stein, LA (2012). "All might have won, but not all have the prize: optimal treatment for substance abuse among adolescents with conduct problems". Substance abuse : research and treatment. 6: 141–55. doi:10.4137/SART.S10389. PMC 3498967. PMID 23170066.
  5. ↑ Dopp, Alex R; Borduin, Charles M; White, Mark H; Kuppens, Sofie. "Family-based treatments for serious juvenile offenders: A multilevel meta-analysis". Journal of Consulting and Clinical Psychology. 85 (4): 335–354. doi:10.1037/ccp0000183. PMID 28333535.
  6. 1 2 3 4 Leschied, A.W.; Cunningham, Alison (2002). "Ch. 5: MST and the Oversight of MST Services Inc." (PDF). Seeking Effective Interventions for Serious Young Offenders: Interim Results of a Four-Year Randomized Study of Multisystemic Therapy in Ontario, Canada. Centre for Children and Families in the Justice System (London Family Court Clinic Inc.). ISBN 1-895953-17-0.
  7. ↑ "About MST Institute: our Purpose". MST Institute. Retrieved March 17, 2015.
  8. ↑ "Family Services Research Center: Multisystemic therapy". Medical University of South Carolina. Retrieved March 17, 2015.
  9. ↑ Schoenwald, SK; Heiblum, N; Saldana, L; Henggeler, SW (June 2008). "The international implementation of multisystemic therapy". Evaluation & the Health Professions. 31 (2): 211–25. doi:10.1177/0163278708315925. PMC 2408770. PMID 18367755.
  10. ↑ "MULTISYSTEMIC THERAPY". Trademarks411. Retrieved March 23, 2015.
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