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KVC Kentucky

Exploring Multisystemic Therapy Services

In August 2022, KVC Kentucky established a new partnership with the Department for Community Based Services (DCBS) to provide Multisystemic Therapy (MST) services for at-risk youth and their families. These services are made possible through state and federal funding and are administered through nine service regions and offices serving all 120 Kentucky counties. Families and youth referred to KVC Kentucky by DCBS can receive Multisystemic Therapy (MST) to stabilize placement in the home and increase overall healthy family function.

Janet Lewis, MST Supervisor

“We can help an individual to change and teach them to be different,” explains Janet Lewis, KVC’s MST Supervisor. “But as soon as you put them back in that same environment, then they’re going to conform back to the old behavior.” With a therapy that works with the whole family, as MST does, the environment also changes, not just the youth.

Let’s explore what makes this therapeutic approach both so unique and so effective.

What is Multisystemic Therapy?

Multisystemic TherapyMST is a research-based intervention designed to serve young people ages 12-17 with an approach toward the child’s entire ecosystem, which includes family, peers, school, community and more. This in-home family therapy program is available to families referred to KVC when a child is at risk of being placed out of the home, typically due to behaviors involving the legal system or truancy at school.

The Multisystemic Therapy model has proven to be helpful in changing the dynamics of these youth and steering them toward more positive engagement with their homes and communities. Although Multisystemic Therapy is new to KVC, it is not a new therapy practice and thus has very intensive training, research, and national support behind it. Our MST team continues to grow, and we look forward to bolstering our staff with MST Clinical Specialists to serve our community.

What makes MST so unique? First, it’s the family focus: 90% of the work with MST is with the entire environment of the young person and their family. Practically, this looks like active involvement with caregivers — empowering them to inspire change. With this assessment-based and family-centric approach, MST helps families develop solutions they can maintain after the therapy has concluded.

Instead of treating a young person away from home, and then placing them back in an environment where nothing has changed, MST treats within a young person’s natural ecology. This approach is family-driven, culturally-attentive and gets to the real roots of where problematic behaviors begin.

Walking Through the MST Process

From the moment a young person is referred to KVC for MST, to the final in-home therapy session, the process can take anywhere from three to five months. Families enrolled in MST therapy can expect two or three weekly meetings lasting up to three hours each. Sounds intensive? That’s by design. Because the intention is for the child to remain permanently in the home, each therapy session takes place within the home, starting with the initial assessment.

Fit Assessment

A Fit assessment is an MST tool used to identify problematic behaviors and the drivers behind them. This process lays the groundwork for therapeutic priorities. Which behaviors and drivers are most important to target first? What next steps are needed to get to the core of an issue? How can families work together and work outward to understand and treat interconnected actions? These questions and more are addressed through the holistic assessment process.

As part of the initial Fit assessment, we focus on outlining the desired outcomes for each individual in the family (the child, the caregivers and any siblings or other people in the home), as well as the desired outcome from the referral source, the school system, the court system and any other involved parties in the community. This multi-tiered approach is one reason why MST is such a successful and proven treatment.

Multisystemic Therapy

Continual Reassessment

Another great strength of the MST therapy model is its heavy emphasis on assessment throughout. MST therapists are always assessing whether the interventions are working and if the families and youth are engaged in the process and putting forth continuous effort. Not working? Then it’s time for a pivot.

Because the MST process takes place over several months, the focus is not on quick solutions. Many traditional therapy interventions focus on problem-solving each session. In contrast, MST is focused on assessing every Fit and every driver, making it extremely flexible to each unique situation.

Training and Expert Support

All MST therapists at KVC Kentucky receive expert training and support from the MST Institute, as well as a dedicated MST expert to assist with the implementation of the model. Each member of the MST team attends a five-day orientation, plus booster training each quarter. MST therapists also send weekly summaries of their cases to our MST Supervisor, which are reviewed by our MST Institute expert to ensure adherence to the model across states and agencies.

“MST is about staying present in the here and now rather than getting stuck in the problems of the past,” said Lewis. “Weekly reviews are about the now, not the before. We focus on the positive and looking forward.”

Sustainable Benefits and Proven Results

Families in MST are empowered to be their own change agents, so the treatment plans remain sustainable after the therapy has concluded. MST therapists focus on helping families stay present-focused and goal-oriented, constantly directing them back to their strengths when the family feels like giving up. With MST, families can take ownership of the therapeutic process. Their voices are heard, and the family unit as a whole is empowered to change.

When it comes to the advantages of MST, the results speak for themselves:

Multisystemic Therapy

  • 91% of youth in the program were able to remain in their home
  • 86% of youth in the program experienced an improvement in school attendance and academic performance
  • 87% decrease in youth arrests after starting the program
  • 95% had no abuse incidents following the program
  • 91% of youth reported no PTSD for abused and neglected children following the program

A Family-First Approach

What makes MST so effective is the focus on family members as agents of change. MST helps families develop parenting skills, encourage structure in the young person’s life and determine interventions to deal with the drivers contributing to behaviors. Multisystemic Therapy is transforming lives in communities around the world, and we are proud to offer these services to families in Kentucky.


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