Multisystemic Therapy (MST)

Multisystemic Therapy (MST) is an intensive family and community-based treatment program addressing the multiple determinants of serious anti-social behaviors in juvenile offenders.

The approach views individuals as being nested within a complex network of interconnected systems that encompass individual, family and extra-familial factors such as peer groups, schools, the community, and the courts and other service systems. MST focuses on addressing all environmental systems that impact chronic and violent juvenile offenders and strives to promote behavior change in the youth’s natural environment – their home and family, school and teachers, neighborhood and friends.

MST works with youth ages 12 through 17 who have a history of arrests and/ or other externalizing behaviors. The major goal of MST is to empower parents by equipping them with the skills and resources needed to independently address the difficulties that arise in raising teenagers.

Within a context of support and skill building, the therapist places developmentally appropriate demands on the adolescent and family for responsible behavior. Intervention strategies are integrated into a social ecological context and may include strategic family therapy, structural family therapy, behavioral parent training, contingency management and cognitive behavioral interventions.

MST recognizes that each system of care plays a critical role in a youth’s world and each system requires attention when effective change is needed to improve the quality of life for youth and their families.

Program Outcomes
An evidence-based practice, MST has proven successful in working with the most challenging youth and the circumstances surrounding them.

MST blends the best-practices of various clinical treatments, from cognitive behavioral therapy and behavior management training to family therapies. Evaluations of MST have demonstrated:

  • Reduced long-term rates of criminal offending in serious juvenile offenders
  • Reduced rates of out-of-home placements for serious juvenile offenders
  • Extensive improvements in family functioning
  • Decreased mental health problems for serious juvenile offenders
  • Favorable outcomes at cost savings in comparison with usual mental health and juvenile justice services

Many experts believe that evidence-based practices such as MST should be a standard for addressing the complex needs of juvenile offenders. MST consultants and trainers work with many provider agencies in helping effectively deliver MST services, setting up a network of partner organizations that are committed to the transport of the MST model with full integrity and fidelity.

Click here for a full list of MST sites in Ohio.


NEW STUDY HIGHLIGHTS THE BENEFITS OF MULTISYSTEMIC THERAPY (MST)
Proven results for families and communities
In today’s era of tight budgets and demands for high accountability, states feel the pressure to invest in programs that will give them the most bang for their buck. The best way to meet these demands is by investing in evidence-based programs (EBPs) where research demons. Multisystemic Therapy (MST) is the leading EBP in the field of juvenile justice. Whereas traditional approaches to treating delinquent youths— such as incarceration and out-of-home placements — are tremendously costly and ineffective, MST’s effectiveness has been proven time and again. MST has been proven effective over the course of decades, not months. Long term follow-up studies found that MST reduces rearrests by 54% over 14 years, violent felony arrests by 75% over 22 years and caregiver felony arrests by 94%. The treatment generates a net benefit of up to $200,000 per youth.

While MST’s track record is impressive, the challenge of implementing a new evidence-based practice can be intimidating. To help states overcome that challenge, and better visualize how they can start successful MST programs in their communities, MST Services has compiled this State Success Guide. The guide outlines how five states implemented MST, and what lessons they learned. Read Full Report


Additional Resources:

MST Services
MST Services provides a wealth of information including results, helpful infographics, videos, and more.

National Registry of Evidence-based Programs and Practices (NREPP)
Multisystemic Therapy (MST) for Juvenile Offenders addresses the multidimensional nature of behavior problems in troubled youth. Treatment focuses on those factors in each youth’s social network that are contributing to his or her antisocial behavior. The primary goals of MST programs are to decrease rates of antisocial behavior and other clinical problems, improve functioning (e.g., family relations, school performance), and achieve these outcomes at a cost savings by reducing the use of out-of-home placements such as incarceration, residential treatment, and hospitalization. The ultimate goal of MST is to empower families to build a healthier environment through the mobilization of existing child, family, and community resources. See the National Registry of Evidence-Based Programs and Practices for more information.

