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A Coordinated Approach to Preventing Placement

By Lori Moore, Manager of U.K. Network Partnership, 1st May 2018

Police and professionals get called out to the home. Family members are about to give up...

Her family life was marked by violence. Family members felt so hopeless and unsafe, they constantly rang the police and other professionals for help. Professionals felt so hopeless as she and her family continued to pull on the limited resources of the community. More calls-outs came to the police from her home than any other. Everyone reached the conclusion the only solution was to place the girl in care. 

But not so fast

This young person was lucky. Her community has Multisystemic Therapy (MST), a proven evidence-based treatment program that helps keep young people like her safely at home, in school, while it restores the balance of how community resources are used.  

Before MST

Fifteen-year-old Charlotte* was violent in her home. Police were aware of her punching and kicking her siblings, pushing her mum to the floor repeatedly hitting her, and threatening her family members with knives. Once when Charlotte was in the family car being aggressive, she put her feet against the windscreen and it cracked.  She would even threaten to self-harm if anyone tried to put a limit in place. Charlotte also was missing school due to a poorly managed physical illness, which added stress to her family and community. 

At the time of her referral to MST, the police had been called out to her home so often, they felt like they were co-parenting Charlotte with her mum and stepfather. 

The situation appeared hopeless to everyone around her. 

With MST

MST was considered Charlotte and her family’s last hope to keep her in the home. When the referral came into the U.K. Network Partnership Barnsley-Rotherham team, they knew they had to act fast to help professionals and family members come together to address Charlotte’s concerning behaviours. 

Focused Interventions

The therapist, Denise, worked to develop a coordinated approach with professionals, ensuring that those involved with the family were effectively communicating with one another. A key to this was supporting professionals as they empowered Charlotte’s parents to be the ones to manage her behaviours. Professionals were coached on how to not diminish parental power. The therapist also worked to limit the number of people working in the home. When given the right tools, families can and will manage their own child.

For a successful treatment, the family had to find the needed tools. To that end, mum and stepdad limited Charlotte’s access to harmful items, worked to identify times when increased supervision and monitoring were needed for not only Charlotte, but also her siblings. The carers worked on setting clear expectations for all of their children and holding them each accountable for meeting these expectations. As clear rules, rewards and consequences increased, so did family warmth. Mum curtailed swearing when she was frustrated, and everyone in the family became better at managing their emotional responses toward one another. The family learned to recognize early warning signs of aggression. Cognitive-behavioural interventions were used to address the thoughts, feelings and actions that are powerful in these types of interactions. 

Charlotte also received consistent and appropriate medical care that helped her better deal with a physical illness. This led to an 80-percent increase in school attendance.

Family and police celebrate 

In measuring the success of MST, the Barnsley-Rotherham team looks for clear evidence of behavioural changes. In this case, Charlotte remained in the home, school attendance improved, and the use of community resources was streamlined to what was necessary to support the empowerment of this family.

Mum reported to the MST therapist “we had our best Christmas ever together.”

She said, “MST has been brilliant. MST helped me to love my kids better and got our family together.”

The police celebrated, too. There have been no police call-outs since September.

If you have young people like Charlotte in your community, if you have families who are feeling hopeless, if your resources are being strained, learn more about bringing Multisystemic Therapy into your community. Don’t delay—families and young people are counting on you.


The name and age were changed to protect confidentiality.