A Therapeutic Approach to Teen Treatment

Email this ArticlePrint This Page


  • Multi-Systemic Therapy, or MST, an intensive approach to treatment, shows high rates of success.
  • MST therapy teams have small caseloads and work closely with the whole family, contacting them almost daily.
  • Payment for MST frequently comes from social service or juvenile justice agencies or through public funding.

The Multisystemic Therapy Model for Outpatient Treatment

Multisystemic Therapy (MST) is widely considered one of the most effective forms of treatment for adolescent problem behaviors. This therapeutic approach uses an intensive, home-based model to reduce barriers that keep families from getting services. A practical and goal-oriented treatment, MST specifically targets the factors in each youth's social group and environment that contribute to his or her antisocial and/or drug-using behavior. It tries to address many different parts of the adolescent's life and relationships that may be related to their drug use and other problem behaviors. MST therapists:

  • have small caseloads of four to six families at a time
  • work as a team; are available 24 hours a day, 7 days a week
  • provide services at times convenient to the family

The average treatment involves about 60 hours of contact during a 4-month period. A family with an MST therapist should expect that the therapist will:

  • help the parents improve their parenting skills by identifying and building on things the family already does well and helping them learn new ways to parent their adolescent.
  • help the family find people in their community who can be helpful to them (e.g., extended family, neighbors, friends, church members)
  • help the family figure out ways to address other problems in their lives (e.g., parental substance use, high stress, poor relationships between partners).
  • have almost daily contact with the family (several weekly therapy sessions and several phone contacts) travel to the family home or meet the family in the community so that therapy is convenient for the family.
  • be available (or have one of their therapy teammates available) by pager and/or cell phone 24 hours a day, 7 days a week so that the family and adolescent will have the opportunity to get advice from the therapist when situations arise

The therapist will help the family figure out the things that need to change and make a plan for making changes, but the family will be expected to try to do assignments at home and make changes on a daily basis so that changes can happen as quickly as possible. Funding for MST frequently comes from social services agencies, juvenile justice agencies, Medicaid or mental health funds; there is not typically a cost to the family to participate.

MST has licensed agencies in over 30 states and in several countries. As a result, MST is now provided to more than 12,000 families annually. To find a licensed MST program in your state, go to www.mstservices.com/text/licensed_agencies.htm.

If MST is not available in your community, you can investigate other substance treatment programs in your state by searching www.drugstrategies.org or http://findtreatment.samhsa.gov.

To find detailed articles/readings about the MST model and its demonstrated effectiveness, go to www.musc.edu/psychiatry/research/fsrc/pubs.htm.