One minute guide: Multi-systemic therapy

Multi-Systemic Therapy (MST)

MST is an internationally recognised and proven evidence based treatment programme aimed at supporting families to reduce the need for children and young people to become looked after. In the UK, MST (Standard) and MST CAN (Child Abuse and Neglect) are both recognised by NICE (National Institute for Health and Care Excellence) and the Early Intervention Fund as effective interventions.

MST teams work intensively with all the systems around a child or young person (for example families, carers, schools, other professionals and local communities) to develop and align intervention plans to achieve positive outcomes.

The standard MST model was developed specifically for anti-social behaviour in adolescents, but since its inception the model and principles have been applied to other presentations in young people, and a number of adaptations have been developed. In Leeds we currently have

MST-CAN and MST Return Home as well as standard MST.

MST (standard)

MST standard works with families and young people aged 11-17 who demonstrate severe antisocial behaviour that puts them at risk of entering care or custody. It uses pragmatic solution focused approaches such as parenting, family work and Cognitive Behavioural Therapy to empower families to no longer need services. Following a specific model and a set of principles that continuously inform the work, input lasts for no longer than 20 weeks.

Therapists have small caseloads, can offer 24-hour support and are committed to the MST approach of doing 'whatever it takes' to engage families and help them achieve the best outcomes that they can. This involves high commitment and adherence to restorative practice. The MST therapist takes the lead practitioner role for the young person for the duration of the treatment, which provides consistency and reduces the number of practitioner and professional contacts for the family. There are standard MST teams in Leeds covering all areas of the city.

MST-CAN

Multi Systemic Therapy Child Abuse and Neglect (MST-CAN) an evidence-based programme aimed at helping families with severe and complex difficulties whose children are in receipt of child protection services or are at risk of being taken into care due to neglect or physical abuse. Whilst working in many similar ways to standard MST, utilising the same analytical pro- cess to understand behaviour and target interventions, the focus is on child protection concerns, and therapists are additionally trained to deliver specific evidence-based treatments that address substance use and trauma in both children and adults. Treatment is intensive, lasting for 6-9 months, and can focus on several family members during the same treatment period. MST-CAN also offer 24-hour support.

Referrals can only be taken for families who have a child or children aged 6-17 years old, subject to a child protection plan under the specific categories of neglect and physical abuse. There is currently one city-wide team, receiving referrals through the area social work teams.

MST-CAN is recommended in the NICE guidance for therapeutic interventions after abuse and neglect and in the Early Intervention Foundation's Handbook.

MST return home

MST Return Home is an exception to the MST Standard model which aims to support and enhance the period of transition of the young person aged 11-17 from local authority provision to home or to a permanent placement with an identified care giver.

MST Return Home referrals are appropriate where young people currently display challenging behaviours, or displayed them for at least 6 months prior to being placed away from home.

An MST therapist works with the family for eight weeks before the young person returns home full time, and for a further 20 weeks after the young person has returned home. MST Return Home builds on the MST model and treatment approach with the addition of Dialectical Behaviour Therapy (DBT) and Motivational Interviewing.

Referrals for this service are considered on a case by case basis and are co-ordinated between the supervisor for MST Return Home, the Leeds Reunification team and the young person’s Children’s Social Work Team.

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