Multisystemic Therapy – Building Stronger Families (MST-BSF)

MST-BSF is a treatment model for families experiencing co-occurring physical abuse and/or neglect and parental substance abuse. As a specialty substance abuse program, 100% of cases involve parental substance abuse.

With Standard MST principals as the core base, MST-BSF is a mix of MST-CAN and Reinforcement Based Therapy (RBT) for substance abuse. MST-BSF is the first application of RBT implemented home-based and with families who come under the guidance of Child Protective Services.

MST-BSF was developed in 2004 by Drs. Cindy  Schaeffer and Cindy Swenson through funding to the Medical University of South Carolina with the collaboration of Connecticut DCF, Wheeler Clinic, and Maxine Stitzer of Johns Hopkins University. The Annie E. Casey Foundation funded the pilot research. Connecticut DCF funded the clinical services to families and the National Institute on Drug Abuse funded a 5-year recently completed randomized clinical trial.

Like MST-CAN, MST-BSF services are provided in the home through a clinical team consisting of a supervisor, 3 masters-level therapists, a family case manager, and part-time psychiatrist. Importantly, the MST-BSF team works closely with Child Protection to facilitate positive relationships and good clinical outcomes with families.  Our major goals are to prevent out-of-home placement, keep children safe, and to support the parent in attaining abstinence with substance abuse.

Research Outcomes

A research pilot conducted in Connecticut showed strong preliminary support for the effectiveness of MST-BSF in addressing co-occurring child maltreatment and parental substance abuse

  • Reductions in alcohol and drug use during treatment
  • Improved mental health functioning
  • Improved parent-child interactions
  • Mothers 3 times less likely to have another incident of maltreatment
  • Youth 2 times less likely to experience another incident (though not statistically significant)

Medium to large effect sizes were shown on clinically significant outcomes



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