Multisystemic Therapy (MST) is an evidence-based intervention for youth at high risk of severe system consequences due to serious anti-social and/or delinquent behaviors. Youth and families receive support within their communities via a full team of licensed MST providers. Central to the MST treatment approach is the view that the MST “client” includes not only the youth, but also the multiple systems within which the youth is embedded: immediate and extended family, peers, schools, neighborhood, providers, and other key participants. MST teams provide immediate support to families when and where it is needed—within any combination of these systems—and are dedicated to improving youth and family functioning. See full description of services under “Additional Information”.
The MST Services team preserves the integrity of the treatment model, thereby ensuring the best possible outcomes for the youth and families treated. MST Services maintains licensing agreements with all MST provider organizations, provides training and quality assurance procedures, in addition to leadership and support in program start-up/expansion, program adherence, program development, and adherent implementation of MST to have accountability for program outcomes. In Texas, MST Services employs three (3) experts and two (2) program developers, whose roles and functions are described above.
Services take place in the home, school, and community of the youth and their family. Local Mental Health Authorities (LMHAs) providing MST services include but are not limited to the following counties: Comal, Hays, Uvalde, Denton, Lubbock, Collin, Ellis, Guadalupe, Caldwell, Gonzales, and Hidalgo. See HHSC LMHA site map under “Additional Information”. Local Mental Health Authority Service Areas (texas.gov)
Referrals can be made from a wide range of sources that come into direct contact with the child or youth including social workers, case managers, probation officers, community-based mental health providers as well as parents, legal guardians, foster parents, or other caregivers.
For the programs funded through HHSC, services are free for families who are referred to and enroll in the MST program.
The target population to receive MST services includes youth between 12-17* years of age at risk of serious system consequence due to serious externalizing, anti-social, and/or delinquent behaviors
*Exceptions for youth ages 10, 11, or 18 can be requested
Example Behaviors include:
• Theft and other criminal behaviors
• Aggressive/violent/assaultive behavior
• Substance abuse
• Selling substances
• Chronic school absences and/or problem behaviors at school
• Sexual offenses in conjunction with other anti-social behavior
Examples of Serious System Consequences include:
• Out-of-home placement (e.g., via juvenile justice mental health, youth care, or social care)
• Arrest and/or charges
• Violation of probation
• School expulsion
• Child Welfare involvement
• Youth might present with diagnoses including, but not limited to Conduct Disorder, Oppositional Defiant Disorder, Substance Use Disorders, and/or ADHD
• Youth might also present with co-occurring needs in conjunction with anti-social behaviors
o e.g., trauma-related symptoms, depression, anxiety, mild or moderate intellectual disability, autism spectrum disorder level 1/childhood autism based on mild difficulties
• Youth living independently.
• Youth who engage in sex offending in the absence of other anti-social behavior
• Youth with moderate to severe autism (difficulties with social communication, social interaction, and repetitive behaviors)
• Youth who are actively homicidal, suicidal, or psychotic
Youth whose psychiatric problems are primary reason leading to referral, or who have severe and serious psychiatric problems.
The average length of treatment for MST is 3 to 5 months. MST program discharge criteria, however, are based on achievement of goals set by the family and the MST team (i.e., are outcome-based rather than duration-focused).
MST professionals are Master’s-prepared (clinical degreed) professionals. The minimum license requirements to become an MST Therapist in Texas are: LPC-A, LPC, LCSW, and LMFT. An MST professional working actively under the supervision of LMSW may also be considered.
Yes! Each LMHA providing MST services has or is pending hire of a Spanish-speaking MST professional. In the event additional bilingual services are needed, each LMHA is equipped with access to obtain an interpreter.
MST engages families by doing ‘whatever it takes’ and anticipates active participation by the primary caregiver(s) and other family members. The MST staff should contact the youth and family according to the frequency with which is necessary to achieve targeted weekly goals. Therapists are expected to go to great lengths to engage hard to reach families/caregivers and are trained to work and collaborate with families/caregivers who may have had previous involvement in the JJ system and/or other treatment services.
Yes! Master’s level QMHP’s are eligible for hire in Texas. Bachelor’s level QMHP’s may also be considered.
General steps to become a mental health professional in Texas are as follows:
- Complete a bachelor’s degree in a behavioral, social science, or psychology field.
- Earn a master’s degree in mental health counseling.
- Complete graduate and postgraduate internship experience for certification/licensure requirements.
- Pass any required counseling exams for licensure.