In this section:

Multisystemic Therapy for Child Abuse and Neglect (MST-CAN®) and Functional Family Therapy through Child Welfare (FFT-CW®)

Responsible government

  • New South Wales

Fourth Action Plan actions

  • Primary prevention is key
    • 5 Promote healthy and safe relationships and build gender equitable values through initiatives for children and young people.
  • Support Aboriginal and Torres Strait Islander women and their children
    • 8 Develop innovative and alternative models for victim and perpetrator support that contribute to safe healing and sustainable behaviour change.
  • Respect, listen and respond to the diverse lived experience and knowledge of women and their children affected by violence
    • 11 Deliver policies and services to address the disproportionate impact of violence on particular groups.

What are we doing?

Multisystemic Therapy for Child Abuse and Neglect (MST-CAN®) and Functional Family Therapy through Child Welfare (FFT-CW®), deliver world-leading evidence-based in-home therapeutic services for the whole family, which focuses on treating underlying causes of trauma, harm, and concerning behaviours.

The primary goals of MST-CAN® and FFT-CW® are preservation and restoration, that is, to reduce the number of children entering out-of-home care (preservation) and increase the number of children exiting out-of-home care (restoration). These models have been shown to be successful with families internationally.

The NSW Government is providing over 900 places per year via these evidence-based intensive family preservation and restoration services aimed at keeping families together. Supporting Aboriginal families is a priority for these services.

FFT-CW® is an evidence-informed home and community-based treatment for families with substantiated physical abuse and/or neglect of a child or young person aged 0 to 17 years, and provides a comprehensive family therapy for at-risk families. The model also aims to address child abuse and neglect, substance abuse, mental illness, school difficulties and history of out-of-home care or involvement with the NSW child protection system. The model focuses on engaging with the family’s broader social environment, and develops each family’s social and community networks that are considered a central component of the service response.

MST-CAN® is a home-based evidence-based, 24/7 intensive therapeutic treatment model for families where there has been substantiated physical abuse and/or neglect of a child or young person age 6-17 years. The model provides 24/7, intensive support to a family where the Therapists meet with the entire family a minimum three times a week in their home at times convenient to the family for up to nine months and provides a 24/7 on-call service for families in crisis. MST-CAN® focuses on empowering the family by using identified strengths to address the family’s needs, and developing and building upon family and community support networks.

What have we achieved so far?

MST-CAN® and FFT-CW® have been fully implemented in NSW. There are MST-CAN® teams in six priority locations and 18 FFT-CW® teams in 11 priority locations across NSW.

Since MST-CAN® and FFT-CW® commenced in August 2017, 3,957 referrals have been accepted into the programs, including 1,070 Aboriginal families. As at June 2021, a total of 1,762 families have successfully completed therapy, including 442 Aboriginal families.

An initial independent outcomes evaluation of MST-CAN and FFT-CW by the National Drug and Alcohol Research Centre at the University of NSW was completed in late 2020. This evaluation demonstrated that although the programs are in the early stages of their life cycle:

  • Completion rates across both MST-CAN and FFT-CW are positive.
  • Entries to care are substantially lower than control groups for families who have successfully completed programs.
  • Lower re-report rates than control groups for families who successfully completed other programs.
  • Referrals of Aboriginal families have been lower than expected and the number of Aboriginal families accessing services could be improved.
  • Families and districts are enthusiastic about the therapeutic and practical value of both programs.

The Greater Sydney COVID-19 Delta outbreak in July 2021 has had the greatest impact in eight LGAs of concern, leading to tighter restrictions in South Western and Western Sydney which impacted a number of Sydney-based teams. As essential services, all FFT-CW and MST-CAN practitioners have continued to utilise COVID-safe service provision, including working from home and transitioning to telehealth via phone or video at families’ request.

What is next?

MST-CAN® and FFT-CW® will continue to collect evidence to shape the service system for vulnerable families. Ongoing improvements being made to the programs include:

  • Continuing to evaluate MST-CAN and FFT-CW on a regular basis
  • Identification of the characteristics of families who withdraw early
  • Continuing a project to understand the experience of Aboriginal families, and identify and implementing strategies to increase referrals of Aboriginal families into MST-CAN and FFT-CW
  • Revising the program logic to review the relevance of the current suite of outcome measures
  • Continuing to work with stakeholders to further embed the models to the NSW content.

The 2020-21 NSW Government budget announced a four-year commitment of up to $171.9 million ($41.4 million in 2020-21) to implement therapeutic programs that support family preservation and restoration across NSW, such as Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) and Functional Family Therapy – Child Welfare (FFT-CW).

What difference will we make?

The aim of MST-CAN® and FFT-CW® is to deliver improved outcomes for children, young people and families experiencing vulnerability. Both models deliver an in-home therapeutic service for the whole family, which focuses on treating underlying causes of trauma, harm and concerning behaviours.

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