Multi Systemic TherapyOverview

Breaking the cycle of problematic behaviourby keeping young people at home, in school and out of

trouble

Overview

What is MST?

How does MST work in practice?

MST Newcastle

What is MST?

Community-based, intensive, family driven approach for young people who are at risk of custody or being placed into Local Authority Care due to their OWN behaviour.

The MST ‘client’ is the entire ecology of the young person: family, peers, school, local community.

Focus is on empowering the caregivers to solve current and future problems.

Ultimate MST Outcomes

To keep families together when the young person is at risk of entering care or custody.

For the young person to be engaged in education / training.

For there to be a reduction in antisocial behaviour and charges brought against the young person.

Instrumental Outcomes

Improved parenting skillsImproved family relationsImproved access to supportsSuccess in education and trainingImproved involvement with pro social

peers and activitiesChanges sustained for 3-4 weeks

Theoretical underpinnings

Social Ecological approachYoung people live in a social ecology of

interconnected systems.Behaviour is influenced across a number

of different systems.In order to change behaviour we need to

target factors at an individual, family, school, peer and community level.

Social Ecological Model

MST theory of change

Research led models of intervention

We bring together some intensively researched and evidence based interventions to enable families to build on their strengths and resources to make changes:

Structural Family TherapyStrategic Family TherapyBehavioural Parent TrainingCognitive Behavioural Therapy

Evidence Base

Strong research base showing that MST is effective

Evidence shows that MST is successful as it;Targets the known causes of problematic

behaviours; family and peer relations, school and community factors

Is family driven and takes place at homeProviders are accountable for outcomesContinuous quality improvement occurs at all

levels

How Does MST work in Practice?

How does it work in practice?

Single worker working intensively with 4 to 6 families at a time.

Negotiate outcomes with the family and key participants.Work is done in the home, school and local community.24 hour / 7 days a week team availability: ‘on call’

system.Typical intervention lasts 3-5 months.MST worker will take the lead on delivering interventions

to address referral behaviours. What does this mean in practice?

MST workers work primarily with parents to help them:

Increase their parenting skillsImprove family relationsInvolve the young person with more pro

social peers and activitiesImprove school attendanceCreate family support networks

Core elements of MST

MST treatment principles

MST analytical process

MST quality assurance system

MST Principles

1. Find the fit

2. Positive and strength focussed

3. Increased responsibility

4. Present focussed, action oriented, well defined

5. Targeting sequences

6. Developmentally appropriate

7. Continuous effort

8. Evaluation and accountability

9. Generalisation

Finding the Fit;Sample Fit circle

YP is struggling academically

Lack of consequences at home

Poor home school link

YP does not like school

Ineffective school consequences

Peers reinforce behaviours

Verbal aggression at school

MST Newcastle

Why Newcastle?

Newcastle has a high number of young people being placed in Local Authority Care for short periods of time, suggesting that they may not need to enter care at all if an appropriate family intervention can be provided.

Research has shown MST to:Reduce re-arrest rates by up to 70%Reduce out-of-home placements by up to 64%

Referral Criteria

Young Person must be aged between 12 and 17 years (or 11yrs if in year 7)

AND The young person must be at risk of

entering care or custody due to THEIR OWN problematic behaviour, such as offending and substance misuse.

Exclusionary criteria

Young people living independently or already in care or custody or for whom a caregiver can’t be located.

Young people who mainly present with a serious mental health problem or developmental disorder, e.g. Autism.

Young people who mainly present with concerns around suicide, homicide or psychotic behaviour.

When the concern is mainly around the behaviour of the parent rather than the young person.

Typical referral behaviours

Verbal and physical aggression at home/ school/ community

Low/ no school attendanceOffending behaviourDrug and alcohol useAssociation with anti-social peersMissing behavioursPoor family relations

Newcastle to date

Started taking referrals in May 2012Worked with 39 families so farClosed 32 families 27 cases closed due to successfully addressing

referral behaviours, 2 cases discharged due to Team’s inability to

sustain engagement2 YP accommodated, 1 YP moved out of area

Ultimate Outcomes: May 2012 to May 2013 for 32 Closed CasesPercentage of YP living at home = 90.9% (30

out of 32 YP)

Percentage of YP in school or working = 81.8% (26 out of 32 YP)

Percentage of YP with no new charges during MST = 66.7% (21 out of 32 YP)

Instrumental Outcomes: May 2012 to May 2013 for 32 Closed CasesPercentage of families with parenting skills necessary to

handle future problems = 78.8% (25 out of 32 families)

Percentage of families with improved family relations = 78.8% (25 out of 32 families)

Percentage of families with improved network of supports = 66.7% (21 out of 32 families)

Percentage of YP with success in education or training = 78.8% (25 out of 32 families)

Instrumental Outcomes: May 2012 to May 2013 for 32 Closed CasesPercentage of YP involved with pro social

peers/activities = 48.5 (15 out of 32 young people)

Percentage of cases where positive change has been sustained = 78.8% (25 out of 32 families)

All Outcomes are based on families self reporting and worker assessment

Some feedback on MST Newcastle From Families

How is MST different?;The intense 3 days a

week contact and phone contact the whole time

I would like to say thank you to MST, especially my worker. She has made my relationship with my son

better

Very determined to help the

family as much as they could. Very friendly

I am very grateful to

have received

the service

Our worker never gave up on our

moods and she had ideas about resolving

each problem

The call service is great as I

really needed this

Newcastle’s MST Team

Supervisor: Sarah RitsonAbby Waites (Maternity Leave)

MST Team:Ashley RobsonPhilip Sammut- SmithWarren PetitjeanNew Worker hired but not yet in post

For more information…

Visit www.mstservices.com

Email: mstadmin@newcastle.gov.ukTelephone: 0191 2782762

Cookery Block - Heaton ComplexTrewhitt Road, HeatonNE6 5DY

Any Questions?