multi systemic therapy overview breaking the cycle of problematic behaviour
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Multi Systemic Therapy Overview Breaking the cycle of problematic behaviour by keeping young people at home, in school and out of trouble. Overview. What is MST? How does MST work in practice? MST Newcastle. What is MST?. - PowerPoint PPT PresentationTRANSCRIPT
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Multi Systemic TherapyOverview
Breaking the cycle of problematic behaviourby keeping young people at home, in school and out of
trouble
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Overview
What is MST?
How does MST work in practice?
MST Newcastle
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What is MST?
Community-based, intensive, family driven approach for young people who are at risk of custody or being placed into Local Authority Care due to their OWN behaviour.
The MST ‘client’ is the entire ecology of the young person: family, peers, school, local community.
Focus is on empowering the caregivers to solve current and future problems.
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Ultimate MST Outcomes
To keep families together when the young person is at risk of entering care or custody.
For the young person to be engaged in education / training.
For there to be a reduction in antisocial behaviour and charges brought against the young person.
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Instrumental Outcomes
Improved parenting skillsImproved family relationsImproved access to supportsSuccess in education and trainingImproved involvement with pro social
peers and activitiesChanges sustained for 3-4 weeks
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Theoretical underpinnings
Social Ecological approachYoung people live in a social ecology of
interconnected systems.Behaviour is influenced across a number
of different systems.In order to change behaviour we need to
target factors at an individual, family, school, peer and community level.
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Social Ecological Model
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MST theory of change
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Research led models of intervention
We bring together some intensively researched and evidence based interventions to enable families to build on their strengths and resources to make changes:
Structural Family TherapyStrategic Family TherapyBehavioural Parent TrainingCognitive Behavioural Therapy
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Evidence Base
Strong research base showing that MST is effective
Evidence shows that MST is successful as it;Targets the known causes of problematic
behaviours; family and peer relations, school and community factors
Is family driven and takes place at homeProviders are accountable for outcomesContinuous quality improvement occurs at all
levels
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How Does MST work in Practice?
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How does it work in practice?
Single worker working intensively with 4 to 6 families at a time.
Negotiate outcomes with the family and key participants.Work is done in the home, school and local community.24 hour / 7 days a week team availability: ‘on call’
system.Typical intervention lasts 3-5 months.MST worker will take the lead on delivering interventions
to address referral behaviours. What does this mean in practice?
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MST workers work primarily with parents to help them:
Increase their parenting skillsImprove family relationsInvolve the young person with more pro
social peers and activitiesImprove school attendanceCreate family support networks
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Core elements of MST
MST treatment principles
MST analytical process
MST quality assurance system
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MST Principles
1. Find the fit
2. Positive and strength focussed
3. Increased responsibility
4. Present focussed, action oriented, well defined
5. Targeting sequences
6. Developmentally appropriate
7. Continuous effort
8. Evaluation and accountability
9. Generalisation
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Finding the Fit;Sample Fit circle
YP is struggling academically
Lack of consequences at home
Poor home school link
YP does not like school
Ineffective school consequences
Peers reinforce behaviours
Verbal aggression at school
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MST Newcastle
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Why Newcastle?
Newcastle has a high number of young people being placed in Local Authority Care for short periods of time, suggesting that they may not need to enter care at all if an appropriate family intervention can be provided.
Research has shown MST to:Reduce re-arrest rates by up to 70%Reduce out-of-home placements by up to 64%
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Referral Criteria
Young Person must be aged between 12 and 17 years (or 11yrs if in year 7)
AND The young person must be at risk of
entering care or custody due to THEIR OWN problematic behaviour, such as offending and substance misuse.
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Exclusionary criteria
Young people living independently or already in care or custody or for whom a caregiver can’t be located.
Young people who mainly present with a serious mental health problem or developmental disorder, e.g. Autism.
Young people who mainly present with concerns around suicide, homicide or psychotic behaviour.
When the concern is mainly around the behaviour of the parent rather than the young person.
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Typical referral behaviours
Verbal and physical aggression at home/ school/ community
Low/ no school attendanceOffending behaviourDrug and alcohol useAssociation with anti-social peersMissing behavioursPoor family relations
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Newcastle to date
Started taking referrals in May 2012Worked with 39 families so farClosed 32 families 27 cases closed due to successfully addressing
referral behaviours, 2 cases discharged due to Team’s inability to
sustain engagement2 YP accommodated, 1 YP moved out of area
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Ultimate Outcomes: May 2012 to May 2013 for 32 Closed CasesPercentage of YP living at home = 90.9% (30
out of 32 YP)
Percentage of YP in school or working = 81.8% (26 out of 32 YP)
Percentage of YP with no new charges during MST = 66.7% (21 out of 32 YP)
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Instrumental Outcomes: May 2012 to May 2013 for 32 Closed CasesPercentage of families with parenting skills necessary to
handle future problems = 78.8% (25 out of 32 families)
Percentage of families with improved family relations = 78.8% (25 out of 32 families)
Percentage of families with improved network of supports = 66.7% (21 out of 32 families)
Percentage of YP with success in education or training = 78.8% (25 out of 32 families)
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Instrumental Outcomes: May 2012 to May 2013 for 32 Closed CasesPercentage of YP involved with pro social
peers/activities = 48.5 (15 out of 32 young people)
Percentage of cases where positive change has been sustained = 78.8% (25 out of 32 families)
All Outcomes are based on families self reporting and worker assessment
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Some feedback on MST Newcastle From Families
How is MST different?;The intense 3 days a
week contact and phone contact the whole time
I would like to say thank you to MST, especially my worker. She has made my relationship with my son
better
Very determined to help the
family as much as they could. Very friendly
I am very grateful to
have received
the service
Our worker never gave up on our
moods and she had ideas about resolving
each problem
The call service is great as I
really needed this
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Newcastle’s MST Team
Supervisor: Sarah RitsonAbby Waites (Maternity Leave)
MST Team:Ashley RobsonPhilip Sammut- SmithWarren PetitjeanNew Worker hired but not yet in post
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For more information…
Visit www.mstservices.com
Email: [email protected]: 0191 2782762
Cookery Block - Heaton ComplexTrewhitt Road, HeatonNE6 5DY
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Any Questions?