Multisystemic Therapy for Youths With Problem Sexual Behaviors: Development and Dissemination of a Family-Based Treatment

Abstract

Sexual offenses and other problematic sexual behaviors by youths are viewed in many countries as a legal problem rather than as a public health problem that can be treated. Multisystemic Therapy for Problem Sexual Behaviors (MST-PSB) was developed to address the dearth of effective treatments for youths with criminal and non-criminal sexual behavior problems. This article begins by describing the empirical and theoretical underpinnings of the MST-PSB treatment model and the various characteristics of the model that make it well suited for the treatment of youths with problem sexual behaviors. Next, we discuss the various clinical interventions used in MST-PSB and delineate how the model is operationalized and provided to youths and their families. Research findings that demonstrate the positive clinical outcomes, mechanisms of change, and economic benefits of MST-PSB are then reviewed, followed by a summary of how MST-PSB is implemented by provider organizations using a comprehensive approach to establishing and maintaining treatment fidelity. For family therapists who treat youths with problem sexual behaviors but are not practicing within an MST-PSB program, we hope that the conceptual framework, clinical interventions, and treatment principles described in this article can contribute to the effectiveness of your work. In addition, we suggest that administrators of programs that treat youths who engage in problem sexual behaviors should consider the current evidence base as they make decisions about the adoption of interventions for this clinical population of youths. Finally, we recommend that comprehensive, empirically supported treatment models such as MST-PSB be increasingly considered by policymakers when allocating scarce financial resources to treatments for youths with problem sexual behaviors.