The California Evidence-Based Clearinghouse for Child Welfare
The California Evidence-Based Clearinghouse for Child Welfare

This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/

Multisystemic Therapy (MST) - Implementation Information

Scientific Rating: 1
"Well-Supported by Research Evidence"

Pre-implementation Assessments to be given to organizations or providers in order to measure organizational or individual readiness:

  • The objectives of the pre-implementation assessment process are to:
    • identify the mission, policies, and practices of the customer organization and of the community context in which it operates
    • specify the clinical, organizational, fiscal, and community resources needed to successfully implement MST.
  • Using the MST Feasibility Questionnaire, an MST Program Developer will attempt to assess the needs of the future MST program site by reviewing the resources needed to operate a successful MST program.
  • An MST Program Developer will also provide on-site and/or telephone consultation that will include activities such as the following:
    • Meetings with the organization's leadership and clinical staff.
    • Meetings with staff from agencies that influence patterns of referral, reimbursement, and/or policy affecting the customer organization's capacity to implement MST.
    • Presentation of MST to the community stakeholders to assure the buy-in needed for program success after start-up.
    • Assistance in designing clinical record-keeping to document treatment goals and progress.
    • Assistance in developing systems to measure outcomes.
    • Review of evaluation proposals.
    • Consultation regarding Requests for Proposals (RFPs) relevant to the development and funding of the MST program.
    • Assistance with recruiting additional staff including sample job descriptions, review of hiring advertisements, interviewing and selecting the most qualified staff.

For further information about this process, please contact either Marshall E. Swenson, MSW, MBA, Vice President & Manager of New Program Development, email: marshall.swenson@mstservices.com, phone: 843-284-2215 or Melanie Duncan, PhD, Program Development Coordinator, email: melanie.duncan@mstservices.com, phone: 843-284-2221.

Implementation Tools for the program (e.g., implementation guides or manuals):

All components of the MST program are manualized. The treatment manuals for antisocial behavior (Multisystemic Therapy for Antisocial Behavior in Children and Adolescents) and serious emotional disturbance (Serious Emotional Disturbance in Children and Adolescents: Multisystemic Therapy) are available from Guilford Press. Additional MST-related manuals are provided to sites when they implement MST. These sites are licensed through MST Services, Inc., which has the exclusive license for the transport of MST technology and intellectual property developed at the Family Services Research Center of the Medical University of South Carolina. The following are included separately:

  • Multisystemic Therapy for Antisocial Behavior in Children and Adolescents - Second Edition - specifying MST clinical protocols based on the nine core treatment principles. Available through the MST store.
  • MST Supervisory Manual - specifying the structure and processes of the weekly onsite supervisory sessions and ongoing development of therapist competences.
  • MST Consultation Manual - specifying the role of the MST consultant in helping teams achieve youth outcomes and in building the competencies of team therapists and supervisors.
  • MST Organizational Manual - addressing administrative issues in developing and sustaining a MST program.

Fidelity measures:

Quality assurance support activities focus on monitoring and enhancing program outcomes through increasing therapist adherence to the MST treatment model. The MST Therapist Adherence Measure (TAM) and the MST Supervisor Adherence Measure (SAM) have been validated in the research on MST with antisocial and delinquent youth and are now being implemented by all licensed MST programs. Both measures are available through the MST Institute. An overview of the Multisystemic Therapy (MST) Quality Assurance Program can be found at the MST Institute. A brief review of the two MST fidelity measures is below:

  • The Therapist Adherence Measure Revised (TAM-R) is a 28-item measure that evaluates a Therapist's adherence to the MST model as reported by the primary caregiver of the family. The adherence scale was originally developed as part of a clinical trial on the effectiveness of MST. The measure proved to have significant value in measuring an MST therapist's adherence to MST and in predicting outcomes for families who received treatment. More information is available at: the MST Institute.
  • The Supervisor Adherence Measure (SAM) is a 43-item measure that evaluates the MST Supervisor's adherence to the MST model of supervision as reported by MST therapists. The measure is based on the principles of MST and the model of supervision presented in the MST Supervisory Manual. More information is available at: the MST Institute.