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? 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. 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. Instrumental Outcomes Improved parenting skills Improved family relations Improved access to supports Success in education and training Improved involvement with pro social peers and activities Changes sustained for 3-4 weeks Theoretical underpinnings Social Ecological approach Young 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. Social Ecological Model MST theory of change 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 Therapy Strategic Family Therapy Behavioural Parent Training Cognitive Behavioural Therapy 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 home Providers are accountable for outcomes Continuous quality improvement occurs at all levels How Does MST work in Practice? 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? MST workers work primarily with parents to help them: Increase their parenting skills Improve family relations Involve the young person with more pro social peers and activities Improve school attendance Create family support networks Core elements of MST MST treatment principles MST analytical process MST quality assurance system 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 Finding the Fit; Sample Fit circle Peers reinforce behaviours Ineffective school consequences YP is struggling academically Verbal aggression at school YP does not like school Lack of consequences at home Poor home school link MST Newcastle 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% 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. 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. Typical referral behaviours Verbal and physical aggression at home/ school/ community Low/ no school attendance Offending behaviour Drug and alcohol use Association with anti-social peers Missing behaviours Poor family relations Newcastle to date Started taking referrals in May 2012 Worked with 39 families so far Closed 32 families 27 cases closed due to successfully addressing referral behaviours, 2 cases discharged due to Team’s inability to sustain engagement 2 YP accommodated, 1 YP moved out of area Ultimate 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) Instrumental 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) Instrumental 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 Some feedback on MST Newcastle From Families Our worker never gave up on our moods and she had ideas about resolving each problem Very determined to help the family as much as they could. Very friendly The call service is great as I really needed this How is MST different?; The intense 3 days a week contact and phone contact the whole time I am very grateful to have received the service I would like to say thank you to MST, especially my worker. She has made my relationship with my son better Newcastle’s MST Team Supervisor: Sarah Ritson Abby Waites (Maternity Leave) MST Team: Ashley Robson Philip Sammut- Smith Warren Petitjean New Worker hired but not yet in post For more information… Visit www.mstservices.com Email: [email protected] Telephone: 0191 2782762 Cookery Block - Heaton Complex Trewhitt Road, Heaton NE6 5DY Any Questions?