Behavioral Health Juvenile Justice
The Behavioral Health Juvenile Justice (BHJJ) initiative, a shared effort of the Ohio Department of Mental Health and Addiction Services (OhioMHAS) and the Ohio Department of Youth Services (DYS), was created to enhance local options for providing services to juvenile offenders with serious behavioral healthcare needs. Pilot projects that started in a few Ohio counties in early 2000 have grown into a statewide initiative with strong support from additional state and local stakeholders. The projects are designed to transform child-serving systems by enhancing their assessment, evaluation, and treatment of multi-need, multi-system youth and their families.In addition, they provide the Juvenile Court judges an alternative to incarceration. Pilot projects that started in a few Ohio counties in early 2000 have grown into a statewide initiative with strong support from additional state and local stakeholders. The projects are designed to transform child-serving systems by enhancing their assessment, evaluation, and treatment of multi-need, multi-system youth and their families.In addition, they provide the Juvenile Court judges an alternative to incarceration.

Considering MST for your area or agency?

Contact
CIP MST Experts

Maureen Kishna, MSSA, LISW-S
MST Expert and Developer, Center for Innovative Practices
Maureen Kishna
(216) 368-5883
(216) 870-0192

Pamela Mitterling, M.A.Ed., RN, LPCC-S, LICDC-CS, LSW
MST Expert, Center for Innovative Practices
Pamela Mitterling
(419) 929-6410

Works on MST for Dissemination

To read, “Combating Racial Disparity in the Juvenile Justice System with MST” by Maureen Kishna, Click here.

To read, “Ohio’s Successful Youth Incarceration Alternatives Program” by Patrick Kanary, Founding Director of the CIP and MST Model Implementation Pioneer, Click here.



HEALTHY KIDS LEARNING COMMUNITY WEBINARS | 2018-19

One of the immediate missions of the Healthy Kids Learning Community initiative has been to create an accessible, continuing resource for clinicians and caregivers dealing with the surmounting crises and dimensions that has occurred during the Ohio opiate epidemic over the past half decade.

In keeping with this mission, the Center for Innovative Practices, in collaboration with WraparoundOhio.org and the Healthy Kids Learning Community initiative, partnered with some of Ohio’s foremost experts in their respective fields to lend their perspectives via their areas of expertise in a community share for the Buckeye State’s youth, families, clinicians, and various stakeholders dealing with the challenges and recovery of those youth and families.

Below is the five-session series, exploring the various facets of the crisis, notably including various ways to help service provider staff avoid burnout and turnover.


The Opioid Crisis and the Impact on Families and Children Part 1
Presented by Angela LaRiviere, Director of Youth Move Ohio and Timothy Schaffner, M.Ed., LSWTrustee
Executive Director, Trumbull County Children Services

The Center for Innovative Practices (CIP), in partnership with the Ohio Department of Mental Health and Addiction Services, Ohio Family and Children First, and with the support of the Substance Abuse and Mental Health Administration (SAMHSA), presents a webinar on “The Opioid Crisis and the Impact on Families,” exploring the unique impact of parental opiate use on the development of the child and the resulting challenges. Visit Overview Page | View Webinar

Understanding Opioid Addiction
Presented by Michael Fox, LPCC-S, LCDC III
The Center for Innovative Practices (CIP), in partnership with the Ohio Department of Mental Health and Addiction Services, Ohio Family and Children First, and with the support of the Substance Abuse and Mental Health Administration (SAMHSA), presents a webinar on “Understanding Opioid Addiction and Pathways to Recovery,” providing an overview opiates, opioids, addiction, and some promising practices toward recovery and reduction of use. The webinar was presented by Michael Fox, LPCC-S, LCDC III, Consultant and Trainer: Center for Innovative Practices. Visit Overview Page| View Webinar


