An Overview of Multisystemic Therapy (MST )

Innovative Conversations Session 9 – Recorded October 2019

Host and first CIP Director, Patrick Kanary, talks with longtime colleague Maureen Kishna on the Multisystemic Therapy (MST) and its effectiveness in helping youth with mental health, substance use, and juvenile justice challenges

Maureen Kisha, MST Expert and Developer with the Center for Innovative Practices (CIP), has worked for the last 17 years within the field of Multisystemic Therapy (MST).  She has been a therapist, supervisor, consultant, and program developer in this model. Additionally, Maureen is a certified cognitive therapist and school social worker.

Prior to MST, Maureen worked in a wide array of settings locally and internationally including in a residential treatment center, community youth centers, a family planning clinic, schools, and in a community-based respite program for adolescent boys with severe emotional and behavioral challenges.

In In addition to supporting her work with MST and the agency staff, Maureen works diligently to inform the public about MST and its benefits to the family and community. She presented at the 2017 Ohio Behavioral Health Conference regarding MST and published a white paper for MST Services, Inc. regarding Combating Racial Disparity in the Juvenile Justice System using MST.

Listen to Maureen Kishna’s MST Overview

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

(Click on pics for PDF of Infographic)

The 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.

(Click on pics for PDF of Infographic)

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.

View MST PowerPoint

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 in Ohio

Proven results for families and communities
In today’s era of tight budgets and demands for high accountability, states feel the pressure to invest in programs that will give them the most bang for their buck. The best way to meet these demands is by investing in evidence-based programs (EBPs) where research demons. Multisystemic Therapy (MST) is the leading EBP in the field of juvenile justice. Whereas traditional approaches to treating delinquent youths— such as incarceration and out-of-home placements — are tremendously costly and ineffective, MST’s effectiveness has been proven time and again. MST has been proven effective over the course of decades, not months. Long term follow-up studies found that MST reduces rearrests by 54% over 14 years, violent felony arrests by 75% over 22 years and caregiver felony arrests by 94%. The treatment generates a net benefit of up to $200,000 per youth.

While MST’s track record is impressive, the challenge of implementing a new evidence-based practice can be intimidating. To help states overcome that challenge, and better visualize how they can start successful MST programs in their communities, MST Services has compiled this State Success Guide. The guide outlines how five states implemented MST, and what lessons they learned. Read Full Report

Additional Resources:

MST Services
MST Services provides a wealth of information including results, helpful infographics, videos, and more.

National Registry of Evidence-based Programs and Practices (NREPP)
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. See the National Registry of Evidence-Based Programs and Practices for more information.

Behavioral Health Juvenile Justice
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.

Considering MST for your area or agency?
Contact Maureen Kishna, Program Developer

(Pictured Right | MST Services State Success Guides Click on pic for PDF)

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

ADDITIONAL RESOURCES: is presented by The Center for Innovative Practices (CIP)
and the Child and Adolescent Behavioral Health Center of Excellence (CABH COE)
Part of the Begun Center for Violence Prevention
at Case Western Reserve University’s
Mandel School of Applied Social Services
Campus Location: 11235 Bellflower Road Room 375  |
Cleveland, OH 44106 Mailing Address: 10900 Euclid Avenue |
Cleveland, OH 44106-7164
Telephone: 216-368-6293 | email:
© 2018 Center for Innovative Practices, Cleveland, Ohio 44106 is presented by The Center for Innovative Practices | Part of the Begun Center for Violence Prevention
at Case Western Reserve University’s Mandel School of Applied Social Services
Campus Location: 11235 Bellflower Road Room 375  | Cleveland, OH 44106
Mailing Address: 10900 Euclid Avenue | Cleveland, OH 44106-7164
Telephone: 216-368-5235 | email:
© 2020 Center for Innovative Practices, Cleveland, Ohio 44106