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Multisystemic Therapy - Case Study

The Case Study

This case was referred to MST because of the physical aggression of the daughter towards her mother and father.  Hostility within the household stemmed from frustration around the daughter’s poor attendance at school. She was also coming home late and had a friendship group that neither parent approved of. The parents struggled to set boundaries and attempts to steer their daughter’s behaviour often resulted in physical outbursts. They also had a bad relationship with their daughter’s school. 

Within the family unit, a safety and behaviour plan were introduced. The safety plan sought to avoid hostility through better communication and a recognition of the triggers for aggression. The behaviour plan, for the young person and her brother, helped the parents develop agreed house rules and a set of rewards for adherence.  
Outside the home, the MST therapist worked with teachers at the school to make attendance more appealing. This involved addressing problems at school as well as disincentivising missing school and staying at home.  Additionally, the therapist also helped with the daughter’s time management skills, helping to set a morning and an evening routine.

The family unit was progressing well, but at three months they hit a difficult period in the run-up to the school Christmas holidays. Working with the therapist, they developed specific communication plans for the school Christmas holiday period. The plan and the holiday were a success, communication improved and arguments, when they did happen, were reduced and nonviolent. 

The final approach the MST therapist adopted was to support the relationship between the mother and daughter. The young person confided in and trusted her mother; but conversations between the two would often get shut down by her mother’s frustrations with school attendance and her friendship group. The therapy built on the trust already present to help the mother and daughter to have a more constructive relationship. Mentoring, advice and support helped the daughter to, among other things, change her peer group, helping her break another source of family tension. 

This case is typical of many MST cases, where a therapist seeks to address the causes of problem behaviour with the family and other parties, in this instance the girl’s school. The MST therapy sessions ended with the family in a much happier and stable position, and with the daughter being removed from the ‘Child at Risk’ register.

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