Trauma Informed Biographical Timeline
Presented by Sarah Buffie, CEO, Soul Bird Consulting
The Trauma Informed Biographical Timeline (TIBT) is a trauma informed assessment that helps to put a person’s current situation in context with their life experiences.  It is a way to help see the whole person, not just the case files.  This 37 minute webinar introduce you to the TIBT concepts and provide a brief preview of what to expect at Sarah’s full day training. Visit Overview Page | View Webinar


Urban Zen: Avoiding Burnout in High Stress Work Environments
Presented by Marcia Miller, E-RYT 500
Marcia Miller has been teaching yoga for over 40 years and has taught all levels and types of students from new beginners to yoga teachers and everyone in between. In 2001 Marcia was one of the founders/owners of Yoga on High. She is one of a few Master Teacher Trainers for the Urban Zen Integrative Therapy (UZIT) Trainings and in charge of Reiki training for UZIT. She is on a community advisory board for the Center for Integrative Health and Wellness at the Ohio State University and offers UZIT modalities in Wexner Medical Center at the Ohio State University. Visit Overview PageView Webinar


The Opioid Crisis and the Impact on Families and Children Part 2
As was covered in Part 1, Ohio, being at the forefront of the opiate crisis, children and families have been impacted by this epidemic at rates unparalleled in modern times. Beyond the immediate impact on children’s well-being, the effects may be more long lasting as abrupt changes in parental attunement can impact patterns of attachment. Also notable, routine interventions may be inadequate to address children and family needs. – The objectives in Part 2 include: Completing the overview of Part 1 on the impact on individual children; providing updates on the current opiate crisis impact on youth, families and child welfare in Ohio; and an overview of interventions on multiple levels including system of care, agencies, programs, individuals and communities. Visit Overview Page | View Webinar


Innovative Conversation | A State of Ohio Perspective on the Family First Prevention Services Act (FFSPA)
Guests Crystal Ward Allen, MSW, LSW, Senior Director and Strategic Consulting with Casey Family Programs, Carla Carpenter, Deputy Director of the Office of Families and Children (OFC) at the Ohio Department of Job and Family Services, and Angela Sausser, Executive Director at the Public Children Services Association of Ohio, speaks with former CIP Director and Innovative Conversations host, Patrick Kanary presenting an Ohio overview discussing the Family First Prevention Services Act (FFSPA) and its impact on the state and its communities. It is the second installment of a two-part discussion, the first of which will explored Family First from a national perspective with national expert dealing with youth and families at risk, Sheila Pires, which you can listen to and experience below.  To learn more, click here.

View and Download PDF of FFPSA in Ohio Overview

Listen to Session


New Webinar | A National Perspective on the Family First Prevention Services Act (FFPSA)
An Innovative Conversations Webinar with Sheila Pires
Guest Sheila Pires, Managing Partner, Human Service Collaborative​ Core Partner, National TA Network for Children’s Behavioral Health​, speaks with former CIP Director and Innovative Conversations host, Patrick Kanary present a national perspective discussing the Family First Prevention Services Act (FFSPA). It is the first installment of a two-part discussion, the second of which will explore Family First from a state-wide perspective with specialists from Ohio. This session involves the Family First Prevention Services Act (FFPSA) and what it means to states funding in-home treatment and recovery for at-risk you dealing with the challenges of mental health, substance use, trauma, and judicial justice issues.

View Video of Webinar Session | Learn More about FFPSA


WraparoundOhio.org is presented by
The Center for Innovative Practices | Part of the Begun Center for Violence Prevention
at Case Western Reserve University’s Mandel School of Applied Social Services
Campus Location: 11235 Bellflower Road Room 375  | Cleveland, OH 44106
Mailing Address: 10900 Euclid Avenue | Cleveland, OH 44106-7164
Telephone: 216-368-5235 | email: pxm6@case.edu
© 2019 Center for Innovative Practices, Cleveland, Ohio 44106


Calendar of Events & Trainings


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Wed 08
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CANS | CANS Office Hours

February 9 @ 9:00 am - 10:00 am
Fri 10

MRSS | MRSS Core and Crisis Stabilization Training

February 10 @ 9:00 am - 4:00 pm