Working as a family therapist has been one of the most rewarding and fulfilling jobs I have ever had. It’s never fair to make a comparison between two things but working as private therapist was almost a vacation compared to sitting in someone’s home while they are yelling and shouting at each other in front of you, or even sometimes witnessing an out of control anger rage with all that it could include, even flying objects that might hurt you.
When I started as an MST (Multisystemic Therapy) therapist I was full of fear and anxieties if a young girl like me could manage to make such an impact and change on what we call dysfunctional families. One of the biggest lessons I have learned is that age doesn’t make a difference but a heart can. Meeting these families wholeheartedly and believing in the possibility for change in every and each human often made the magic. Seeing people as dysfunctional can often be the root of their dysfunctionality. Instead we look at the reality of every behaviour and its functionality within the family, school and other systems. We try to find out what the desired outcomes of each and every behaviour are and we work together towards the real desires instead of falling into old dysfunctional habits that never worked out.
MST method builds on the theory of change with the assumption that caregivers are usually the main conduits of change within adolescent behaviour. MST maintains a systematic focus; the whole is more than the sum of its parts. MST is an intensive family community based treatment for adolescents presenting serious antisocial behaviour and their families. The home based model overcomes barriers to service access with high fidelity. MST therapists address any known risk factors that have an effect on the undesirable behaviour (at individual, family, peer, school or community levels). The family is viewed as central to achieving favourable outcomes as MST promotes family functioning as the key mechanism of clinical change for the children and adolescents.
One of the most important facts in MST that no other therapy methods has is the method’s faith in the inherent strength of each family and the therapists most important part is to engage and empower the family to make the changes they want, rather than doing it for them. The idea is that when the therapist leaves the family they have become therapists themselves and can tackle new problems on their own.
I could never imagine the possibilities this work could give me, entering people’s homes, gaining their trust, showing them an accepting yet hopeful attitude, laughing together when a mum proudly no longer falls for the button pushing strategies of her child. It is quite a moment when you finish the treatment and the goals are met.
One of my most eventful days at work was when I had a social support meeting, gathering the relatives of a single mom who had been struggling between maintaining her work schedule and monitoring her son’s curfew. One of the surprises that no one could have expected was that the tough boy who was so good at provoking everyone, myself included, showed for the first time his soft side when he saw all his relatives gathered together with his mother. He and his mother recognized a strength and belonging that they hadn’t paid attention to before.
These are the core goals that we try to achieve during each treatment:
- Engaging families and specifying their strengths. Helping families shift their focus from all the failures to see the small and big accomplishments each one of the family can make.
- Promoting positive family relationships and parenting practice through continuously mapping the ineffective strategies and evaluating the effective ones.
- Steering teens away from deviant peers and towards prosocial friendships and activities and helping parents to take an active role in promoting that change.
- Improving school performance and preventing dropout. We work on the home school link and create new strategies helping the parents to monitor school performance.
- Helping caregivers develop strong social support networks. We map down neighbours and family members. Friends that in one way or another can strengthen the family’s new strategies. We even sometimes help to create these links by guiding the family to take initiative towards building new relationships or repairing broken ones.
MST – the treatment proven to decrease crime, violence and substance abuse. Something that sets MST apart from some other treatments is that it has evidence—concrete evidence and three decades of research did confirms MST reduces criminal activity and out-of-home placements for violent and chronic offenders. Results show:
- long-term re-arrest rates reduced by 25-70 percent
- out-of-home placements reduced by 47-64 percent
- families functioning much better
- decreased substance use
- fewer mental-health problems for serious juvenile offenders
And MST’s positive results are long lasting. A 14-year follow-up study by the Missouri Delinquency Project showed youths who received MST had:
- up to 54 percent fewer re-arrests
- up to 57 percent fewer days of incarceration
- up to 64 percent fewer drug-related arrests
- up to 43 percent fewer days on adult probation
