Multisystemic Therapy Frequently Asked Questions

What is Multisystemic Therapy (“MST”)?

MST is an intensive family- and community-based treatment program that addresses all environments that impact high risk youth - homes and families, schools and teachers, neighborhoods and friends. MST clinicians:

  • Travel to the youth and are on call 24/7

  • Work intensively to empower parents and caregivers

  • Work with caregivers to focus youth on school and gaining job skills

  • Introduce youth to recreational activities as an alternative to hanging out with anti-social peers

What is MST Services?

MST Services, licensed by the Medical University of South Carolina, is the organization responsible for disseminating Multisystemic Therapy with clinical fidelity. MST Services supports the implementation and ongoing fidelity of MST worldwide by charging standard fees for program development, intellectual property licensing, ongoing training, support and quality assurance.

How do I know if MST will work for my community?

MST is an evidence-based practice, meaning it is scientifically proven to work better than alternatives in experiments with real people. We feature the largest body of evidence, by far, of successful interventions for high risk youth. 

Learn More about MST’s Proven Results

What are adaptations of MST?

As MST became a recognized leader in treating chronic juvenile offenders, researchers adapted MST to treat additional clinical problems such as child abuse and neglect.  Adaptations are subject to rigorous scientific evaluation including pilot studies, efficacy/effectiveness trials, and transportability pilots.

How much does MST cost?

The cost to implement MST varies from region and provider as most of the cost relates to the salaries of dedicated MST staff. As a rule of thumb, we tell agencies to budget for having 4 to 6 Masters level clinicians including salary, benefits, and fringe. Other significant expenses include office, equipment, therapist drive time, flex funds for families, and administrative overhead for the agency. We at MST Services will work with providers during program development to complete a pro-forma budget specific to the provider agency. We also support the provider to work with stakeholders and funders to provide the necessary funding for sustainable delivery of MST.

How is success measured with MST?

Success is measured by the goals for each specific case tailored to the behaviors of the youth, and agreed upon by the young person, the family, and key participants. MST’s ultimate outcomes are to keep youth safely at home, in education or working, and out of trouble with the law. Treatment is not measured by the length of time a family has spent in MST.

What do we mean by program feasibility or program sustainability?

The ability of the provider organization to recover all program costs including profit margin.

How are treatment outcomes tracked? How does MST measure fidelity and quality adherence?

Throughout treatment, several clearly-defined adherence measures are tracked. The primary caretaker of the family reports how well the MST Therapist is adhering to MST’s treatment principles. In addition, the clinicians on the MST team report how well the Therapists, Supervisor(s), and Consultant(s) are adhering to the treatment model.

Model fidelity is critically important as research demonstrates that proper adherence and supervision results in a 64% reduction in incarceration.

MST providers use a state-of-the-art website ( to track case level outcome data. At the time of discharge, MST measures three ultimate outcomes for each youth receiving treatment: 1) is the youth at home? 2) is the youth in school or working? and 3) was the youth arrested during MST treatment?

How long, on average, does it take to develop an MST program?

It depends on several factors including the responsiveness of the provider agency and availability of funding. An expectation of 3 to 6 months for program development is reasonable.

If I am a funder, how can I determine the location for an MST program?

Location is best determined by geographic proximity to likely referrals. Questions to consider: Where are there currently the most instances of juvenile delinquency? Where is the highest population density? Where is there the biggest need in terms of service gaps for at-risk juveniles and/or youth displaying anti-social behaviors? MST Services can help identify a specific location, such as a behavioral health agency, or “home base” for the clinicians to operate out of. Although treatment is not done within this setting, it gives clinicians and other MST staff a place to coordinate as a team.


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