- Celebrating Black History Month 2023 Natalie Wilmot, Office Manager and Training Coordinator, reflects on what Black History month means to her and the black...
- 10 years of MST in Leicester We congratulate Leicester City Council on ten years of MST practice! We were thrilled to be able to join them in their celebrations in...
- Croesco to North East Wales The first MST Family Integrated Transitions team (MST-FIT) in Wales! The team will deliver MST FIT across two local authorities, Wrexham...
UK & Ireland Research
Pattni, S, Fox, S & Glorney, E (2022), 'Therapist and supervisor experiences of the application of standard MST to young people with suspected or diagnosed Level 1 Autistic Spectrum Disorder', Journal of Family Therapy. https://doi.org/10.1111/1467-6427.12396
Multisystemic Therapy (MST) is an intervention offered to young people presenting with antisocial and aggressive behaviour and is currently being adapted for use with the autism spectrum disorder (ASD) population. This qualitative study aimed to provide the first consideration of the experiences of MST therapists and supervisors of delivering standard MST to young people with suspected or diagnosed Level 1 ASD. Semi-structured interviews were carried out with 11 MST therapists and supervisors with experience of working with the client group. Thematic analysis identified three major themes: (1) nuanced delivery of MST for Level 1 ASD, (2) need for knowledge and resources, and (3) positive experiences with delivering the intervention.
Findings suggested the need for an increased focus on understanding the individual needs of a young person in assessment and intervention, the increased importance of structure and consistency, and psychoeducation for all systems around the young person in order to meet the developmental needs of young people with Level 1 ASD.
Research has indicated that multisystemic therapy (MST) is an effective treatment for youth with antisocial behaviours. This qualitative study explored minority ethnic young peoples’ experiences of MST, focusing on their understanding of their presenting difficulties and aspects of the intervention which facilitated or hindered engagement and change. Seven semi-structured interviews were conducted with young people from London who had taken part in MST. A constructivist version of grounded theory analysis was employed. Specific cultural theoretical codes emerged; understanding the family culture and the practitioner acting as a cultural broker, consideration of acculturation differences within the family, exploring the young person’s cultural identity and reflecting on cultural differences in the therapeutic relationship. Findings suggest potential advances to MST practice to meet the needs of minority ethnic young people, including the importance of appropriate training and supervision, sensitively working with salient cultural issues such as the impact of acculturation, and consideration of the role of therapist ethnicity and culture.
Khan, N., Fox, S., & Glorney, E. (2020). Practitioner experiences of working with ethnic minority families using Multisystemic therapy (MST).
Existing research has focused on accounts of ethnic minority young people and caregivers using Multisystemic Therapy (MST), but research examining the perspectives of practitioners is lacking. Further, there has been little to advance understanding of ethnic minority groups that do not engage or complete treatment, or do not speak English. This study aimed to utilise the clinical experience of MST therapists and supervisors in order to better understand the issues facing ethnic minority families using MST, particularly those who are ‘harder to reach’. A qualitative design using a constructivist version of grounded theory was used. A purposive, theoretical sampling strategy led to a total of 22 participants. Data was collected from seven focus groups and one interview across three geographical regions of the United Kingdom (UK). Ten theoretical codes emerged in the current analysis, and were used to build a theoretical model to understand factors related to engagement and change for ethnic minority families. These included: access; the family’s relationship to help; building a therapeutic alliance; family structure and functioning; acculturation and identity; the disempowered family context; working as a cultural broker; empowering families; power and language within the family; and working with interpreters. The analysis highlighted a number of novel findings. Overarchingly, this study draws attention to the systemic factors associated with power, culture and language, influencing the family’s journey through MST.
Fonagy et al. (2020). Multisystemic therapy versus management as usual in the treatment of adolescent antisocial behaviour (START): 5-year follow-up of a pragmatic, randomised, controlled, superiority trial. The Lancet, 7 (5) 420-430
The control group (young people outside Court 55 for which the presiding Judge refused bail) experienced a reduction in reoffending of 37 per cent over an equivalent timeframe. As such, on average the young people enrolled on the BSS had a reduction in reoffending almost twice that of the control group. Combining findings from analysis of both Extern’s case records and interview data provides evidence that the young people who completed BSS with a planned exit10 showed marked improvement in adherence to bail conditions as the intervention progressed. Indeed, the majority of young people who completed the intervention demonstrated full adherence to bail conditions on exit. In addition, of the 13 young people who completed a full course of MST intervention, 11 attracted a non-custodial disposal at the sentencing hearing,11 thereby avoiding detention.
Pattni, S., Fox, S., & Glorney, E. (submitted). Therapists’ experiences of delivering MST to young people with ASD. Journal Family Therapy.
Multisystemic Therapy (MST) is an intervention offered to young people presenting with conduct problems and is currently being adapted for use with the ASD population. This qualitative study aimed to provide the first consideration to MST therapists’ experiences of delivering the non-adapted MST to young people with a mild Autism Spectrum Disorder (ASD), with a focus on the strengths and challenges associated with the model. Semi-structured interviews were carried out with 11 MST therapists. Thematic analysis identified three major themes: (1) Nuanced delivery of MST for ASD; (2) Need for knowledge and resources; and (3) Therapists had positive experiences when delivering MST to an ASD population. Findings were discussed in light of the current application of MST. Findings suggested the need for an increased focus on understanding the individual needs of the young person in assessment and intervention, the increased importance of structure and consistency, and psychoeducation for all systems around the young person in order to meet the developmental needs of the young people with ASD. Limitations and directions for future research were discussed.
European Multisystemic Therapy (MST®) Research Summary 2020 This document provides a summary of the many areas of MST research and proven outcomes conducted in Europe with traditional MST and MST clinical adaptations as well as research on the transport of MST to community practice settings.
Research on the application of multisystemic therapy (MST) has focused on the experiences of caregivers, families and the young people with behavioural conduct difficulties for whom MST has been established as an effective intervention. Perspectives of MST therapists are lacking, yet hold relevance for MST model adherence and services. Using a social constructivist grounded theory approach, eight MST therapists in the United Kingdom took part in a semi‐structured interview designed to explore the requirements of the role. Data revealed four categories: two of explicit roles that included establishing rapport, engaging with families, defining the drivers to a young person’s behaviour, and doing ‘whatever it takes’ to overcome challenges; while underpinning these were two categories of implicit roles related to coping with the organisational environment and interpersonal skill demands of the role. This study widens the understanding of both individual and organisational factors/climate and its impact on therapist performance in MST practice.
- young people showed significant reductions in offending compared to usual services;
- MST resulted in significant improvements in family relationships;
- MST was more cost effectiveness than usual services.
- 98% of children remain at home;
- 97% are in school or working;
Bauch J, Hefti S, Oeltjen L, Pérez T, Cupit Swenson C, Fürstenau U, Rhiner B, Schmid M, Multisystemic therapy for child abuse and neglect: Parental stress and parental mental health as predictors of change in child neglect, Child Abuse & Neglect, Volume 126, 2022, 105489, ISSN 0145-2134. The following intervention study investigated whether changes in parental mental health and parental stress after MST-CAN are related to changes in child neglect. The findings suggest that parental stress might be a promising target for evidence-based interventions to reduce the occurance of child neglect.
The full study and findings can be accessed HERE.
- identify the issues in implementing MST-FIT;
- determine whether it is a feasible intervention;
- identify other groups for whom it may be suitable.