Multisystemic Therapy for Conduct Problems in Youth
Multisystemic Therapy (MST; Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998, 2009) is a comprehensive family- and community-based treatment for youth with serious conduct problems who are at imminent risk of out-of-home placement (e.g., de
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Multisystemic Therapy (MST; Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 1998, 2009) is a comprehensive family- and communitybased treatment for youth with serious conduct problems who are at imminent risk of out-of-home placement (e.g., detention, incarceration, residential treatment). The effectiveness of MST has been established with chronic and violent juvenile delinquents and substance abusing youth. Adapted versions of the MST model have also been successfully applied to youth with other clinical problems, such as problem sexual behavior, psychiatric disturbance, and pediatric chronic illness. This chapter outlines the theoretical and empirical foundations of MST and provides a brief overview of the MST treatment model. A case example is used to illustrate the clinical aspects of the MST approach. The remainder of the chapter summarizes the growing evidence base for MST established through efficacy, effectiveness, and transportability trials. Portions of this chapter were published previously in Evidence-Based Psychotheropies for Children and Adolescents, Second Edition, edited by J.R. Weisz and A.E. Kazdin (2010), New york: Guilford Press. We greatly appreciate the permission from Guilford Press to reprint this material.
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CINDY M. Schaeffer ● Medical University of South Carolina Michael R. McCart ● Medical University of South Carolina Scott W. Henggeler ● Medical University of South Carolina Phillippe B. Cunningham ● Medical University of South Carolina
R.C. Murrihy et al. (eds.), Clinical Handbook of Assessing and Treating Conduct Problems in Youth, DOI 10.1007/978-1-4419-6297-3_11, © Springer Science+Business Media, LLC 2010
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CHARACTERISTICS OF THE MST MODEL Theoretical and Empirical Foundations MST is designed to address the array of risk factors commonly ssociated with conduct problems among youth. Decades of cross-sectional a and longitudinal research has shown that risk factors for conduct problems involve influences at multiple individual and environmental levels (Deater-Deckard, Dodge, Bates, & Pettit, 1998; Elliott 1994; Loeber, Farrington, Stouthamer-Loeber, & Van Kammen, 1998; Thornberry & Krohn, 2003). At the individual level, for example, conduct problems are associated with low IQ, cognitive biases about the advantages of aggression, and social skill deficits. Environmental influences are present in the contexts of the family, peer network, school, and neighborhood. For example, high levels of parental substance use, low parental supervision, and inconsistent family discipline are linked with elevated risk for behavior problems among youth, and association with deviant peers is a consistently strong predictor of adolescent conduct problems. Schoollevel influences include low academic achievement, low commitment to education, and an overly authoritarian teaching style. Further, neighborhoods characterized by high levels of poverty, residential mobility, and drug availability predict high rates of adolescent involvement in antisoc
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