How our service can help you
MST-UK provide training and consultancy services in the Multisystemic
Therapy (MST) model to teams in local authorities, health trusts and
voluntary organisations providing MST to children and families, where
children are at risk of entering care or custody or to support young
people to return home safely from care.
We hold the licence for the United Kingdom Network Partnership
agreement with MST Services in the USA and under this agreement can
provide services across all countries of the UK and in the Republic of Ireland.
What is Multisystemic Therapy?
MST was developed to work with young people with complex behavioural
and emotional difficulties and their families, with a focus on young
people at risk of out of home placement in care or custody due to
offending or other anti-social, and high risk behaviours.
MST is provided by clinical teams of a supervisor and three or four
therapists, who offer intensive family interventions in the community,
for 3 -5 months, including an on-call service for families. MST is a
systemic family intervention, with therapists using a range of
evidence-based interventions, including structural and strategic family
therapy, Cognitive Behavioural Therapy and Behavioural Interventions.
Multisystemic Therapy for Child Abuse and Neglect (MST-CAN
) is an adaptation of MST focused on families where children are on a
child protection plan due to physical abuse and/or neglect and are at
risk of entering care as a result. It is based on the same principles as
MST, but the intervention is for 6-9 months and includes evidence-based
approaches to work with adult substance abuse and also trauma in young
people and adults.
MST UK are now able to provide UK based training and consultation in
both these models.
Who do MST-UK Provide a Service for?
MST-UK do not provide a direct service to children and families, but we
provide training, consultation, and organisational support to the
following range of organisations:
- Local authority Children's Social Care departments and partner agencies.
- Clinical Commissioning groups and NHS Trusts
- Children's Trusts
- Voluntary organisations
- Health Boards (N Ireland)
Our outcomes include:
- Successful partnership work with over 30 local authorities, voluntary organisations, and health providers since 2008
- Provision of high-quality training and consultation in the UK
- Promoting stability for children and young people with over 90% of children able to remain safely at home.
- Improved parenting skills and mental health for parents
- Reduced offending and at-risk behaviours by young people
- Service Type: Child and Adolescent Mental Health Services (National and Specialist) Service Borough Covers: National (Child and Adolescent services) Treatment type: Training and service delivery
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Contact the service
Site Location: Maudsley Hospital Known As: MST-UK Email: cathy.james@kcl.ac.uk Phone Number: 07787 510273 - Disabled Access: No
- Address: Institute of Psychiatry, Psychology & Neuroscience, PO51,16 De Crespigny Park, London, SE5 8AF
- Business Hours/Visiting Hours: Monday to Friday, 9am to 5pm
- Conditions: Addictions, Conduct disorder, Depression, Self-harm
Other essential information
Eligibility criteria
MST is targeted at young people aged 11 to 17 years who are at risk of out of home placement in care or custody, due to offending, or anti-social behaviours, including aggression, school difficulties, missing from home and offending.
MST-CAN is targeted at children aged six to 17 years who are subject to a child protection plan for physical abuse and neglect and where parents may have underlying difficulties with substance abuse or past trauma.
Exclusion
MST does not work with young people who are living independently, those who have committed sexual offences or where serious mental illness, including psychosis is the primary issue.
For MST-CAN, teams do not work with families where child sexual abuse is the primary issue.
Teaching and Training
MST-UK and Ireland provide licensed MST training across the UK and Ireland and to delegates from other European countries.
Current training offered includes:
- MST Orientation Training
- MST Supervisor Orientation Training
- MST Child Abuse and Neglect (CAN) Orientation Training
- MST-CAN Trauma Training
For details of this training please contact natalie.wilmot@kcl.ac.uk
We are also able to offer introductory training on MST to undergraduate and post-graduate courses in social work and mental health and also research opportunities for students and trainees. Please contact us to discuss details.
Interventions
MST was originally developed by Professor Scott Henggeler and colleagues at the Medical University of South Carolina (USA) over 40 years ago. It has been successfully implemented within the UK for over 15 years. MST was developed to work with young people with complex behavioural and emotional difficulties and their families, with a focus on young people at risk of out of home placement in care or custody due to offending or other antisocial or high risk behaviours.
MST is provided by clinical teams of a supervisor and three or four therapists, who offer intensive family interventions in the community, for three to five months, including an on-call service for families. MST is a systemic family intervention, with therapists using a range of evidence-based interventions, including structural and strategic family therapy, cognitive behavioural therapy and behavioural interventions.
Multisystemic therapy for child abuse and neglect (MST-CAN) is an adaptation of MST focused on families where children are on a child protection plan due to physical abuse and/or neglect and are at risk of entering care as a result. It is based on the same principles as MST but the intervention is for six to nine months and includes evidence based approaches to work with adult substance abuse and also trauma in young people and adults.
The MST Family Integrated Transitions (MST-FIT) model is based on MST principles with additional Dialectical Behaviour Therapy components to address needs around emotional regulation and the context of young people returning home from care or custody. MST-FIT works for 3 to 4 months with young people and their carers while they are placed away from home, in residential or foster care and also with the young person’s family to identify any barriers which would prevent a successful return home. Once the young person has returned home, work continues with the family and their network to support sustained change.
Outcomes
- Successful partnership work with over 30 local authorities, voluntary organisations and health providers across the UK and Ireland
- Provision of high quality training and consultation
MST programme outcomes
- Improved parenting skills and mental health for parents
- Reduced at-risk behaviours by young people
- Reductions in incidents of abuse and neglect (MST-CAN)
- Increased confidence in the future for parents and young people
- Keeps children in their homes – 95.2% of young people remain at home.
