Multisystemic therapy

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

Reviews of clinical studies have been unable to establish a consensus as to its effectiveness in comparison to other interventions.[1][2][3][4] There is no evidence of harm.[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]

Effectiveness

A 2005 meta-analysis by the Cochrane Collaboration found that there was no evidence to suggest that MST is any more effective than other services for youth.[1] Another meta-analysis, published in the Clinical Psychology Review in 2014, reported small improvements in delinquency, psychological problems, and substance use.[2]

Adverse effects

There is no evidence of harm resulting from MST.[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.[5]: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.[5]: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.[5]:113-114

In 1996, MST Services, a private for-profit corporation, was formed to oversee dissemination of the method and provide supervision.[5]: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."[6] MST Services has an exclusive license from the Medical University of South Carolina for intellectual property[7] covering the assessment instruments, and the protocols used in MST.[1][8] 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.[9]

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, T; Asscher, JJ; Stams, GJ; Deković, M; et al. (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. ↑ 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. PMID 23170066.
  5. 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.
  6. ↑ "About MST Institute: our Purpose". MST Institute. Retrieved March 17, 2015.
  7. ↑ "Family Services Research Center: Multisystemic therapy". Medical University of South Carolina. Retrieved March 17, 2015.
  8. ↑ 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 2408770Freely accessible. PMID 18367755.
  9. ↑ "MULTISYSTEMIC THERAPY". Trademarks411. Retrieved March 23, 2015.
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