Multisystemic therapy across Europe: Implementation and evolution

Multisystemic Therapy (MST) is a community-based, family intervention for young people with complex social, clinical and educational problems such as aggression, antisocial behaviour or substance misuse. Since the first efficacy trial (Henggeler et al., 1986) and subsequent implementation of MST, the treatment has been expanded globally. There are now more than 600 MST programmes across 15 countries worldwide, including 10 European countries. This article reviews the MST journey in Europe, regarding its implementation, research and adaptation. The difference between the US emphasis on fidelity of implementation and the more flexible need-responsive approach taken in Europe is discussed, together with the implementation challenges related to cultural and contextual differences. We provide a reflection on the related research challenges and differences found in trial results between the US and Europe. The article highlights the way Europe has responded to societal needs by developing more tailored and adapted programmes and the subsequent implications for research.