Engaging Multiproblem Families in Treatment: Lessons Learned Throughout the Development of Multisystemic Therapy

Abstract

Multisystemic therapy (MST) is a family-based treatment model that has achieved high rates of treatment completion with youths who present serious clinical problems, and their families. The success of MST in engaging challenging families in treatment is due to programmatic commitments to family collaboration and partnership as well as to a conceptual process that delineates barriers to family engagement, develops and implements strategies to overcome these barriers, and evaluates the success of these strategies. This article provides an overview of the nonspecific/universal engagement strategies used by MST therapists, frequently observed barriers to achieving therapist-family engagement, and specific strategies to overcome a sampling of these barriers.

Engagement in Mental Health Treatment Among Adolescents and Young Adults: A Systematic Review

“…Almost all of the interventions studies attempted to understand service engagement are primarily based on the ecological perspective . The results of service delivery level interventions indicate that practitioners and organizations have a primary role to play in the engagement process (Cunningham and Henggeler 1999;Liddle 1995;McKay et al 1995a;Santisteban and Szapocznik 1994). As many different types of service delivery level approaches (e.g.…”

“…When client engagement emerges in empirical studies, conceptual definitions vary broadly and frequently refer to clients keeping appointments and staying in treatment (Littell et al 2001). On the other hand, in the practice literature, the term engagement commonly refers to the early stage of activities with clients, whether the emphasis is on cooperation during sessions (Prinz and Miller 1994), emotional involvement in sessions and progress toward goals (Cunningham and Henggeler 1999), or some other aspect of the help-seeking process.…”

Are Children with Anxiety Disorders Privately Referred to a University Clinic Like Those Referred from the Public Mental Health System?

“…Further, engagement with the child and family would also become a therapeutic task. Evidence suggests that client engagement is related to outcomes for families with children experiencing externalizing behavior problems (e.g., Cunningham and Henggeler 1999;Patterson and Chamberlain 1994) and to mental health service utilization among children and families in urban inner cities (McKay et al 1996).…”

Engaging resistant adolescents in drug abuse treatment

“…Most traditional intervention programs, including those that are ecologically based, typically depend on social systems to identify youth in need of treatment services (Henggeler & Borduin, 1990;Sexton & Alexander, 2002). Although youth who are remanded to treatment (e.g., court order, in lieu of school suspension) likely still have limited commitment to change and readiness for treatment (Cunningham & Henggeler, 1999;Diamond, Liddle, Hogue, & Dakof, 1999;Melnick, DeLeon, Hawke, Jainchill, & Kressel, 1997;Prochaska, DiClemente, & Norcross, 1992) most interventions incorporate procedures to enhance adolescents' readiness for change (Dennis et al, 2004b;Waldron et al, 2001) once they begin to meet with a therapist. When youth elude treatment or maintain active refusal to participate in therapy, however, linking them with available services requires the development of qualitatively different and more effective engagement interventions than are currently available in the field.…”