Multisystemic Therapy

Multisystemic therapy is a way to improve well-being by addressing interactional and systemic factors that increase the risk for delinquency across multiple levels of influence (e.g., family, school, peers, and community). The goal of MST is to reduce the frequency, intensity, and duration of delinquent behavior.

What is Multisystemic Therapy?

Multisystemic Therapy (MST) is an evidence-based therapy strategy used to address behavioural and emotional difficulties in adolescents. It is a family and community-based intervention that focuses on empowering families and utilising available resources to make good changes in the lives of young people. MST is based on the premise that a young person's behaviour is influenced by a variety of systems, including his or her family, school, peer groups, and community. MST strives to eliminate harmful behaviour and enhance healthy development by addressing these systems and their interactions.

Principles of Multisystemic Therapy

Multisystemic Therapy (MST) is based on the following principles −

  • Systemic Perspective − MST recognises that several systems, such as the home, school, peers, and community, influence a young person's behaviour. It adopts a comprehensive approach, taking into account the interplay and impact of various systems on the individual.

  • Focus on Natural Settings − MST takes place in the young person's natural environment, which includes their home, school, and community. In these situations, therapists engage directly with the family and other relevant individuals to address the circumstances contributing to the youth's difficulties.

  • Targeting Multiple Domains − MST tackles problems in multiple aspects of a young person's life, including family dynamics, peer interactions, school functioning, and community involvement. Interventions are adapted to each area in order to achieve complete and lasting change.

  • Individualised Care − MST understands that every family and young child is unique. Therapists undertake detailed assessments to understand the family's unique issues and strengths, and therapy plans are tailored accordingly.

  • Collaboration and Empowerment − MST requires collaboration among the therapist, the family, and other stakeholders. Therapists collaborate with families as partners, recognising their knowledge and involving them in decision-making. The goal is to encourage families to take an active role in addressing their problems and promoting good change.

  • Natural Supports Development − MST emphasises the development and use of natural supports in the young person's environment. Identifying and mobilising existing resources, such as extended family, neighbours, teachers, and community organisations, to provide continuing support and reinforcement is part of this process.

  • Continual Assessment and Adaptation − MST uses continuous assessment and adaptation to evaluate the progress and efficacy of interventions. Therapists obtain feedback from the family on a regular basis and change the treatment plan accordingly. This allows for flexibility and ensures that interventions are responsive to the young person's and their family's evolving requirements.

  • Evidence-founded Practises − MST is founded on empirical research and employs evidence-based practices. To deliver effective and validated interventions, it blends ideas from several therapeutic modalities such as cognitive-behavioural therapy, family therapy, and behaviour modification.

These concepts govern MST practice and contribute to its success in addressing youth behavioural and emotional difficulties while encouraging positive growth and well-being.

Components of Multisystemic Therapy

Multisystemic Therapy (MST) is made up of several critical components that work together to meet the requirements of the young person and their family. These elements are as follows −

  • Assessment − MST starts with a detailed assessment process. Therapists collect data on a young person's behaviour, family dynamics, school functioning, peer interactions, and community influences. The assessment aids in identifying the unique difficulties, strengths, and resources of each system.

  • Therapeutic Interventions − MST employs a variety of evidence-based treatment strategies that are tailored to the unique requirements of the family and the young child. These methods incorporate cognitive-behavioural therapy, family counselling, behaviour modification, and skill-building approaches. Therapists collaborate directly with families and other key stakeholders to carry out these interventions.

  • Family Interventions − MST places a high value on working with the entire family. Therapists work with clients on family dynamics, communication habits, and problem-solving abilities. They assist families in developing effective conflict resolution skills, establishing appropriate boundaries, and improving overall family functioning.

  • School and Community Interventions − MST recognises the impact of the school and community surroundings on the behaviour of young people. Therapists collaborate with teachers, school personnel, and community resources to address school-related difficulties, give support, and improve young people's participation and achievement in various settings.

  • Evaluation and Feedback − MST incorporates ongoing evaluation and feedback to monitor progress and make necessary adjustments to the treatment plan. Therapists regularly collect data, seek input from the family, and use outcome measures to assess the effectiveness of the interventions and make informed decisions about treatment modifications.

These components of MST work together in a systemic and comprehensive manner to promote positive changes in the young person's behaviour, enhance family functioning, and improve overall outcomes.

Multiple-Family Group Therapy

This is a forerunner of psychoeducational family intervention, which emerged in part as a pragmatic alternative form of intervention - particularly as an adjunct to the treatment of severe mental disorders with a significant biological basis, such as schizophrenia - and posed a conceptual challenge to some of the "systemic" (and thus potentially "family-blaming") pathogenesis paradigms that were implicit in many of the dominant models of family therapy.

In the late 1960s and early 1970s, Ross Speck and Carolyn Attneave pioneered network therapy, behavioural marital therapy (renamed behavioural couples therapy in the 1990s) and behavioural family therapy emerged as models in their own right. By the late 1970s, the weight of clinical experience, particularly in treating major mental diseases, had led to some reconsideration of a number of the original models and a reduction of some of the earlier stridency and theoretical purism.

There were signs of a general softening of the tight demarcations between schools, with attempts towards reconciliation, integration, and eclecticism - yet some attitudes within specific schools were hardened. However, there was an increasing desire and proclivity among family therapists to collaborate in multi-modal treatment partnerships with other members of the helping and medical professions. From the mid-1980s to the present, the area has been characterised by various approaches that mirror the founding schools while drawing on other theories and practises from individual psychotherapy.

Brief therapy, structural therapy, constructivist approaches (e.g., Milan systems, post-Milan/collaborative/conversational, reflective), solution-focused therapy, narrative therapy, a variety of cognitive and behavioural approaches, psychodynamic and object relations approaches, attachment and Emotionally Focused Therapy, intergenerational approaches, network therapy, and multisystemic therapy (MST) are among these approaches and sources. Approaches that are multicultural, intercultural, and integrative are also being developed.

Goals of Multisystemic Therapy

MST's goals are to eliminate problem behaviours in youth and promote positive development within the context of their social systems. MST attempts to do the following −

  • Reduce Problem Behaviours − MST aims to reduce the young person's problem behaviours, such as delinquency, substance misuse, aggressiveness, truancy, and antisocial behaviour. The purpose is to assist young people in developing healthy coping mechanisms, improving impulse control, and making better decisions.

  • Improve Family Functioning − MST focuses on enhancing family dynamics, communication skills, and problem-solving abilities. The goal is to improve the family's ability to successfully assist and guide the young person, settle problems, and provide a supportive and stable home environment.

  • Improve Academic Achievement − MST attempts to improve students' school involvement, attendance, and academic achievement. Therapists collaborate closely with schools, instructors, and educational resources to overcome success hurdles and encourage pleasant school experiences.

  • Encourage Prosocial Involvement − MST encourages young people to participate in prosocial activities and community involvement. The purpose is to encourage positive behaviours, boost self-esteem, foster a sense of belonging, and create chances for adolescents to actively contribute to their community.


Through its systematic approach and evidence-based strategies, Multisystemic Therapy (MST) provides an effective and empowering way to address a young person's behavioural and emotional difficulties. It focuses on empowering families, mobilizing available resources, and promoting prosocial behaviour in order to make lasting positive changes in the life of the young person.a

Updated on: 07-Nov-2023


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