A comprehensive treatment model for co-occurring child maltreatment and parental substance abuse.
The Evidence Summaries presented on this site were drawn from the best available evidence of the program’s effectiveness from this review. It does not necessarily reflect all the evidence about the program. The research was selected and assessed for inclusion on the Menu and towards the evidence rating because it met selection criteria related to the specific topic area, study design, quality assessment and the outcomes of interest.
Overview
Evidence Rating
Pathway
- Early help
- Targeted and specialist
- Continuing care
Australian Study
Risk of Bias
Cost
Target Age Group
About
Multisystemic Therapy for Building Stronger Families® (MST-BSF®) serves families with youth aged 6 to 17 who may come under the attention of child welfare services. The program is an integrated treatment model of Multisystemic Therapy for Child Abuse and Neglect® (MST-CAN®) and Reinforcement-Based Treatment (RBT) for adult substance abuse. It is designed to address co-occurring parental substance abuse and child maltreatment among families and to overcome barriers to service access and treatment coordination for this population. MST-BSF® applies interventions that are individualised to address the individual, family, peer, school and community-level problems of families.
Aims
- Reduce and prevent contact with child protection system
- Prevent and reduce re-abuse and of out-of-home care
- Increase families’ natural support systems to achieve abstinence from drugs and/or alcohol
- Reduce risk to children
- Eliminate parental substance
- Reduce parent and child mental health difficulties
- Sustain treatment gains without ongoing child welfare involvement.
Impact
Evidence suggests that MST-BSF® was effective in reducing the number of alleged maltreatment, the co-occurrence of child maltreatment and parental substance abuse and the the number of out-of-home placements. Youths who received MST-BSF® spent less days out of their homes compared to their Comprehensive Community Treatment (CCT) counterparts but the difference was small.
| Outcome domain | Outcome measured | Positive effect | No effect | Negative effect |
|---|---|---|---|---|
| System | Child protection system contact | Yes | Not found | Not found |
| System | Out-of-home care | Yes | Not found | Not found |
How to read the table:
When ‘Yes’ is indicated for one of the three directions of effect, this means there is evidence of ‘positive’, ‘no effect’ or ‘negative effect’. Evidence is mixed and inconclusive when ‘Yes’ is indicated for two or more directions of effect. Further information about direction of effect can be found on the Using the Menu page.
MST-BSF® has an evidence rating of Supported+.
This means that MST-BSF® has evidence from one randomised controlled trial (RCT) or quasi-experiment (QE) demonstrating positive, long-term impact on at least one child and family outcome.
This assessment is based on one research output of QE design. MST-BSF® has not received a Well-supported rating as it has not yet replicated its results in another RCT or QE with a different population or setting.
| Study design | Number of research outputs included |
|---|---|
| Systematic review with meta-analysis | Not identified or included |
| Randomised controlled trial | Not identified or included |
| Quasi-experiment | 1 |
The evidence has some concerns with risk of bias.
The quality of evidence in the included QE is low and results should be interpreted with caution.
The study was conducted in the United States and does not include Aboriginal children and families.
Aboriginal knowledge and evidence is critical to recognise, document and share practices that lead to improved outcomes for Aboriginal children and families. The department is consulting with the Aboriginal community and stakeholders on how Aboriginal knowledge and evidence is defined and included on the Menu.
Location
- This study was conducted in Connecticut, United States.
Sample
- Participants receiving MST-BSF® were 25 mother-youth dyads served by the New Britain Area Office of the Connecticut Department of Children and Families (DCF). An additional 18 families with similar demographic and case characteristics received CCT.
- Participants identified as White, Non-Hispanic (79%), Hispanic (12%), and Black, Non-Hispanic (5%).
Implementation
Delivery model, mode and setting
- MST-BSF® is delivered in-person, to the parent only, or in a group format with other parents and children.
- The program is typically conducted in the community, home, school and neighbourhood to remove barriers to service access.
Target cohort
- Children and families under the attention of child welfare services
- Children aged 6 to 17.
Program delivery
- Treatment is provided to all adults and children in the family on a 24-hour, 7-day week team availability with on call system.
- A functional analysis of abuse/neglect incidents is conducted and findings are included in service planning and treatment interventions.
- All MST-BSF® families receive:
- Comprehensive adult behavioural substance abuse treatment such as Reinforcement-Based Therapy (RBT) with frequent drug testing
- Safety planning specific to the family to prevent harm to children during family conflict or substance abuse relapse
- Comprehensive family-based clinical interventions that address the drivers of maltreatment, such as poor parenting skills, and other family needs, such as financial instability and low social support
- Sustainability planning to help ensure family gains persist after treatment ends
- A clarification process for parents to accept responsibility for the maltreatment and apologise to their children
- Cognitive-Behavioural Therapy (CBT) for anger management and post-traumatic stress disorder (PTSD)
- Behavioural family therapy
- Other empirically based treatments and case management services to support improve family communication and assistance.
Duration and intensity
- The MST-BSF® team provides a minimum of 3 home visits per week over 3 to 5 months of treatment time (4 months on average across cases).
Guides and manuals
- The MST-BSF® program is supported by traditional MST treatment model and its implementation guidelines and training protocols.
Additional information
- The MST Services website has a fact sheet about MST-BSF®.
Staffing
- MST-BSF® clinicians work as a team of 2 to 4 therapists and one full-time supervisor.
- Each therapist carries a maximum caseload of 4 to 6 families.
- Staff require a master’s degree in Psychology, Social Work or a related subject area.
Training
- We were unable to locate any information on training requirements to implement MST-BSF®.
To our knowledge, MST-BSF® is not available and has not been implemented in Australia.
Cost
We were unable to locate any information on the cost of MST-BSF®.
Conclusion
References
Studies identified and included in the review
- Schaeffer CM, Swenson CC, Tuerk EH and Henggeler SW (2013). Comprehensive treatment for co-occurring child maltreatment and parental substance abuse: outcomes from a 24-month pilot study of the MST-Building Stronger Families program. Child Abuse & Neglect 37(8): 596-607.
Studies identified but not counted towards the evidence rating due to study quality
No studies that were identified were excluded due to study quality.