Multisystemic Therapy – Substance Abuse
Multisystemic Therapy – Substance Abuse (MST-SA) is an adaptation of Multisystemic Therapy (MST) designed for youth ages 12–17 with substance use issues and their caregivers. MST-SA integrates contingency management, a behavior change model that provides rewards for positive behavior, with the MST approach to provide substance use treatment. MST-SA aims to help youth manage situations that have previously led to substance use, build protective factors such as social skills and family involvement, and increase contact with peers who model positive behaviors.
Therapists begin by introducing contingency management and outlining the components of the program. In the initial session, the therapist engages youth and caregivers in treatment and aims to address potential barriers to engagement. Therapists next use validated assessment instruments to determine whether the youth’s substance use indicates potential abuse or dependence. If problematic substance use is identified, therapists proceed to engage families in treatment.
The initial phase of therapy includes an antecedents, behaviors, and consequences (ABC) assessment, which examines the times, places, situations, persons, thoughts, and feelings that accompany substance use. The ABC assessment informs the youth’s treatment plan.
The next phase of therapy introduces self-management planning and drug refusal skills training. In this phase, therapists teach cognitive behavioral strategies to help youth avoid high-risk situations and to cope with unavoidable risky situations. During each treatment session, therapists, youth, and caregivers review the effectiveness of these strategies and revise self-management plans.
In the final phase, therapists aid youth and caregivers in developing a system aimed at changing behavior through incentives (e.g., rewards and privileges) for clean drug and alcohol tests and disincentives (e.g., extra chores) when screens or tests indicate continued substance use. Therapists teach caregivers to monitor progress through random urine drug screens and alcohol breath tests administered at home.
MST-SA does not currently meet criteria to receive a rating because no studies met eligibility criteria for review.
Date Research Evidence Last Reviewed: Sep 2022
Sources
The program or service description, target population, and program and service delivery and implementation information were informed by the following sources: the program or service manual, the program or service developer’s website, the National Registry of Evidence-based Programs and Practices, the National Institute of Justice’s CrimeSolutions clearinghouse, and the Washington State Institute of Public Policy.
This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the download the Handbook of Standards and Procedures, Version 1.0
Target Population
MST-SA is designed to serve youth ages 12–17 with substance use issues and their caregivers.
Dosage
Program dosage varies based on youth and family needs. A treatment team of two to four therapists is available 24 hours per day, 7 days per week to provide services. Therapists provide services over a 3–5-month period. Sessions are typically conducted weekly but may occur more or less frequently depending on youth and family availability and needs. The first session introducing families to contingency management takes 30 minutes. Subsequent sessions on the components of contingency management take 60–90 minutes each. Therapists have caseloads of four to six families.
Location/Delivery Setting
Recommended Locations/Delivery Settings
MST-SA can be delivered in the home, school, or community.
Education, Certifications and Training
Therapists who work for licensed MST teams and organizations deliver MST-SA. MST therapists typically have master’s degrees in social work, psychology, counseling, or marriage and family therapy. Most supervisors have a master’s or doctoral degree in social work, psychology, counseling, or marriage and family therapy.
MST therapists must first complete an initial 5-day MST training. The training includes teaching, role-playing, and other exercises designed to develop skills used in the treatment process and to provide opportunities to practice using MST assessment strategies. The training also aims to familiarize therapists with the theory underlying the MST model, the causes of serious behavior problems that MST can address, the strategies MST teams use to build collaborative relationships with stakeholder agencies in the community, and the therapists’ role in continuous quality improvement. Ph.D. and master’s level mental-health specialists provide the training. After completing the initial MST training, MST therapists receive an additional 1.5 days of supplemental training introducing the contingency management techniques used in the MST-SA treatment model. Therapists that deliver MST-SA also participate in on-the-job learning, including weekly structured supervision and feedback from an on-site MST supervisor.
Program or Service Documentation
Book/Manual/Available documentation used for review
The Contingency Management for Adolescent Substance Abuse Manual is implemented in conjunction with the Multisystemic Therapy for Antisocial Behavior in Children and Adolescents Manual.
Henggeler, S. W., Cunningham, P. B., Rowland, M. D., & Schoenwald, S. K. (2012). Contingency management for adolescent substance abuse. The Guilford Press.
Henggeler, S. W., Schoenwald, S. K., Borduin, C. M., Rowland, M. D., & Cunningham, P. B. (2009). Multisystemic Therapy for antisocial behavior in children and adolescents (2nd ed.). The Guilford Press.
Available languages
MST-SA materials are available in English.
Other supporting materials
For More Information
Website: http://www.mstservices.com/
Phone: (843) 856-8226
Email: info@mstservices.com
Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.
| Results of Search and Review | Number of Studies Identified and Reviewed for Multisystemic Therapy – Substance Abuse |
|---|---|
| Identified in Search | 3 |
| Eligible for Review | 0 |
| Rated High | 0 |
| Rated Moderate | 0 |
| Rated Low | 0 |
| Reviewed Only for Risk of Harm | 0 |
Studies Not Eligible for Review
Study 10015
Henggeler, S. W., Halliday-Boykins, C. A., Cunningham, P. B., Randall, J., Shapiro, S. B., & Chapman, J. E. (2006). Juvenile drug court: Enhancing outcomes by integrating evidence-based treatments. Journal of Consulting and Clinical Psychology, 74(1), 42-54. https://doi.org/10.1037/0022-006x.74.1.42
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).
