Multisystemic Therapy

One holistic approach to violence prevention is multisystemic therapy (MST). The theory behind MST nests individuals in an ecological system of family, peer, school, and neighborhood systems (Henggeler, Cunningham, Pickrel, Schoenwald, & Brondino, 1996). MST interventions are tailored to individual cases and designed to address multiple systems thought to influence severe antisocial behavior (Henggeler et al., 1996). Barriers to effective parenting, such as high stress, substance use, or lack of knowledge, are often addressed in the initial phases. Frequent components of the intervention include cognitive-behavioral and family therapies, and agencies work with the MST organization to develop a system for delivering these services, with MST providing help with budgeting, hiring, and quality assurance (MST, 2014). Although this is a resource-intensive approach, it has the advantage of identifying risk factors most salient for each case, making efficient use of interventions. MST has been found to be effective in reducing offending among juveniles who have already gotten into serious trouble (e.g., Borduin et al., 1995). In one study, serious juvenile offenders randomly assigned to MST or “usual services” in a community mental health center had significantly fewer arrests and self-reported offenses, spent less time in jail, and their families reported increased cohesion and lower youth aggression (Henggeler,

Melton, & Smith, 1992). In another study, reduced aggression was evident after treatment (Scherer, Brondino, Henggeler, Melton, & Hanley, 1994). A study of serious juvenile offenders in Missouri found a dramatic difference between MST completers, who recidivated at only 22% in four years of follow-up, versus MST drop-outs (47%), individual therapy completers and drop-outs (71%), and treatment refusers (88%).

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