Multi-Systemic Therapy for Juvenile Offenders (MST-JO)

Intervention Basics

Multi-Systemic Therapy for Juvenile Offenders  (MST-JO) is an intensive family and home-based treatment. It was developed to address the limitations of existing mental health services for juvenile offenders, but it has been modified for use with non-offending adolescents who have substance abuse or conduct-related problems.

The primary goals of MST-JO programs are to decrease rates of antisocial behavior and other clinical problems, improve functioning and achieve these outcomes at a cost savings by reducing the use of out-of-home placements such as incarceration, residential treatment, and hospitalization. MST-JO also helps parents identify their strengths, develop a natural support system, and remove barriers. MST-JO focuses on three interventions:


  • Institutional placement
  • Individual counseling
  • Life/Social skills training


  • Family therapy
  • Parent education
  • Parenting skills training


  • Peer-resistance education

Once the parents have become engaged, they collaborate with the therapist to develop strategies to:

  • Set and enforce curfew and rules
  • Decrease the youth’s involvement with deviant peers
  • Promote friendships with pro-social peers
  • Improve the youth’s academic/vocational performance
  • Cope with any criminal subculture that may exist in the neighborhood
Expectation of Sessions: 
Average of 60 hours during a 4-month period. Ideal treatment cycles are 3-5 months.

Recommended Populations

  • Youth between the ages of 13 - 17 years of age

Special Considerations for Juvenile Drug Courts

JDC teams should understand that MST providers (and program components) should drive treatment decisions regarding youth. Generally it is recommended, regardless of intervention, that there is little attempt made by the court to influence the treatment process; however, this approach would not work well with a JDC team that would sway or alter the treatment as prescribed by the model – where it is delivered (this is a home-based treatment model) or how it is delivered. Program developers and those providing oversight to MST therapists ensure a very high degree of fidelity to the model throughout every stage of the process. Program costs are cited by many jurisdictions as a reason for not sustaining the approach after adopting it with an infusion of grant or other time-limited funding.

Keep in mind that reduction in substance use/abuse is limited to alcohol and marijuana. 

Engagement Strategies

Because this is home-based intervention, once the court has assigned a youth and family/caretakers to MST, engagement and retention is seen as a critical function of the JDC team and the MST team. JDC teams should consider providing additional incentives for treatment compliance for both the youth and the family/caretakers to help increase engagement and retention outcomes (i.e., implement a fish bowl or rocket docket for youth and families working hard to complete treatment goals).  Given the intensity of the treatment approach, it will be helpful for the JDC team to frame program requirements for the youth and family/caretakers based on MST recommendations.

Implementation Requirements/Recommendations 

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