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MST-Emerging Adults

Multisystemic Therapy for Emerging Adults (MST-EA) was designed for young people aged 17-26 at the highest risk for negative long-term outcomes -- those with multiple co-occurring problems and extensive systems involvement. MST-EA is an adaptation of standard MST, an evidence-based treatment with decades of research supporting its effectiveness with juvenile justice populations. MST-EA has been tested thus far with young adults who have justice involvement and co-occurring behavioral health disorders (including mood, anxiety, trauma, psychotic, and/or substance abuse disorders). These young adults present extraordinarily high rates of recidivism and are at elevated risk for expensive placements.

MST-EA clients can be living on their own, with family or friends, in foster care, or in community-based group homes. Referred clients have included juvenile and adult justice-involved clients, youth aging out of foster care, prison re-entry populations, and young people in supported housing programs.

Treatment Targets

MST-EA has been used to:

  • Reduce recidivism and
  • Treat mental illness:
    • Mood Disorders (including Bipolar Disorder)
    • Anxiety Disorders (including PTSD and other trauma-related symptoms)
    • Psychotic Disorders (including Schizophrenia)
  • Treat substance use
  • Target housing and independent living skills
  • Target education and career goals
  • Develop an effective social network (including family, friends, and partners)
  • Reduce interpersonal conflict and maintain client and social network safety

Treatment Description

MST-EA addresses factors that are the most likely causes of offending and behavioral health problems in emerging adults. Further, MST-EA directly supports the developmentally appropriate life goals (e.g., education, employment, housing) of emerging adults and also helps them build an effective social network, while retaining the underlying principles, processes, and service delivery model of standard MST.

The emerging adult collaborates with the MST-EA therapist in designing the treatment plan that will be carried out over approximately 7-8 months (services generally range 4 to 12 months depending on client needs). Contact is multiple times per week in-person and by phone, and emerging adults are an active participant in each stage of treatment and planning for post-treatment success. Therapists are available 24/7 to emerging adults and their social network to address emergencies and remove barriers to treatment.

The emerging adult is the focus of MST-EA; therefore, family or caregiver involvement is not required. However, involvement of family or other natural supports is strongly recommended, and all efforts are made to identify such supports and include them in treatment. As needed, MST-EA teaches parenting skills to young adult clients who are pregnant or parenting.

The MST-EA team includes paraprofessional “Coaches” who help teach clients concrete life skills and engage clients in sustainable prosocial activities. In addition to treatment from a MST-EA therapist, psychiatric and physical health professionals are engaged by the MST-EA therapists to coordinate effective psychopharmacological and other health care.

Published Outcomes

Aside from the extensive efficacy and effectiveness data supporting standard MST for youth with antisocial behavior and other serious problems, preliminary support for MST-EA comes from both an open trial conducted by investigators and the clinical data collected by the community-based MST-EA program. This NIMH- and NIDRR-funded work focused on evaluating MST-EA for young people aged 17-21 who had both justice involvement and serious mental illness (most of whom also were treated for substance use problems). Outcomes from this initial research are summarized in two peer-reviewed publications and demonstrate.

For additional information on MST-EA implementation contact us.