Evidence has shown that Multisystemic Therapy (MST) has been particularly effective in the treatment of youth with antisocial behaviour from ethnically diverse backgrounds. Although the process of change within MST has been explored, there is a dearth of research in looking at this for families from ethnic minority backgrounds. This qualitative study aimed to explore ethnic minority caregiver experiences of MST and understand how this might impact on engagement, the presenting problems and the process of change. Semi-structured interviews were conducted with seven ethnic minority caregivers who had completed treatment. A constructivist version of grounded theory was used to analyse the data. Specific cultural theoretical codes that emerged were around the consideration of cultural difference in terms of the engagement process, the conceptualisation of difficulties and the therapist acting as cultural broker in the process of change. This research integrates culturally specific ideas into the existing MST Analytical Process. Practitioner points• Being culturally understood, cultural sensitivity and respecting difference can help engagement with ethnic minority caregivers • The role of culture may be important to consider in the conceptualisation of difficulties • For change to occur therapists may need to act as cultural brokers

Multisystemic Therapy (MST) is an intervention offered to adopted young people presenting with antisocial behaviour. Despite the substantial evidence base for MST in non-adoptive populations, a review of the literature identified that there has been no evaluation of its effectiveness in adoptive populations. This qualitative study aimed to provide the first exploration of adoptive parents’ lived experiences of standard MST in relation to their context as an adoptive family, focusing on aspects of the intervention that promoted or limited change. Ten semi-structured interviews were carried out with 11 adoptive parents. Thematic analysis identified five major themes that were service user validated: situation prior to MST; enablers to change; barriers to change; outcomes of MST; and developing MST to better meet the needs of adoptive families. Findings suggest potential advances to current MST practice to meet the needs of adoptive populations, including the importance of appropriate training and supervision, sensitivity working with adoption and the incorporation of adoption related theory. Limitations and future developments are also discussed.