Presentation on theme: "Multi Systemic Therapy"— Presentation transcript:
1Multi Systemic Therapy OverviewBreaking the cycle of problematic behaviourby keeping young people at home, in school and out of trouble
2OverviewWhat is MST?How does MST work in practice?MST Newcastle
3What 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.
4Ultimate MST OutcomesTo 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.
5Instrumental 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
6Theoretical 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.Based on social ecological theory of Uri Bronfenbrenner;Children and YP live in a social ecology of interconnected system that impact their behaviours inn direct and indirect ways. These influences act in both directions
8MST theory of change Key MST assumptions; Children’s behaviour is strongly influenced by their families, friends and communitiesFamilies and communities are central and essential partners and collaborators in MST treatmentCaregivers and parents want the best for their childrenFamilies can live successfully without formal servicesProfessional treatment providers should be accountable for achieving outcomes
9Research 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
10Evidence 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 factorsIs family driven and takes place at homeProviders are accountable for outcomesContinuous quality improvement occurs at all levelsTransportability study;45 MST programmes in 12 states and Canada, 453 clinicians, 1979 YP1 year post treatment reductions in YP’s probelmatic behaviours and functioningOver 2 year post treatment reductions in criminal activityIncreased worker adherence to the model results in improved outcomes; more significant decreases in criminal activity and arrest rates
12How 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?
13MST 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
14Core elements of MST MST treatment principles MST analytical process MST quality assurance systemQuality assurance system includes weekly group supervision and consultation with an MST expert; ongoing training; monitoring of sessions via field visits and tape Recording; feedback from professionals to improve performance; feedback from families re their experiences of MSTQA; weekly group supervision, weekly consultation, families feedback on workers, workers feedback on manager, all feedback on consultant
15MST Principles 1. Find the fit 2. Positive and strength focussed 3. Increased responsibility4. Present focussed, action oriented, well defined5. Targeting sequences6. Developmentally appropriate7. Continuous effort8. Evaluation and accountability9. GeneralisationPrinciples used in developing intervention and carrying out interventions. Guide us in every aspect
19Why 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%
20Referral CriteriaYoung Person must be aged between 12 and 17 years (or 11yrs if in year 7)ANDThe young person must be at risk of entering care or custody due to THEIR OWN problematic behaviour, such as offending and substance misuse.
21Exclusionary 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.
22Typical referral behaviours Verbal and physical aggression at home/ school/ communityLow/ no school attendanceOffending behaviourDrug and alcohol useAssociation with anti-social peersMissing behavioursPoor family relations
23Newcastle to date Started taking referrals in May 2012 Worked with 39 families so farClosed 32 families27 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
24Ultimate Outcomes: May 2012 to May 2013 for 32 Closed Cases Percentage 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)
25Instrumental Outcomes: May 2012 to May 2013 for 32 Closed Cases Percentage 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)
26Instrumental Outcomes: May 2012 to May 2013 for 32 Closed Cases Percentage 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
27Some feedback on MST Newcastle From Families Our worker never gave up on our moods and she had ideas about resolving each problemVery determined to help the family as much as they could. Very friendlyI am very grateful to have received the serviceThe call service is great as I really needed thisI would like to say thank you to MST, especially my worker. She has made my relationship with my son betterHow is MST different?;The intense 3 days a week contact and phone contact the whole time
28Newcastle’s MST Team Supervisor: Sarah Ritson Abby Waites (Maternity Leave)MST Team:Ashley RobsonPhilip Sammut- SmithWarren PetitjeanNew Worker hired but not yet in post