MST programs are usually housed in community-based mental health organizations considered
to have a culture more rehabilitative than punitive. The program staff creates strong working
relationships with referral sources such as juvenile justice and the family court. They work
closely with deputy juvenile officers, social welfare workers, teachers, and guidance counselors,
for example, to obtain the perspectives of multiple systems or "stake-holders" who have the
common goal of improving children, adolescent and family treatment goals. Each youth referred
to the program is assigned to an MST therapist who designs individualized interventions in
accordance with the nine MST treatment principles, thereby addressing specific needs of the
youth and his or her specific environment.
MST is a time-limited (four to six months) intensive therapeutic program that provides services
in the family's home, at other locations (school, neighborhoods), or wherever the family feels
most comfortable. After the initial sessions, family members who attend family sessions with the
therapist will vary depending on the nature of the particular problem being discussed. For
example, children are not included in sessions addressing intimate marital issues between parents
or dealing with poor parental discipline, so as not to undermine parental authority.
Characteristics of the MST model—such as availability of the MST staff (24 hours a day, seven
days per week), flexible scheduling, and delivery of services in the home—all provide safety for
the family, prevent violence, develop a joint working relationship between therapist and family,
provide the family with easier access to needed services, increase the likelihood that the family
will stay in treatment, and help the family maintain changes in behaviors. The MST staff are full-
time practitioners, wear pagers, carry cellular telephones, and work in teams of three. They can
provide intensive services because of small caseloads and have multiple contacts with the family
during the week (sometimes daily). They stay as long as required and at times most convenient to
the family, including weekends, evenings, and holidays. Services provided by staff at unusual
times (10 P.M.to 8 A.M.) are discouraged, except in emergencies. The development of an
informal support system in which the family can call on a friend or family member at crucial
times is part of the treatment goals. Families have less contact with the therapist as they get
closer to being discharged from treatment.
MST is designed to be a flexible intervention to provide highly individualized treatment to
families. Specific treatment techniques or therapies are used as a part of MST interventions.
These include behavior parent training, structural