- Keeps children in school – 83.6% are in school or working.
- Keeps children out of trouble – 94.8% have no new criminal charges.
- 95.6 % of parents/carers with no new reports of child maltreatment for MST CAN
Figures cover data at the end of treatment the period from 1 January 2020 to 31 December 2020 for MST teams in the UK and Ireland.
Feedback from families
“You have done the unimaginable. If it wasn’t for your guidance our family would no longer be a family. We thank you for all of you have done and will never forget you." (MST parent)
"I’ve stayed in college. I was very surprised about that. I know my mum was surprised at that but I stayed in college for 2 years. I’ve definitely got my head on my shoulders. I know what I want to do now for a fact so that’s really good." (Sammi, 18)
“My life has completely changed since working with MST-CAN. I had many failed attempts at staying abstinent but after working with MST-CAN. I have now been drug free for nearly 2 years!” (MST-CAN Parent)
“It was good really. It helped with a few things like dealing with my anger and other normal things. MST never let go!” (Young person, MST-CAN)
Case Studies
Case Study: Exploitation - Siblings Cameron & Daniel, aged 10 and 15
What were the issues at referral?
Cameron (10 years) and Daniel (15 years) and their 2 younger siblings had been open to the local authority on Child Protection plans for 2 years prior to referral. Worries were growing that Daniel was gang affiliated and that his anti-social behaviour in the community was growing - having been reported to be carrying weapons, going missing, damaging property in the community and stealing money. There were attendance and behaviour issues at school and Daniel had been excluded. Within the home Cameron and Daniel were fighting daily. In an attempt to keep track of Daniel, mum would send Cameron to follow Daniel, which was putting him at further risk, as he was starting to associate with negative peers.
Mum was stating that she could no longer cope with Cameron’s behaviour and was requesting for him to be taken into care. Cameron had presented himself at a local police station on several occasions reporting that his Mum treated him differently to his siblings and asking to not be returned to her care. School were awaiting a residential placement for Cameron and mum was keen for this to happen. Mum was struggling to cope with Cameron’s behaviours – verbal aggression, physical aggression towards his siblings and threats to achieve suicide. Cameron had been permanently excluded from mainstream school and was attending a specialist school for children with emotional and behaviour difficulties.
The reason for Cameron and Daniel originally coming to the attention of the local authority was because mum had chastised Cameron using a belt and had also put him in stress positions to try and alter his behaviour. Both boys were on EHCP plans.
What did MST do with the family and systems around the young person?
Mum was fixed in her views at the start of treatment that her children needed strong boundaries with physical discipline. Early in treatment some of mum’s actions and communication with her children was not always helpful or safe. For example, when Cameron got a knife and stated that he was going to kill himself, mum got him a sharper knife as the one he had fetched ‘wouldn’t do anything’. Although this stopped Cameron’s behaviour, the therapist was able to take mum through the sequence and help her to see that this was not the most helpful way of responding and could have had serious consequences.
The therapist worked with mum using sequencing, a tool we use in MST to understand how incidents build, to gain a better picture of escalation and threats of self-harm in the home. As mum was empowered to recognise these sequences, she was able to not only label what she was feeling and thinking but also became skilled at doing this with Cameron. The therapist and mum wrote scripts for how she could respond to her children differently, and role played out how this could go. This helped mum and quickly we saw and heard mum using these scripts within sequences to change her interactions with her children.
The therapist worked with mum on increasing her warmth towards the children as well as having pre planned rewards rather than relying on punishments. Mum quickly started to see improvements in her children’s behaviour and at the midpoint review described the therapist as ‘sent from God’.
Mum made good use of on call and good use of her therapist when incidents were happening. This enabled the MST Therapist and their team to see things live and in action and to be able to talk mum through safety planning and plans to help things calm down in the home.
The therapist supported mum to communicate and work with Daniel’s school system, including sharing the behaviour plans and thinking through how the systems can work together to support the attendance and behaviour in the school setting. The therapist helped mum to identify the peers and develop expectations around the boys for when they were allowed out.
Mum’s first language was French and although mum did not require an interpreter, she did prefer to read plans in French. Copies of the MST Analytical Process (the MST Roadmap for Treatment) were given to mum in French as well as important plans and documents.
The therapist was interested in and took time to understand mum’s heritage, culture and her belief systems and how these impacted on her parenting. When some of these were identified as causing or sustaining the behaviours, the therapist used sensitivity to address these with mum.
What was the impact?
At the end of treatment Daniel was attending school daily and there were no issues with his behaviour within school. Daniel is engaged in pro social activities and has pro social peers. There has been no further weapon carrying or property damage within the home. All referral behaviours have reduced.
Cameron’s behaviours within the home have decreased and he is enjoying a much better relationship with his mum and his siblings. Mum and Cameron spend individual time with each other which they are both enjoying. Mum is now questioning, given the improvements whether the school that Cameron attends is the right school for him.
The case went down from Child Protection to a Child in Need with all professionals in agreement and pleased with the progress the family were making. If the worries continue to stay small the case will close to Children’s Social Care within the next 6 months.
When a residential school place become available for Cameron, school and mum no longer felt that was suitable for Cameron and mum turned down this place. At the time of closure mum continued to work with school to get him back into mainstream school.
