The Development and Transportability of Multisystemic Therapy-Substance Abuse: A Treatment for Adolescents with Substance Use Disorders

ABSTRACT Multisystemic Therapy (MST; Henggeler, Schoenwald, Borduin, Rowland, & Cunningham, 2009) is an evidence-based treatment that has been shown to be effective with adolescents with conduct-related problems. This article describes the development and transportability process related to an adaptation of MST titled Multisystemic Therapy-Substance Abuse (MST-SA). MST-SA is designed to treat adolescents with substance use disorders and is based on the work of Budney and Higgins (1998) and Azrin and colleagues (2001). Budney and Higgins have developed an effective treatment for adult cocaine abusers titled Community Reinforcement Approach (CRA). CRA is a form of contingency management (an evidence-based treatment for substance use disorder), which consists of frequent drug testing, an extensive reward system, functional analyses of triggers for drug use, plans to address triggers for drug use, and drug refusal skill training. Azrin and colleagues (2001) have developed an effective treatment for adolescents with substance use disorders, which includes an extensive list of rewards adolescents can earn for having negative drug screens. This article discusses results from an adaptation pilot, a randomized clinical efficacy trial, an effectiveness trial, and transportability pilots of MST-SA. Overall, results have been favorable for MST-SA, and efforts to transport MST-SA are underway with more than 30 transportability pilots of MST-SA in the United States, England, and Denmark.