MST is a pragmatic and goal-oriented treatment that specifically targets factors of each youth’s social network that are contributing to his or her antisocial behavior.Thus, MST interventions typically aim to improve caregiver discipline practices, enhance family affective relations, decrease youth association with deviant peers, increase youth association with prosocial peers, improve youth school or vocational performance, engage youth in prosocial recreational outlets, and develop an indigenous support network of extended family, neighbors, and friends to help caregivers achieve and maintain such changes. Specific treatment techniques used to facilitate these gains are integrated from those therapies that have the most empirical support, including cognitive behavioral, behavioral, and the pragmatic family therapies.
MST services are delivered in the natural environment (e.g., home, school, community). The treatment plan is designed in collaboration with family members and is, therefore, family-driven rather than therapist-driven. The ultimate goal of MST is to empower families to build an environment, through the mobilization of indigenous child, family, and community resources, that promotes health. The typical duration of home-based MST services is approximately 4 months, with multiple therapist-family contacts occurring each week.
The first controlled study of MST with juvenile offenders was published in 1986, and since then, numerous randomized clinical trials with violent and chronic juvenile offenders have been conducted. In these trials, MST has demonstrated:
Reduced long-term rates of criminal offending in serious juvenile offenders,
Decreased recidivism and rearrests,
Reduced rates of out-of-home placements for serious juvenile offenders,
Extensive improvements in family functioning,
Decreased behavior and mental health problems for serious juvenile offenders,
Favorable outcomes at cost savings in comparison with usual mental health and juvenile justice services.