Multisystemic therapy (MST)

Multisystemic therapy (MST) is a short-term treatment program designed for children and adolescents with severe psychosocial and behavioral problems. It is a widely used, evidence-based and common treatment program for youth involved in trouble with the juvenile justice system. MST is family and community-based, and is designed to remedy issues such as delinquency, substance abuse, and underlying psychological problems. This type of therapy takes into account a youth’s interactions with family, peer groups, school, and the neighborhood. MST has been shown to be successful in the treatment of antisocial behavior in adolescents and has achieved mixed results for other conditions such as serious emotional disturbances.

Overview

MST was developed by psychiatrist Scott W. Henggeler at the Family Services Research Center at the Medical University of South Carolina in the late 1970s and further refined and expanded during the 1990s through the Medical University of South Carolina and its Family Services Research Center. Its methods are oriented around the youth’s home and community. It is primarily used to treat adolescents experiencing the most severe of psychosocial problems. This type of therapy draws on other established treatment practices from a range of other therapies, such as structural family therapy, strategic family therapy, and cognitive behavioral therapy. It is based on social ecological and family systems theories as well as studies related to the causes and correlations of serious antisocial behavior in youth. Its conceptual framework takes into account the multifaceted influences of the youth’s family, peer group, neighborhood, school, and overall community.

In terms of the social ecological theory of human development, MST utilizes the view that behavior is a product of mutual interactions between an individual and their social environment. In its basis in the family systems theory, MST views children’s behaviors as a reflection of complex family interactions. The therapy’s clinical practices include a thorough assessment of the child’s development, family relations, and their family’s experiences in other social systems. MST was developed to allow for flexibility in treatment approaches, understanding that a range of techniques may be necessary when dealing with severe psychosocial problems in children.

MST is designed to provide services for a limited time, usually three to five months, and often involves the entire family. Youths are treated by a variety of professionals such as therapists and crisis caseworkers. Many times, these professionals are usually supervised by clinical psychologists, psychiatrists, or experienced and advanced master-level clinicians. Treatment programs are customized to suit each individual youth and their family. Therapy extends beyond the home and therapist’s office to the youth’s school, peer groups, and social networks.

Therapy may focus on changing the youth’s behavior, thought processes, communication skills, family dynamics, peer relationships, or a combination of each. Treatment extends to the youth’s family to encourage beneficial methods for dealing with the child’s behavior. Positive family participation will encourage the youth’s progress and improve their chances of therapeutic success.

Following a comprehensive assessment of the child’s current and past home and social life, professionals will identify a series of treatment goals, which usually involve a set of tasks to be completed. These tasks will be assigned to the youth and their family members. Progress will be monitored during weekly family sessions in an office or in the family home, with treatment duration relying on the successful completion of assigned tasks. Studies have suggested that MST is effective at improving youth social skills and family cohesion, but evidence is mixed for outcomes such as peer relations, school outcomes, and other youth skills. It has also been shown to reduce unlawful behavior in adolescents.

Bibliography

“Family Safety & Stabilization.” Catholic Charities, www.ccwny.org/services/what-is-mst. Accessed 20 Mar. 2026.

Henggeler, Scott W., et al. Multisystemic Therapy for Antisocial Behavior in Children and Adolescents. Guilford Press, 2009.

Henggeler, Scott W., editor. Serious Emotional Disturbance in Children and Adolescents: Multisystemic Therapy. Guilford Press, 2002.

Littell, J.H., et al. “Multisystemic Therapy for Social, Emotional, and Behavioral Problems in Youth Aged 10–17 (Review).” The Cochrane Collaboration, 2009, library.college.police.uk/docs/Multisystemic-therapy-2005.pdf. Accessed 20 Mar. 2026.

“Multisystemic Therapy.” Family Services of NW PA, www.fsnwpa.org/our-services/in-home-services/multisystemic-therapy. Accessed 20 Mar. 2026.

“Multisystemic Therapy.” Youth Villages, www.youthvillages.org/intensive-in-home-treatment/multisystemic-therapy-mst. Accessed 20 Mar. 2026.

“Multisystemic Therapy (MST).” Ohio Systems of Care for Children and Families, socohio.org/soc_best_practices/best-practice-1. Accessed 20 Mar. 2026.

“Program Profile: Multisystemic Therapy (MST).” National Institute of Justice, 17 July 2024, www.crimesolutions.gov/ProgramDetails.aspx?ID=192. Accessed 20 Mar. 2026.

Public Safety Canada. “Results from the Multisystemic Therapy Program.” Government of Canada, www.publicsafety.gc.ca/cnt/rsrcs/pblctns/rslts-mltsystmc-thrpy-prgrm/index-en.aspx. Accessed 20 Mar. 2026.