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From Crisis Point to Turning Point

The Rees Centre, 4th September 2019


A new report from the Rees Centre, University of Oxford, highlights the impact of Multi Systemic Therapy (MST) in helping to keep young people out of care in Essex. The evaluation looks at quantitative data collected by Essex County Council for 302 young people who received MST.

The MST service was delivered via a £3.1M Social Impact Bond over five years to 380 adolescents at the edge of care in Essex. Social services referred young people aged 11 to 16 at risk of entering the care system to the service, who display anti-social, offending behaviour or other conduct disorders. The therapy is delivered over a period of 3-5 months to young people and their parents by specially qualified therapists, who each work with around ten families a year providing 24/7 support. The MST service was provided by Action for Children, a national children’s charity.

The independent evaluation shows that MST had a positive effect with 91% of the cohort of 302 young people having social care provision in the two years prior to MST, and only 55% of young people having provision in the year after MST. The evaluation was commissioned by Essex County Council and the programme manager - Children’s Support Services Limited (CSSL).

The Essex Social Impact Bond (SIB) successfully completed in March 2019. Essex County Council was the first local authority in the UK to commission a SIB using a therapeutic programme to improve outcomes for young people and their families on the edge of care. Social Finance was instrumental in the development and programme management of the Essex SIB, supporting CSSL and Essex County Council to achieve the planned outcomes, and overseeing the contract with Action for Children.

Jonathan Flory, Director at Social Finance, said: “CSSL as a programme manager was very keen to ensure an independent evaluation of the multisystemic therapy service that we supported for over five years in Essex. We are pleased to see this report published which testifies to the positive impact the service has had on the lives of young people and their families, and for the learning from this important project to be shared.”

The evaluation report is based on nine interviews with parents and carers, one focus group with social care managers and senior practitioners, and the analysis of quantitative data collected by Essex County Council for 302 young people who received MST. The evaluation principally focused on the question of ‘What has been the impact of MST on families and young people?’ and sought to explore outcomes for the young people following completion of MST.

Lisa Holmes, Director at Rees Centre, said: “We hope that the findings from this small-scale evaluation will helpfully add to the MST evidence base, in particular helping to understand subsequent interactions of children and families to children’s social care following MST”.

The evaluation demonstrated that the MST service has had a profound and positive impact on the families interviewed. The therapeutic alliance between the family and the MST therapist was critical in influencing parental change, changes in the young person and in the whole family dynamic. MST service was positively regarded by the social care managers and practitioners. The quantitative analysis demonstrated a significant reduction in child in need plans, child protection plans, and care entries following MST.

One family interviewed commented: “Where we were a year ago to where we are now…. we are in such a better place… Yes, so looking back, it’s improved our life no end.”

The report also makes recommendations for the future for MST delivery and provision. Some families would have benefited from earlier referral with implications for ‘optimal timing’ on the referral pathway. There were also strong indications that some young people had underlying mental health conditions and would have benefited from continuing help with these problems.

For further information please contact antoinette.ale@socialfinance.org.uk or huw.thomas@socialfinance.org.uk.