Multi-Systemic Therapy (MST)

MST is an intensive family and community-based treatment program addressing the multiple determinants of serious anti-social behaviors in juvenile offenders.

multi-systemic-therapyThe approach views individuals as being nested within a complex network of interconnected systems that encompass individual, family and extra-familial factors such as peer groups, schools, the community, and the courts and other service systems. MST focuses on addressing all environmental systems that impact chronic and violent juvenile offenders and strives to promote behavior change in the youth’s natural environment – their home and family, school and teachers, neighborhood and friends.

MST works with youth ages 12 through 17 who have a history of arrests and/ or other externalizing behaviors. The major goal of MST is to empower parents by equipping them with the skills and resources needed to independently address the difficulties that arise in raising teenagers.

Within a context of support and skill building, the therapist places developmentally appropriate demands on the adolescent and family for responsible behavior. Intervention strategies are integrated into a social ecological context and may include strategic family therapy, structural family therapy, behavioral parent training, contingency management and cognitive behavioral interventions.

MST recognizes that each system of care plays a critical role in a youth’s world and each system requires attention when effective change is needed to improve the quality of life for youth and their families.

Program Outcomes

An evidence-based practice, MST has proven successful in working with the most challenging youth and the circumstances surrounding them.

MST blends the best-practices of various clinical treatments, from cognitive behavioral therapy and behavior management training to family therapies. Evaluations of MST have demonstrated:

  • Reduced long-term rates of criminal offending in serious juvenile offenders
  • Reduced rates of out-of-home placements for serious juvenile offenders
  • Extensive improvements in family functioning
  • Decreased mental health problems for serious juvenile offenders
  • Favorable outcomes at cost savings in comparison with usual mental health and juvenile justice services

Many experts believe that evidence-based practices such as MST should be a standard for addressing the complex needs of juvenile offenders. MST consultants and trainers work with many provider agencies in helping effectively deliver MST services, setting up a network of partner organizations that are committed to the transport of the MST model with full integrity and fidelity.

Click here for a full list of MST sites.

Additional Resources:

Multisystemic Therapy (MST) for Juvenile Offenders addresses the multidimensional nature of behavior problems in troubled youth. Treatment focuses on those factors in each youth’s social network that are contributing to his or her antisocial behavior. The primary goals of MST programs are to decrease rates of antisocial behavior and other clinical problems, improve functioning (e.g., family relations, school performance), and achieve these outcomes at a cost savings by reducing the use of out-of-home placements such as incarceration, residential treatment, and hospitalization. The ultimate goal of MST is to empower families to build a healthier environment through the mobilization of existing child, family, and community resources.

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The Behavioral Health Juvenile Justice (BHJJ) initiative, a shared effort of the Ohio Department of Mental Health and Addiction Services (OhioMHAS) and the Ohio Department of Youth Services (DYS), was created to enhance local options for providing services to juvenile offenders with serious behavioral healthcare needs. Pilot projects that started in a few Ohio counties in early 2000 have grown into a statewide initiative with strong support from additional state and local stakeholders. The projects are designed to transform child-serving systems by enhancing their assessment, evaluation, and treatment of multi-need, multi-system youth and their families. In addition, they provide the Juvenile Court judges an alternative to incarceration.

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MST is an internationally-recognized program for at-risk youth and their families. For more than 30 years, MST has consistently demonstrated positive outcomes with chronic juvenile offenders. Based on this success, rigorous randomized trials were conducted to explore the feasibility and effects of adaptations of MST with other target populations. Results have been positive for treating problem sexual behavior, child abuse and neglect, substance abuse, serious emotional disturbances, and chronic health care conditions. These documents highlight the many areas of MST research and proven outcomes with traditional MST and MST clinical adaptations as well as on the transport of MST to community settings. (updated January 2013)


This introduction provides information on the MST Quality Assurance/Quality Improvement (QA/QI) Program and how the different elements of that program work together. (updated January 2013)

MST Experts

Maureen Kishna
Pamela Mitterling
Renne Dragomir

Considering MST for your area or agency?
Contact Maureen Kishna


Combating Racial Disparity in the Juvenile Justice System with MST, Maureen Kishna
Ohio’s Successful Youth Incarceration Alternatives Program, Patrick Kanary
2017 Ohio Behavioral Health Conference