Modifying Multisystemic Therapy with Telehealth to Expand Reach: Preliminary Feasibility and Outcomes

Multisystemic Therapy (MST) is a well-established evidence-based intervention for adolescents who engage in serious antisocial behavior and substance use and face the risk of out-of-home placement. Although MST is effective, the required implementation delivery model has challenges reaching families in rural or underserved areas, limiting access to care. Telehealth-enhanced MST aims to address this gap by expanding service reach while maintaining treatment fidelity and clinical outcomes. The purpose of this study was to establish preliminary feasibility and similar effectiveness of telehealth-enhanced service delivery of MST compared with standard delivery.

This pilot study used a quasi-experimental multi-informant design to assess implementation effectiveness of telehealth-enhanced MST and compare outcomes with standard MST delivery. Five therapists delivered telehealth-enhanced MST to an analytic sample of 29 youth, who were matched to a comparison group using propensity scores.

The evaluation found no statistically significant differences between the two groups in youth placement status or new arrests at the end of treatment. Telehealth-enhanced MST maintained high fidelity to the MST model and produced clinical outcomes comparable to standard delivery.

Findings are consistent with other studies using telehealth strategies for family therapy in community-based settings. This evaluation highlights an example of how to ensure treatment modifications do not compromise underlying fidelity requirements.

These findings provide preliminary support for telehealth-enhanced MST as a feasible and acceptable modification that preserves the effectiveness of MST while improving accessibility.