Multisystemic Therapy MST

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Multisystemic Therapy (MST)

• Lee P. Ohnmacht, LCSW-C
• Baltimore County MST Project Director
• Baltimore County Bureau of Mental Health/
• Core Service Agency

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What is MST?

• Community-based, family-driven treatment for
  antisocial/delinquent behavior
• Focus is on empowering caregivers to solve
  current and future problems
• MST client is the entire ecology of the youth -
  family, peers, school, neighborhood
• Highly structured supervision and quality
  assurance processes are employed

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Who is eligible? (Baltimore County eligibility
criteria)

• Youth must meet ALL the following
• Youth under formal DJS supervision (COMPACT
  eligible)
• (However,at one time, youth with history of at
  least one arrest or an established pattern of
  delinquency were eligible)
• Live with his/her family or a long-term foster
  family
• Live in Baltimore County
• Ages 11-17
• IQ above 70

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Who is not eligible?

• Youth who have ANY of the following are NOT
  eligible
• Diagnosis of autism or PDD
• In need of immediate hospitalization
• Referred because of a sexual offense without
  other delinquent behaviors

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MST Assumptions Beliefs

• Childrens behavior is strongly influenced by
  their families, friends and communities (and vice
  versa)
• Families are key to success
• Families can live successfully without formal,
  mandated services
• Change can occur quickly
• Professional treatment providers should be
  accountable for achieving outcomes
• Science/research can provide guidance

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Ecological Model
Community/Culture
Neighborhood
School
Peers
Family
Child
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How is MST Implemented?

• Single therapist working intensively with 4 to 6
  families at a time
• 4-6 months is the typical treatment time.
• Work is done in the community home, school
  neighborhood, etc.
• MST staff deliver all treatment.
• MST staff take a lead role in clinical decision
  making for each case.

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Evidence-Based Practice

• U.S. Surgeon General Report on Mental Health and
  Report on Youth Violence
• U.S. Department of Justice-OJJDP
• NIDA, Center for Substance Treatment (CSAT)
  Center for Substance Abuse Prevention (CSAP)
• National Association of State Mental Health
  Program Directors (NASMHPD)
• Washington State Institute of Public Policy
• Blueprints for Violence Prevention

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MST Outcomes

• Research documents a reduction in the following
• Recidivism, association with negative peers,
  alcohol and drug use, out-of-home placement, and
  violent crime.
• Research documents an improvement in the
  following
• Family and peer relations, caregiver discipline
  practice, youth school and vocational performance.

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Outcomes FY 2003- FY 2007 Baltimore County MST

• MST resulted in fewer re-arrests (N191)
• 34 of youth were re-arrested 2.7 years
  following MST treatment.
• Source Schaeffer, Cindy M. (2007) Outcomes for
  Baltimore County Youth Strategies Program
  Evaluation
• Percent of youth living at home 81
• Percent of youth in school/working 76
• Percent of youth with no new arrests 77
• Source MST Institute Program Implementation Data
  Report 1/2002-10/2007

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Outcomes FY 04 FY 05Baltimore County MST

• Number of youth treated 77
• Number of youth who completed MST 51
• Percent of completers placed out-of-the home 29
  or 71 not placed
• Source Review of DJS archival records for youth
  who received MST

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Resources

• MST Services
• www.mstservices.com
• Blueprints for Violence Prevention
• www.colorado.edu/cspv/blueprints/index.html
• SAMHSA Model Programs
• http//modelprograms.samhsa.gov
• Social Programs that Work
• http//www.evidencebasedprograms.org/