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.

Considering MST for your area or agency?

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. is presented by The Center for Innovative Practices (CIP)
and the Child and Adolescent Behavioral Health Center of Excellence (CABH COE)
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: 216-368-6293 | email:
© 2022 Center for Innovative Practices, Cleveland, Ohio 44106