Multisystemic Therapy: Clinical Foundations and Research Outcomes

Multisystemic therapy (MST) is an intensive family and community-based treatment for adolescents presenting serious antisocial behavior and their families. Using a home-based model of service delivery to overcome barriers to service access and a strong quality assurance system to promote treatment fidelity, MST therapists address known risk factors (i.e., at individual, family, peer, school, and community levels) strategically and comprehensively. The family is viewed as central to achieving favorable outcomes, and mediation research supports the emphasis of MST on promoting family functioning as the key mechanism of clinical change. Importantly, 22 MST outcome studies have been published, many of which are independent randomized clinical trials, and the vast majority, including those conducted in Europe, support the capacity of MST to reduce youth antisocial behavior and out-of-home placements. Such outcomes, combined with the advocacy of many juvenile justice stakeholders, have led to the transport of MST programs to more than 500 sites, including 10 nations in Europe.