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Methods
Multisystemic therapy (MST) is a home and community based intervention for juvenile offenders. It may draw upon practices from strategic family therapy, structural family therapy, and cognitive behavior therapy in intensive interventions over four to six months. It is based in part on ecological systems theory. Treatment is individualized depending upon the social systems surrounding the youth.

Although treatment is highly variable, it always includes nine core principles. Which are:


 * 1) The client exists within a series of systems
 * 2) Practitioners use existing positive systems to help client create change
 * 3) Interventions should include increased responsibility of family members
 * 4) MST is present-focused and action-oriented
 * 5) Each interventions targets a specific behavior
 * 6) MST interventions should match the developmental age of the child for which they are created
 * 7) Family members are needed to enact interventions
 * 8) Evaluation of interventions occur from multiple perspectives
 * 9) Each intervention is made to be used over long terms and in multiple settings

Effectiveness of MST
There is no evidence that MST can cause harm in participants. Calls have been made for more research into the effectiveness of MST as a youth treatment intervention because the available evidence is inconclusive across studies. Critiques of MST include the limitations of existing research with international and culturally diverse populations, as well as the use of predominantly male sample populations. Regarding use in the Juvenile Justice System, research has found that there is no significant differences in the use of MST over standard out-of-home placement or supervisory methods.

Use in Juvenile Justice System
Practitioners increasingly use Multisystemic Therapy to help youth within the juvenile justice system to reintegrate into society rather than standard probation or treatment as usual (TAU). MST differs from the usual tactics in that it targets criminogenic factors related to an individual's social environment, particularly within the family system. This intervention is associated with decreased rates of antisocial, criminal, and substance misuse behaviors in youth. It has been identified as a promising treatment model for juvenile offenders by the U.S. Surgeon General in reducing rates of recidivism, though results of these studies have shown little statistical significance compared to other intervention models like Functional Family Therapy or standard supervisory practices The lack of statistical significance may be due in part to the variability of program implementation methods from place to place, as the goal of MST is to individualize client treatment. Because of the inconsistency of results between studies, more research is needed in determining a causal relationship between MST and successful juvenile recidivism prevention.