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there is at present a new and specific challenge: some of the pathologies that we are
seeing are the result of the expansion of pornography on the internet. this demands that
we re-examine our technique, and obliges us to broaden our understanding of perversion:
for example, the relationship to addiction; the role of the superego; the nature of the
object in the mind; and the relationship to the body.
a study of multisystemic therapy: a new type of help in the uK for young
people in trouble with the law
by Charles Wells, Brandon Center, London
Mst was developed by the Family services research Center at the Medical university
of south Carolina. it was apparent that mental health services for serious young offenders
were minimally effective at best, extremely expensive and not accountable for outcomes.
they reviewed the research literature and looked for interventions with documented
success in shaping good outcomes for anti-social young people. they also noted which
interventions, some quite popular, have no empirical support. this process of discarding
ineffective techniques while gleaning those most effective means that Mst is really more
an amalgam of best practices than a brand new method.
Mst adopts a social-ecological approach to under-standing anti-social behaviour.
the underlying premise of Mst is that criminal conduct is multi-causal; therefore, effective
interventions would recognise this fact and address the multiple sources of criminogenic
influence. these sources are found not only in the young person (values and attitudes, social
skills, biology, etc.) but also in the young person’s social ecology: the family, school, peer group
and neighbourhood. it is a key premise of Mst that community-based treatment informed by
an understanding of the young person’s ecology will be more effective than costlier residential
treatment. this is true even when you select as candidates for Mst those young people who are
bound for reform of children’s mental health services: Multisystemic therapy as an example.
research has shown that treating the young person in isolation of the family, school,
peer and neighbourhood systems means that any gains are quickly eroded upon return
to the family, school or neighbourhood. Custody stays could also be counter-productive
because an already troubled young person is immersed in a peer culture where antisocial
values predominate.
Mst uses the family preservation model of service delivery in that it is home-based,
goal-oriented and time-limited. it is present-focused and seeks to identify and extinguish
behaviours that are of concern not only to referring agents but also to the family itself. in
fact the entire family is involved with Mst, in contrast to the many interventions that define
the young person as the “identified client.” Mst involvement will typically be between
three and five months.
Collaboration with community agencies is a crucial part of Mst. the school is a
key player and workers may be in daily contact with teachers and administrators. Mst
therapists will also work in close partnership with youth justice officers from the Youth
offending service, which is the referral source. the Mst team will work closely with the
youth justice officers to ensure that Mst is implemented to maximum effect in the context
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