Multisystemic Therapy (MST) was developed in the late 1970s to address several limitations of existing mental health services for serious child and adolescent disruptive behavior problems, delinquency, and substance abuse. For example, given that serious antisocial behavior is determined by the interplay of individual, family, peer, school, and neighborhood factors, traditional treatment efforts-which are often individually-oriented and narrowly focused-are generally limited in their ability to address the complexity of youth needs. MST recognizes that in order to best deal with a youth in trouble, treatment must target the many "systems" that impact the youth, including the family, school environment, friendships, and peer pressures.
MST is intensive, family-focused therapy. A therapist, who is part of a team of MST clinicians, works closely with the parents and child for three to five months in their home and community. Depending on the situation, the therapist meets frequently with the family, often two, three or more times a week at the start of the intervention, and is available to the family around the clock.
MST is goal-oriented and focuses on helping the caregivers manage and nurture their challenging children more effectively. For instance, if a young person is getting into trouble because he or she stays out late, the therapist helps the parents develop a plan to limit how late the child is allowed out. Then, the therapist works closely with the parents to make sure the curfew is successfully implemented. If for any reason the plan fails, they figure out what went wrong and develop a new strategy. Eventually, caregivers will learn the skills to independently address the difficulties that arise in raising a teenager, both during the treatment and long after the therapist is involved with the family.