Multisystemic Therapy (MST)

Scientific Rating:
Well-Supported by Research Evidence
See scale of 1-5

Additional Implementation Resources

Since this program Multisystemic Therapy (MST) was highly rated on the Scientific Rating Scale, program representatives were asked to provide additional implementation information.

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Multisystemic Therapy (MST) as listed below:

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: Tom Pietkiewicz, Director of Business Development, email:, phone: 843-352-4306 or Melanie Duncan, PhD, Program Development Coordinator, email:, phone: 843-284-2221.

Formal Support for Implementation

There is formal support available for implementation of Multisystemic Therapy (MST) as listed below:

Implementation support is available from either MST Services or from any of the more than 20 MST training organizations, called Network Partner organizations. Contact information for MST Network Partner organizations can be found at

Fidelity Measures

There are fidelity measures for Multisystemic Therapy (MST) as listed below:

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 at An overview of the Multisystemic Therapy (MST) Quality Assurance Program can be found at 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 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:

Implementation Guides or Manuals

There are implementation guides or manuals for Multisystemic Therapy (MST) as listed below:

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 Stores)
  • 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

Research on How to Implement the Program

Research has been conducted on how to implement Multisystemic Therapy (MST) as listed below:

  • Brunk , M. A., Chapman, J. E., & Schoenwald, S. K. (2014). Defining and evaluating fidelity at the program level in psychosocial treatments. Zeitschrift fur Psychologie, 222(1), 22–29.
  • Halliday -Boykins, C. A., Schoenwald, S. K., & Letourneau, E. J. (2005). Caregiver-therapist ethnic similarity predicts youth outcomes from an empirically based treatment. Journal of Consulting and Clinical Psychology, 73(5), 808–818.
  • Henggeler, S. W., Schoenwald, S. K., Liao, J. G., Letourneau, E. J., & Edwards, D. L. (2002). Transporting efficacious treatments to field settings: The link between supervisory practices and therapist fidelity in MST programs. Journal of Child and Adolescent Psychology, 31(2), 155–167.
  • Lange , A. M. C., van der Rijken, R. E. A., Busschbach, J. J. V., Delsing, M. J. M. H., & Scholte, R. H. J. (2017). It's not just the therapist: Therapist and country-wide experience predict therapist adherence and adolescent outcome. Child Youth Care Forum, 46, 455–471.
  • Lofholm, C. A., Eichas, K., & Sundell, K. (2014). The Swedish implementation of Multisystemic Therapy for adolescents: Does treatment experience predict treatment adherence?. Journal of Clinical Child & Adolescent Psychology, 43(4), 643–655.
  • Ogden, T., Bjornebekk, G., Kjobli, J., Patras, J., Christiansen, T., Taraldsen, K., & Tollefsen, N. (2012). Measurement of implementation components ten years after a nationwide introduction of empirically supported programs – A pilot study. Implementation Science, 7, Article 49.
  • Pantoja, R. (2015). Multisystemic Therapy in Chile: A public sector innovation case study. Psychosocial Intervention, 24(2), 97–103.
  • Schoenwald, S. K., Carter, R. E., Chapman, J. E., & Sheidow, A. J. (2008). Therapist adherence and organizational effects on change in youth behavior problems one year after Multisystemic Therapy. Administration and Policy in Mental Health and Mental Health Services Research, 35, Article 379.
  • Schoenwald, S. K., Chapman, J. E., Henry, D. B., & Sheidow, A. J. (2012). Taking effective treatments to scale: Organizational effects on outcomes of Multisystemic Therapy for youths with co-occurring substance use. Journal of Child & Adolescent Substance Abuse, 21(1), 1–31.
  • Schoenwald, S. K., Chapman, J. E., Sheidow, A. J., & Carter, R. E. (2009). Long-term youth criminal outcomes in MST transport: The impact of therapist adherence and organizational climate and structure. Journal of Clinical Child and Adolescent Psychology, 38(1), 91–105.
  • Schoenwald, S. K., Halliday-Boykins, C. A., & Henggeler, S. W. (2003). Client-level predictors of adherence to MST in community service settings. Family Process, 42(3), 345–359.
  • Schoenwald, S. K., Sheidow, A. J., & Chapman, J. E. (2009). Clinical supervision in treatment transport: Effects on adherence and outcomes. Journal of Consulting and Clinical Psychology, 77(3), 410–421.
  • Schoenwald, S. K., Sheidow, A. J., & Letourneau, E. J. (2004). Toward effective quality assurance in evidence-based practice: Links between expert consultation, therapist fidelity, and child outcomes. Journal of Child and Adolescent Clinical Psychology, 33(1), 94–104.
  • Schoenwald, S. K., Sheidow, A. J., Letourneau, E. J., & Liao, J. G. (2003). Transportability of Multisystemic Therapy: evidence for multi-level influences. Mental Health Service Research, 5(4), 22–239.
  • Walsh , C., & Best, P. (2019). Practitioners' experiences of using blended models within family support: A proof of concept study involving Cognitive-Behavioural Therapy (CBT), Multisystemic Therapy (MST) and Incredible Years (IY) interventions. Journal of Family Social Work, 22(4–5), 369–388.
  • Welsh, B. C., & Greenwood, P. W. (2015). Making it happen: State progress in implementing evidence-based programs for delinquent youth. Youth Violence and Juvenile Justice, 13(3), 243–257.