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MST approach helps troubled youth, families

Social workers in St. Croix County are the first in Wisconsin to help at-risk juveniles in a new way.

For the past year, the county's Youth Community Support Services Department has used the Multi-Systemic Therapy (MST) treatment program to assist troubled kids in getting the help they need while staying in their own homes.

In years past, the standard intervention program involved social workers sending chronic young offenders to state-run juvenile detention centers or to foster homes. And the focus of any treatment efforts mostly centered on the individual child.

MST, however, aims to keep juveniles at home and treatment efforts focus not only on the child but also the entire family. Current research indicates such an approach is more effective for setting troubled young people on a better path, because parents are part of the solution.

The MST program has so far proven to work well locally, according to Kathy Dunlap, the county's YCSS administrator. Several counties in Minnesota successfully use the MST approach, but no other counties in Wisconsin have implemented the program.

Dunlap says she's amazed with its success and the quick change seen in some previously troubled families.

"This agency is excited about this program," she said. "We believe this to be a very effective tool for some of our families. It isn't necessary for all of the families. Some of our families don't need this intensive level, but for those families that do, it's great to have the ability to offer it."

The first MST case in St. Croix County started on Feb. 3. There are currently 12 active MST cases dealing with kids ranging from 11 to 17 years old and there are additional high-risk juveniles on a waiting list.

"Of the 19 kids that have closed cases or are currently being worked with, we determined that 17 of them, in our professional belief, had a very high likelihood that they would have been placed outside of the home by this point," Dunlap said, "which is a costly venture for the county and it doesn't instill change."

Dunlap estimated the cost of a foster home placement might average $40 a day, and some placements can cost nearly $375 a day. On average, MST costs around $7,000 per case, but Dunlap says it's worth the money because it really works.

"What MST does is create long-lasting change within a family," she said. "If we put a child in out-of-home care ... often you don't have parents that are fully engaged and participating in anything that has to do with change within the home. There has to be that in order to have life lasting change."

The MST system works because it is an intensive program that requires a great commitment from family members, therapists and at-risk kids and county officials. Law enforcement and school personnel, as well as family friends, are also involved in the treatment effort.

MST therapists spend about 10 hours a week with each family, and the two therapists are on call 24/7. Every week, the therapists and clinical supervisor review each MST case to make sure enough progress is being made.

Dunlap said the intensive work with families is designed to last about 20 weeks. But some families might be released after just 12 weeks and others might remain in MST for 25 weeks or more, depending on their progress.

"What really drives how long we're in the family is whether or not they have been able to make change and whether or not they're able to sustain the change for like a four-week period. And then we start to move out," she said.

Timothy Markgraf, the county's YCSS supervisor, said the families that successfully complete the program are more likely to avoid county intervention in the future.

"The ultimate goal is that the family is not reliant on assistance and services," he said. "So the family can manage their issues on their own or tap into their informal supports to help them deal with particular issues and problems."

By always being on call, Markgraf said, MST therapists can help talk families through crisis situations and possibly avoid the involvement of law enforcement or out-of-home placement.

When working with families, Markgraf explained, it helps to "teach in the moment and educate them through that particular crisis that they're dealing with."

Jane Hurley Johncox, MST clinical consultant, said even if there are "bumps in the road" where families need help, the hope is that setbacks will be minor and clients will get back on course quicker because of their MST experience.

"We see it as our responsibility to get the family engaged and keep them engaged in the process," she explained. "We're continuously looking at how to get any changes to be sustained."