Development of MST in Wales

North-East Wales (NEW) MST Cymru

Betsi Cadwalladr University Health Board, Flintshire and Wrexham Local Authorities are working in partnership to deliver MST in North-East Wales using Welsh Government Transformation Funding.

Multisystemic Therapy is a licensed therapeutic intervention more commonly known as MST. It originated in the USA and is based upon the Socio Ecological theories of Bronfenbrenner and the Causal Model developed by Elliott (1983). Today it has an international evidence base and is used with families in countries across the world. 

MST targets the families of 11 to 17 year olds who are presenting with antisocial behaviours, possibly having involvement of Youth Justice Services and the Police, violent incidents, substance misuse, running away and generally creating a very difficult and out of control family life.

An MST Team consists of one Supervisor and 4 Therapists all of whom have to undertake a significant and thorough interview process before becoming appointed. They also need to be educated to at least Degree level and have substantial experience of working with families. The team receive an initial orientation training of a 5 day period by MST Experts, with the Supervisor having an extra 2 days training. Further training occurs ‘on the job’ via weekly clinical supervision, clinician development  meetings and quarterly ‘booster’ training.

There are also several adaptations of  the standard MST model such as MST-CAN for child abuse and neglect and MST-FIT (Family integrated transitions) for returning young people home from care and custody placements. 

There are currently 3 MST teams operating in North-East Wales: MST, MST-CAN and MST-FIT.

Unlike many other interventions, MST only requires at least one willing significant adult to agree to participate. The referred child does not need to consent for the intervention to be delivered. This is due to MST working with the family member/s to change how they manage and control the eco systems around the young person’s behaviours.

Referrals are made via a child’s social worker and the process can be discussed with the MST Supervisor.