MST interventions typically aim to:

• improve caregiver discipline practices,
• enhance family affective relations,
• decrease youth association with deviant peers,
• increase youth association with pro-social peers,
• improve youth school or vocational performance,
• engage youth in pro-social recreational outlets, and
• develop an indigenous support network of extended family, neighbors, and friends to help caregivers achieve and maintain such changes. 

The program uses a strength-based model that recognizes the positive existing elements of a family’s life, and combines these strengths with the areas for change. MST services are delivered in the natural environment (e.g., home, school, community).  The treatment plan is designed in collaboration with youth and family members and is, therefore, family driven rather than therapist driven.  The ultimate goal of MST is to build on youth and family strengths and empower families to build an environment, through the mobilization of indigenous child, family, and community resources that promotes health.

Youth and families participate in setting specific goals and in evaluating the attainment of those goals and, thus, the success of the program.  At the outset, we will meet with each family unit and work with them to prepare a statement of expectation of services and an outline of specific desirable goals using family strengths as levers to make therapeutic changes.  The family signs this statement and we use this document throughout the service period as a check on progress.

Although MST is a family-based treatment model that has similarities with other family therapy approaches, several substantive differences are evident. 

MST places considerable attention on factors in the adolescent and family’s social networks that are linked with antisocial behavior.  Hence, for example, MST priorities include removing offenders from deviant peer groups, enhancing school or vocational performance, and developing an indigenous support network for the family to maintain therapeutic gains. 

MST programs have an extremely strong commitment to removing barriers to service access. 

MST services are more intensive than traditional family therapies (e.g., several hours of treatment per week vs. 50 minutes).  

Most importantly, MST has well-documented long-term outcomes with adolescents presenting serious antisocial behavior and their families.

MST-trained clinical therapists will visit families in their homes two to three times each week for a service period of three to five months.  Contact will average approximately 60 hours over a period of three to four months with the last 3 to 4 weeks showing a decreased rate of contact as therapeutic change and growing independence is monitored.  A bio-psycho-social assessment of the strengths and weaknesses of the individual, family, neighborhood/community, school and peers will be performed at the outset, with interventions being scientifically based, goal oriented and problem focused.  Overarching goals are carried throughout the life of the case, with weekly goal setting, modifications and treatment planning to be carried out in collaboration with the families.

The MST model specifies low caseloads of four to six families per clinical therapist, each of whom works together with the families to develop an enduring social support network in their own environment.  Services are tailored to take into account the context of the individual family’s existing value system, their beliefs and their cultures. 

Flexible schedules are set to accommodate family needs.  In addition to regular MST clinical therapist visits, on-call services are available 24/7, addressing crisis needs as well as monitoring daily progress.

A unique feature of MST is its emphasis on constructing present-oriented systems of therapy and building responsible behavior rather than treating pathologies.  Specific goals of the program include:

• the improvement of parenting practices with training provided on such issues as alternatives to corporal punishment,
• appropriate supervision of children,
• age-appropriate expectations, choices and consequences, and
• the importance of displaying affection and trust.

In addition to improved parenting skills, building an enduring social support network within the family, neighborhood and community is essential.  This includes moving children from association with deviant to pro-social peers, creating opportunities for positive recreational activities, teaching youth how to find positive recreational activities and, as appropriate, helping them find after-school work.

The clinical team is responsible for teaching the family organizational skills and removing barriers to service accessibility—educational, medical, neighborhood and community services—building hope and positive expectations while helping families develop networks that will remain in place and promote long-term maintenance of favorable changes.