Study 10021
Borduin, C. M., Mann, B. J., Cone, L. T., Henggeler, S. W., Fucci, B. R., Blaske, D. M., & Williams, R. A. (1995). Multisystemic treatment of serious juvenile offenders: Long-term prevention of criminality and violence. Journal of Consulting and Clinical Psychology, 63(4), 569-578. https://doi.org/10.1037//0022-006x.63.4.569
Henggeler, S. W., Borduin, C. M., Melton, G. B., Mann, B. J., Smith, L. A., Hall, J. A., & Fucci, B. R. (1991). Effects of Multisystemic Therapy on drug use and abuse in serious juvenile offenders: A progress report from two outcome studies. Family Dynamics of Addiction Quarterly, 1(3), 40-51.
Sawyer, A. M., & Borduin, C. M. (2011). Effects of Multisystemic Therapy through midlife: A 21.9-year follow-up to a randomized clinical trial with serious and violent juvenile offenders. Journal of Consulting and Clinical Psychology, 79(5), 643-652. https://doi.org/10.1037/a0024862
Schaeffer, C. M., & Borduin, C. M. (2005). Long-term follow-up to a randomized clinical trial of Multisystemic Therapy with serious and violent juvenile offenders. Journal of Consulting and Clinical Psychology, 73(3), 445-453. https://doi.org/10.1037/0022-006x.73.3.445
Wagner, D. V., Borduin, C. M., Sawyer, A. M., & Dopp, A. R. (2014). Long-term prevention of criminality in siblings of serious and violent juvenile offenders: A 25-year follow-up to a randomized clinical trial of Multisystemic Therapy. Journal of Consulting and Clinical Psychology, 82(3), 492-499. https://doi.org/10.1037/a0035624
Johnides, B. D., Borduin, C. M., Wagner, D. V., & Dopp, A. R. (2017). Effects of Multisystemic Therapy on caregivers of serious juvenile offenders: A 20-year follow-up to a randomized clinical trial. Journal of Consulting and Clinical Psychology, 85(4), 323-334. https://doi.org/10.1037/ccp0000199
Klietz, S. J., Borduin, C. M., & Schaeffer, C. M. (2010). Cost-benefit analysis of Multisystemic Therapy with serious and violent juvenile offenders. Journal Of Family Psychology, 24(5), 657-666. https://doi.org/10.1037/a0020838
Dopp, A. R., Borduin, C. M., Wagner, D. V., & Sawyer, A. M. (2014). The economic impact of Multisystemic Therapy through midlife: A cost-benefit analysis with serious juvenile offenders and their siblings. Journal of Consulting and Clinical Psychology, 82(4), 694-705. https://doi.org/10.1037/a0036415
Dopp, A. R., Borduin, C. M., Willroth, E. C., & Sorg, A. A. (2017). Long-term economic benefits of psychological interventions for criminality: Comparing and integrating estimation methods. Psychology, Public Policy, and Law, 23(3), 312-323. https://doi.org/10.1037/law0000134
Borduin, C. M., Henggeler, S. W., Blaske, D. M., & Stein, R. J. (1990). Multisystemic treatment of adolescent sexual offenders. International Journal of Offender Therapy and Comparative Criminology, 34(2), 105-113. https://doi.org/10.1177%2F0306624X9003400204
Mann, B. J., Borduin, C. M., Henggeler, S. W., & Blaske, D. M. (1990). An investigation of systemic conceptualizations of parent-child coalitions and symptom change. Journal of Consulting and Clinical Psychology, 58(3), 336-344. https://doi.org/10.1037/0022-006X.58.3.336
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).
Study 10028
Brown, T. L., Henggeler, S. W., Schoenwald, S. K., Brondino, M. J., & Pickrel, S. G. (1999). Multisystemic treatment of substance abusing and dependent juvenile delinquents: Effects on school attendance at posttreatment and 6-month follow-up. Children's Services, 2(2), 81-93. https://doi.org/10.1207/s15326918cs0202_2
Cunningham, P. B., Henggeler, S. W., Brondino, M. J., & Pickrel, S. G. (1999). Testing underlying assumptions of the family empowerment perspective. Journal of Child and Family Studies, 8(4), 437-449. https://doi.org/10.1023/A:1021951720298
Henggeler, S. W., Clingempeel, W. G., Brondino, M. J., & Pickrel, S. G. (2002). Four-year follow-up of Multisystemic Therapy with substance-abusing and substance-dependent juvenile offenders. Journal of the American Academy of Child & Adolescent Psychiatry, 41(7), 868-874. https://doi.org/10.1097/00004583-200207000-00021
Henggeler, S. W., Pickrel, S. G., Brondino, M. J., & Crouch, J. L. (1996). Eliminating (almost) treatment dropout of substance abusing or dependent delinquents through home-based Multisystemic Therapy. The American Journal Of Psychiatry, 153(3), 427-428. https://doi.org/10.1176/ajp.153.3.427
Henggeler, S. W., Pickrel, S. W., & Brondino, M. J. (1999). Multisystemic treatment of substance-abusing and -dependent delinquents: Outcomes, treatment, fidelity, and transportability. Mental Health Services Research, 1(3), 171-184. https://doi.org/10.1023/a:1022373813261
Schoenwald, S. K., Ward, D. M., Henggeler, S. W., Pickrel, S. G., & Patel, H. (1996). Multisystemic Therapy treatment of substance abusing or dependent adolescent offenders: Costs of reducing incarceration, inpatient, and residential placement. Journal of Child and Family Studies, 5(4), 431-444. https://doi.org/10.1023/a:1022373813261
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).