Multisystemic therapy (MST) is a family- and community-based treatment of serious emotional and behavioural problems presented by adolescents. The development of this model began in the late 1970s, and today MST is a leading evidence-based treatment of serious antisocial behaviour in youths, with programs transported to more than 30 states in the United States and 12 nations, including Australia and New Zealand. This article rerviews the theoretical rationale that underlies MST and presents the central clinical features of the intervention model. In addition, the training and quality assurance protocols used to promote MST program fidelity and treatment adherence are described. Finally, findings from approximately 15 published randomised and two quasi-experimental clinical trials with youths presenting serious clinical problems (e.g., violence, substance abuse, serious emotional disturbance, sexual offending, and chronic illness) are summarised.

Multisystemic therapy (MST) is a highly individualised family- and home-based treatment that has successfully served as a clinically effective and cost-effective alternative to out-of-home placements (e.g., incarceration, psychiatric hospitalisation) for youth presenting serious clinical problems. MST clinical procedures are reviewed and two extensive case summaries are used to explicate the MST intervention process for treating serious antisocial behaviour and modifications in that process needed to safely and effectively serve youth presenting psychiatric emergencies.

Multisystemic therapy (MST) is a family- and community-based treatment that has successfully served as a clinical and cost-effective alternative to out-of-home placements (e.g. incarceration, psychiatric hospitalisation) for youths presenting serious clinical problems. MST clinical procedures and findings from MST outcome studies are reviewed. Several key features differentiate MST from prevailing mental health and juvenile justice practices and probably account for its relative success. These features include interventions that comprehensively address the known determinants of clinical problems, the provision of services in home and community settings to promote service access and ecological validity, and a philosophy that emphasises provider accountability for family engagement and outcomes.