Multisystemic Therapy (MST) London Tri-borough

Age: 10-17
Sex: n/a
Cost: none

 

 

Aims:

  • To prevent the placement of young people into care or custody by working to address the drivers of behaviours and by working in a systemic way with young people and their families.
  • To reduce reoffending by improving young people’s functioning at home, in school and in the community.
  • To offer families an intensive home-based intervention, that is available for a time-limited period of up to five months to work on specific goals (e.g. reducing aggression in the home; not using cannabis).

 

 

Description:

The programme works with young people and families who have typically not engaged well with other services in the past. Not all of the young people we work with have committed offences, but are displaying some form of conduct difficulties, anti-social behaviour and problems in the home and at school. Sometimes their parents have mental health difficulties or struggle to communicate with other professionals in a meaningful way. Multisystemic Therapy (MST) attempts to engage families not just with our service, but to help them make better use of other services such as the Youth Offending Service (YOS). We carry out joint home visits with YOS Practitioners and work closely together.

 

MST’s accountability for engagement means that the entire team takes responsibility for finding different ways to engage young people and their families. Using a strength-based approach, the allocated therapist, with weekly supervision and support of their team members will generate ideas about how to try and meet with and engage families.

The service offers support out of hours 24 hours a day, across 7 days of the week every day of the year so that families can reach a team member who knows their family and has working knowledge of the most up to date intervention plans. This prevents families from having to ‘retell their story’ to out of hours services and provides a continuity in treatment outside of usual working hours, when problems are most likely to occur. Therapists visit families in their homes or in the community setting at least three times per week; this is needed because chronic difficulties require a high intensity intervention.

 

The percentage of young people completing MST with no new offences has varied between 74%-85%. See below for outcomes of the previous three years of the programme:

 

Team Performance Over Time Year 1
1/1/2013 -
31/12/2013
Year 2
1/1/2014 -
31/12/2014
Year 3
1/1/2015 -
31/12/2015
Percent of Youth Living at Home (Target: 90%) 76.92 % 79.17 % 83.87 %
Percent of Youth in School/Working (Target: 90%) 53.85 % 83.33 % 67.74 %
Percent of Youth With No New Arrests (Target: 90%) 84.62 % 75.00 % 74.19 %

 

 MST is an evidenced based model. This means that has been shown to work and only uses intervention techniques that are proven to address the problematic behaviour being targeted. It is not a manualised programme which means that the interventions can be individually tailored to suit the literacy levels, cultural background and systemic needs of the child and family. The attached case study shows how the treatment model was applied to work with a family with poor literacy and historical low engagement with services. The interview between the MST Therapist and YOS Manager outlines our creative way of engaging the different systems that a young person may be involved with.

 

 

Implementing the Practice:

  • MST can form part of a statutory parenting order or be included in part of a young person’s community sentence. However, most families engage voluntarily.
  • MST has been used to develop a parent collaborative.
  • MST has been used to engage young people that professionals have previously deemed high risk.
  • In Hammersmith and Fulham Youth Offending Service Casemanagers/Managers will identify cases that may be suitable for MST via supervision, reflective team meeting or a weekly meeting whereby there is case discussion or discussion around proposals for PSR/Breach and a referral may be considered at that stage.

 

 

Contact:

Source Organisation: London Tri-borough Multisystemic Therapy Service
Name: Dr Jai Shree Adhyaru
Email: Jai.adhyaru@nhs.net  
YOT: Hammersmith and Fulham Youth Offending Service
Name: Alison Sabaroche
Email: Alison.sabaroche@lbhf.gov.uk
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