This program is for families who have a child between the ages of 6 and 17 and an open case with Child Protective Services (CPS) for a report of child abuse or neglect that has been made within the last 180 days.

Multisystemic Therapy for Child Abuse and Neglect (MST-CAN), a community-based program, is an adaptation of standard MST that is designed to promote a safe home environment for youth, decrease out-of-home placements, and improve parenting skills.

Results from an internal randomized controlled trial of MST-CAN demonstrate that families in the treatment group experienced significant reductions in adolescent internalizing problems and out-of-home placements compared to those in Enhanced Outpatient Treatment (EOT). Those who were placed demonstrated fewer changes in placement and decreases in caregiver psychiatric distress, parenting practices associated with maltreatment, and non-violent discipline. In addition, they experienced significant increases in caregiver social support compared to those in EOT. Posttest results from an internal study in a German sample indicated significant reductions in externalizing problems in the intervention group relative to a control group. There were also significant reductions at posttest in the severity of neglect.

MST-CAN takes a strengths-based approach and works with families to reduce incidents of re-abuse, prevent alternative home placements, lessen parent psychological and physical hostility toward youth, improve parent and youth mental health functioning, enhance social support, and strengthen parenting skills. Families are referred to the program by CPS, and, after a needs assessment is conducted, the following interventions are typically provided:

• Cognitive behavioral therapy (CBT) for anger management;
• Trauma-focused CBT for child post-traumatic stress disorder symptoms;
• Behavioral family therapy for communication and problem-solving;
• Prolonged exposure therapy for post-traumatic stress disorder;
• Evidence-based pharmacotherapy for children and adults;
• Safety planning that outlines what family members could do if they feel unsafe; and
• Abuse clarification process in which parents explore their thoughts about the abuse, accept responsibility for the abuse, express awareness of the impacts of the abuse, and apologize to the child and to the family.

Therapists deliver program interventions in the home and in community locations. Medication is provided to youth and parents as needed, and the treatment team provides a 24 hours a day, 7 days a week, on-call service to families to deal with crisis situations. MST-CAN team members are also in regular contact with CPS workers.

MST-CAN is licensed through the Medical University of South Carolina (MUSC). MST Services has an exclusive licensing agreement with MUSC to disseminate MST-CAN technology and intellectual property. Organizations who would like to implement MST-CAN must create goals and guidelines with MST Services, complete a feasibility assessment, and agree to implementation terms to become a licensed program.

MST-CAN is being implemented in six countries across three continents.

This program is implemented by a team of three to four therapists, a full-time supervisor, a case manager, and a psychiatrist who provides 20% time (i.e., 8 hours per week). Team members must complete 5 days of standard MST orientation, on-site or off-site; 4 days of MST-CAN training, on-site; and 4 days of adult and child trauma-treatment training, on-site. Additional on-site supervision, telephone consultations, and on-site booster trainings are mandatory. Please visit http://www.mstservices.com/resources-training for more information.

Considerations for implementing this program include understanding a clinical team must be formed and members must receive training, acquiring buy-in and commitment from families, finding a suitable time for program services, and offering child care for younger siblings.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

If you are interested in implementing MST-CAN, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Treatment lasts 6 to 9 months depending upon participants' needs. Families receive services for a minimum of three times per week, and frequency decreases as progress is made.

Although MST-CAN is intensive and expensive to implement, a cost-benefit analysis performed on data from 86 families in Swenson et al. (2010) demonstrated that the net benefit of MST-CAN versus enhanced outpatient treatment was $26,655 per family at 16-months post-baseline. For every dollar spent on MST-CAN, $3.31 was accumulated in savings to participants, taxpayers, and society. Please use details in the Contact section for information on implementation costs.

To move MST-CAN to the Effective category on the Clearinghouse Continuum of Evidence at least one external evaluation must be conducted that demonstrates sustained, positive outcomes. This study must be conducted independently of the program developer.

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals.  Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu

You may also contact MST Services by phone 1-843-856-8226, email info@mstservices.com, or visit https://www.mstservices.com/contact-us

https://www.cebc4cw.org/program/multisystemic-therapy-for-child-abuse-and-neglect/detailed; http://www.mstservices.com/mst-can-child-welfare-program; https://www.crimesolutions.gov/ProgramDetails.aspx?ID=175; Dopp, Schaeffer, Swenson, and Powell (2018); Schaeffer, Swenson, Tuerk, and Henggeler (2013); and Stallman et al. (2010).