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MST-Problem Sexual Behavior

Multisystemic Therapy for youth with problem sexual behaviors (MST-PSB) targets chronic and violent juvenile offenders who engage in criminal sexual behavior such as

  • sexual assault
  • rape
  • molesting younger children

MST-PSB is built on the foundation of standard MST, an intensive family- and community-based treatment program that focuses on the entire world of the offenders—their homes and families, schools and teachers, neighborhoods and friends. Evidence-based MST-PSB addresses the many factors that influence problem sexual behavior.

PSB graph

As with standard MST, MST-PSB therapists only handle a few cases at a time and see the offender and family in their home setting. During the treatment, they

  • address the denial by the family and offender that there is a problem
  • focus on the aspects of the youth’s environment that contribute to the sexual delinquency
  • help the parents or caregivers to build support networks
  • show the parent or caregivers how to provide unambiguous guidance and support so that the juvenile can develop social skills that will allow him or her to establish healthy relationships with friends


MST-PSB has been shown effective in three randomized clinical trials.

The first, a small 1990 study compared long-term effects of MST-PSB versus the offender receiving treatment from an individual therapist. In a three-year follow-up the study found that only 12.5 percent of the youths in the MST-PSB program committed sexual offenses again. In contrast, 75 percent of the adolescents treated by a therapist reoffended.

In a later study, an 8-year follow-up compared how many offenders who participated in MST-PSB committed sexual crimes again against offenders who took part in usual community services  such as clinics. The results from this study demonstrated the effectiveness of MST-PSB over the traditional community-service approach.

The most recent trial, a large scale effectiveness study assessing multiple domains of functioning through twelve months post recruitment, was published in 2009.

In addition, the cost of MST-PSB was one-fifth of usual community services.

MST-PSB is listed on SAMHSA's National Registry of Evidence-based Programs and Practices (NREPP), which reviews and rates mental-health and substance-abuse interventions and as a Blueprints for Violence Prevention model program which has the most stringent requirements and standards for an evidence-based treatment.

For additional information on MST-PSB implementation visit MST Associates