The problem with Multi-Systemic Therapy is that it requires rigid adherence to the model if it is to produce the desired treatment effects and this means it is expensive and requires staying with an "inner circle" consultant who helps an MST team at adherence. This is why MST is not widely distributed. What we don't know is what happens to which results when you modify it to be more realistic.
MST uses many common behavioral therapies as its components. Scott Henggler, the developer of MST, is a behavioral psychologist. Despite what we have heard about evil behavioral manipulation, good behavior therapies are the most empowering and egalitarian treatments known. Many an be learned by those suffering from anxiety or depression and used after reading from a manual. Good behavior therapists give there stuff away to their patients as fast as their patients can absorb it. But there always has to be some modification if it is to be accepted by a patient as everyone is different. MST is difficult to explore in terms of when and how they apply these evidence based behavioral techniques. They tend to keep secrets which is against my values. It is also a treatment that demands a team, often a team that can only be constructed in a university setting. If that is the case it will not easily take off as a treatment. Beyond MST, there is a way at addressing systems of care even more comprehensively and helping families and youth address systems that seem to be working at cross purposes and drive everyone crazy. That is called System of Care (lousy name), but it is famous for using the Wraparound process. This form of care is the most empowering of all. Like MST it is strength and needs based, emphasizes staying in ones home and community, works to coordinate services and actively seeks to empower parents and older youth. The real difference is that Wraparound emphasizes developing teams that include not just the usual professionals, but relatives, friends and all manner of natural supports. It is truly community building. My experience is that it also works well but is less expensive.
So MST is a good thing when you can get it,but it is rare that one can get enrolled in such a program. And System of Care programs are also hard to find, but many communities have strong parent advocacy programs tied to wraparound methods. And, as I am doing in Seattle, a few communities have the makings of a youth empowerment movement that can influence public policy on how to work with and for youth, not suppress them by using physical constraint and thought control.
Charley Huffine - your friendly shrink
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