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Model Program Seal

Multisystemic Therapy - Problem Sexual Behavior (MST-PSB)

Blueprints Program Rating: Model

A juvenile sex offender treatment program to reduce criminal and antisocial behavior, especially problem sexual behavior, by providing intensive family therapy services in the youth’s natural environment over a 5-7 month period.

Initial Training and Technical Assistance

The program development & start-up fee for one MST-PSB team is $11,000 and $8,000 for any subsequent teams. This fee includes assessment of provider readiness, establishment of program parameters, review of local legislation pertinent to the target population, identification and engagement of community stakeholders, workforce development support, presentation of the MST-PSB model in a community forum, and a 2-day MST-PSB clinical orientation training for treatment team members and program administrators.

Implementing sites are also responsible for paying for travel costs for MST-PSB trainers to attend the orientation at the agency site and a community orientation. These costs are estimated at $4,000.

Team members who are new to the MST model must also attend a 5-day, standard MST orientation training (provided by MST Services in Charleston, SC) to acquire the basic foundations of the MST model; the cost of this training is $850 per staff member, plus travel and lodging costs.

Curriculum and Materials

Costs for curriculum are subsumed within the initial training costs described above.

Licensing

Annual license fees of $4,000 per organization (Agency license) and an additional $2,500 per team (Team license) are required.

Other Start-Up Costs

Costs above are calculated for one MST-PSB team, trained together with their supervisor. Increasing the number of teams trained at one time can produce economies of scale.

Ongoing Curriculum and Materials

None.

Staffing

Ratios: Each MST-PSB therapist serves an average of 4 families at a time.

Qualifications: Supervisors must be licensed Master’s mental health professionals. Therapists should be Master’s Level, but license is not required.

Time to Deliver Intervention: Each family is served for an average of six months with at least one weekly visit to the home.

Other Implementation Costs

Costs that will vary by locality include administrative support, space, travel, supplies, and communications. Implementation costs vary significantly across the country.

Ongoing Training and Technical Assistance

Ongoing training, fidelity monitoring, and technical assistance costs are bundled into one annual consultation fee of $41,000 (provider organization with a single team) or $33,500 (per team when the provider organization has multiple teams).

Fidelity Monitoring and Evaluation

Fidelity Monitoring included in T/A cost above. Additionally, a provider organization may choose to either (a) have the Therapist Adherence Measure-Revised (TAM-R; Henggeler et al. 2006) administered to each family by an approved MST call center at a cost of $25 per family per month or (b) use a designated staff member (estimated at .20 FTE to administer the TAM-R to each family.

Ongoing License Fees

Annual license fees of $4,000 per organization (Agency license) and an additional $2,500 per team (Team license) are required.

Other Implementation Support and Fidelity Monitoring Costs

None.

MST Services, Inc. recommends that, when estimating costs, one should consider the implementation of the “highest quality program” in order to assure accountability for the best possible client outcomes. Economies of scale can be achieved when multiple teams can be supported at one time.

Year One Cost Example

In this example, an organization is setting up two MST-PSB teams, each with a .5 FTE supervisor and four therapists to serve approximately 64 families over the course of a year. This example assumes the agency does not have MST trained therapists on staff and staff and supervisors have to attend the MST training at MST Services Inc. If an agency was already implementing MST, and had trained MST staff available, they would not have to incur training costs. First year costs would include:

Program Development Start-Up Fee (11,000 + 8,000)
$19,000
Travel for MST Services Consultants
$ 4,000
Training for new staff at MST Services Inc (850 * 9)
$ 7,650
Travel and lodging for 5 day training ($2,000 * 9)
$18,000
Licenses-1 organizational and 2 team
$ 9,000
Support fee for two teams charged by purveyor
$67,000
Salary for one supervisor @ $60,000
$60,000
Salaries for eight therapists @ $50,000
$400,000
Administrative staff to collect TAM-R (.20TFE Admin)
$6,000
Fringe @ 30%
$139,800
Overhead @ 25% of staff cost
$151,450

Total Year One Cost
$881,900

With 8 therapists with an average caseload of four families for six months of service, a total of 64 families annually could be served at a cost of $13,780 per family for the first year. The per-family cost would be significantly lower after the first year, when the program no longer incurs program development and initial training fees.