Multi Systemic Therapy
Overview
Breaking the cycle of problematic behaviour
by keeping young people at home, in school and out of
trouble
Overview
What is MST?
How does MST work in practice?
MST Newcastle
What is MST?
 Community-based, intensive, family driven
approach for young people who are at risk of
custody or being placed into Local Authority
Care due to their OWN behaviour.
 The MST ‘client’ is the entire ecology of the
young person: family, peers, school, local
community.
 Focus is on empowering the caregivers to solve
current and future problems.
Ultimate MST Outcomes
To keep families together when the young
person is at risk of entering care or
custody.
For the young person to be engaged in
education / training.
For there to be a reduction in antisocial
behaviour and charges brought against
the young person.
Instrumental Outcomes
Improved parenting skills
Improved family relations
Improved access to supports
Success in education and training
Improved involvement with pro social
peers and activities
Changes sustained for 3-4 weeks
Theoretical underpinnings
Social Ecological approach
Young people live in a social ecology of
interconnected systems.
Behaviour is influenced across a number
of different systems.
In order to change behaviour we need to
target factors at an individual, family,
school, peer and community level.
Social Ecological Model
MST theory of change
Research led models of intervention
We bring together some intensively researched
and evidence based interventions to enable
families to build on their strengths and resources
to make changes:
 Structural Family Therapy
 Strategic Family Therapy
 Behavioural Parent Training
 Cognitive Behavioural Therapy
Evidence Base
Strong research base showing that MST is
effective
Evidence shows that MST is successful as it;
 Targets the known causes of problematic
behaviours; family and peer relations, school
and community factors
 Is family driven and takes place at home
 Providers are accountable for outcomes
 Continuous quality improvement occurs at all
levels
How Does MST work in
Practice?
How does it work in practice?
 Single worker working intensively with 4 to 6 families at a
time.
 Negotiate outcomes with the family and key participants.
 Work is done in the home, school and local community.
 24 hour / 7 days a week team availability: ‘on call’
system.
 Typical intervention lasts 3-5 months.
 MST worker will take the lead on delivering interventions
to address referral behaviours. What does this mean in
practice?
MST workers work primarily with
parents to help them:
Increase their parenting skills
Improve family relations
Involve the young person with more pro
social peers and activities
Improve school attendance
Create family support networks
Core elements of MST
MST treatment principles
MST analytical process
MST quality assurance system
MST Principles
1. Find the fit
2. Positive and strength focussed
3. Increased responsibility
4. Present focussed, action oriented, well defined
5. Targeting sequences
6. Developmentally appropriate
7. Continuous effort
8. Evaluation and accountability
9. Generalisation
Finding the Fit;
Sample Fit circle
Peers reinforce
behaviours
Ineffective school
consequences
YP is struggling
academically
Verbal aggression
at school
YP does not
like school
Lack of consequences
at home
Poor home
school link
MST Newcastle
Why Newcastle?
 Newcastle has a high number of young people
being placed in Local Authority Care for short
periods of time, suggesting that they may not
need to enter care at all if an appropriate family
intervention can be provided.
 Research has shown MST to:
Reduce re-arrest rates by up to 70%
Reduce out-of-home placements by up to 64%
Referral Criteria
Young Person must be aged between 12
and 17 years (or 11yrs if in year 7)
AND
 The young person must be at risk of
entering care or custody due to THEIR
OWN problematic behaviour, such as
offending and substance misuse.
Exclusionary criteria
 Young people living independently or already in
care or custody or for whom a caregiver can’t be
located.
 Young people who mainly present with a serious
mental health problem or developmental
disorder, e.g. Autism.
 Young people who mainly present with concerns
around suicide, homicide or psychotic
behaviour.
 When the concern is mainly around the
behaviour of the parent rather than the young
person.
Typical referral behaviours
Verbal and physical aggression at home/
school/ community
Low/ no school attendance
Offending behaviour
Drug and alcohol use
Association with anti-social peers
Missing behaviours
Poor family relations
Newcastle to date
 Started taking referrals in May 2012
 Worked with 39 families so far
 Closed 32 families
 27 cases closed due to successfully addressing
referral behaviours,
 2 cases discharged due to Team’s inability to
sustain engagement
 2 YP accommodated,
 1 YP moved out of area
Ultimate Outcomes: May 2012 to
May 2013 for 32 Closed Cases
 Percentage of YP living at home = 90.9% (30
out of 32 YP)
 Percentage of YP in school or working = 81.8%
(26 out of 32 YP)
 Percentage of YP with no new charges during
MST = 66.7% (21 out of 32 YP)
Instrumental Outcomes: May 2012
to May 2013 for 32 Closed Cases
 Percentage of families with parenting skills necessary to
handle future problems = 78.8% (25 out of 32 families)
 Percentage of families with improved family relations =
78.8% (25 out of 32 families)
 Percentage of families with improved network of
supports = 66.7% (21 out of 32 families)
 Percentage of YP with success in education or training =
78.8% (25 out of 32 families)
Instrumental Outcomes: May 2012
to May 2013 for 32 Closed Cases
 Percentage of YP involved with pro social
peers/activities = 48.5 (15 out of 32 young
people)
 Percentage of cases where positive change has
been sustained = 78.8% (25 out of 32 families)
All Outcomes are based on families self reporting
and worker assessment
Some feedback on MST Newcastle
From Families
Our worker never
gave up on our
moods and she had
ideas about resolving
each problem
Very determined
to help the
family as much
as they could.
Very friendly
The call service
is great as I
really needed
this
How is MST different?;
The intense 3 days a
week contact and phone
contact the whole time
I am very
grateful to
have
received
the service
I would like to say thank
you to MST, especially my
worker. She has made my
relationship with my son
better
Newcastle’s MST Team
Supervisor:
Sarah Ritson
Abby Waites (Maternity Leave)
MST Team:
Ashley Robson
Philip Sammut- Smith
Warren Petitjean
New Worker hired but not yet in post
For more information…
 Visit www.mstservices.com
 Email: mstadmin@newcastle.gov.uk
 Telephone: 0191 2782762
 Cookery Block - Heaton Complex
Trewhitt Road, Heaton
NE6 5DY
Any Questions?