Multisystemic Therapy (MST)

Placement on the Continuum of Evidence Effective-RCT Download icon Download PDF
Target Population: 
Adolescents, Families
Academic Performance, Antisocial Behavior, Behavioral Problems, Parenting, Relationships
Target Audience 

This program is for adolescents who are 12 to 17 years old and who are juvenile offenders or are engaging in serious disruptive, harmful, or delinquent behaviors and their families.


Multisystemic Therapy (MST), a comprehensive, community-based program, is designed to help reduce adolescent problematic, antisocial, and offending behaviors by focusing on multiple risk factors (e.g., deviant peers, family conflict, skipping school) and protective factors (e.g., pro-social peer relations, skillful parenting, school involvement) that exist within the youth's everyday environment.  


Multiple internal and external randomized controlled trials (RCT) evaluating the effectiveness of MST have been conducted.  Collectively, these studies have documented that, compared to control group youth, MST youth were less likely to be re-arrested, incarcerated, or placed on probation.  In addition, improvements have been noted in other targeted outcomes such as adolescent externalizing behaviors, family functioning and relations, and parenting behaviors.   In general, these findings, especially those related to criminal activity, persist long term, and one study indicates program effects on arrests and incarceration lasted as long as 21 years post recruitment.


MST involves a treatment team that consists of two to four master's degree level, trained therapists and a supervisor.  Therapists administer comprehensive, personalized, and evidence-informed or evidence-based interventions, such as behavioral, cognitive behavioral, and family therapies, to adolescents and their families in their home, school, or community settings.  The family is involved in the development of the intervention they receive.  Though MST interventions are individualized, they are based on the following nine principles:

  • Finding the fit - Determine how an adolescent's achievements and problem behaviors are aligned with his or her environment;
  • Focusing on positives and strengths - Promote behavior change in the youth by using the youth's and family's beneficial characteristics;
  • Increasing responsibility - Encourage the family to engage in mature behaviors and avoid immature conduct;
  • Present focused, action-oriented, and well-defined behaviors - Examine current, as opposed to past, and specific issues facing the adolescent and his or her family so that clear goals and action steps can be identified and measured;
  • Targeting sequences - Centers on behavioral patterns, exhibited across multiple domains of the adolescent's environment, that contribute to and reinforce problem behaviors;  
  • Developmentally appropriate - Ensure interventions are suitable for the youth's age, capabilities, and needs, especially with respect to peer relations, academics, and career competencies;
  • Continuous effort - Confirm that the adolescent and his or her family are consistently practicing newly learned behaviors;
  • Evaluation and accountability - Monitor participant progress and place the onus of positive behavior change on the MST team not the family; and
  • Generalization - Empower the adolescent's caregivers to maintain positive changes so the family can continue to flourish after the intervention is complete.
Previous Use 

MST has been implemented in 38 states and 14 countries.  Currently, MST is being administered in 34 states, the District of Columbia, Australia, Belgium, Canada, Chile, Denmark, England, Iceland, the Netherlands, New Zealand, Northern Ireland, Norway, Scotland, Sweden, and Switzerland.  It reaches nearly 23,000 adolescents and their families every year.


A 5-day, off-site orientation training is required.  The cost for this training is $850 per participant plus travel expenses.  In order to register for this training, individuals must be a member of a licensed MST organization.  If an interested organization is training multiple teams at once, MST services may be able to conduct the training on site.  For more information, please visit or contact Melanie Duncan using the information in the Contact section below.


Considerations for implementing MST include obtaining funding for program costs, developing and maintaining a qualified treatment team, understanding this comprehensive treatment requires small caseloads and frequent interaction with youth and their families, and gaining participant buy-in and commitment.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email


If you are interested in implementing MST, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email


Intervention length varies depending on need, but usually treatment is provided for 3 to 5 months.  At the start of treatment, therapists meet with families multiple times a week; the frequency of visits is reduced over time as improvements are made.  During treatment, therapists are available for continuous support (i.e., 24 hours a day/7days a week).


Program start-up costs, which include program materials and a site visit, are $2,000 plus travel expenses.  Annual program support and service costs range from $19,000 to $29,000 per site plus travel expenses.  Annual license fees, which include the use of web-based services, are $4,000 per organization and $2,500 per treatment team.

Evaluation Plan 

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email


Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email:

You may also contact Melanie Duncan, Ph.D., by phone 1-843-856-8226, email, or visit

*Resources and associated costs reflect those identified at the time of fact sheet publication.