Client 34 did not complete a full course of treatment due to ongoing engagement struggles since the beginning of treatment.  The MST-EA team exhausted efforts to engage the client but ultimately the client was not aligned with continuing services.  While the client did not complete a full course of treatment the client did achieve 75% of the targeted outcomes at program discharge.  The client did not achieve a reduction in behavioral health symptoms largely due to lack of alignment with participating in behavioral health services.

The determination to discharge an EA from MST-EA is based upon evidence of intervention effectiveness as evaluated from multiple perspectives (e.g. EA, social network members, school, probation officer) indicating that:

• a majority of the Overarching Goals for the case have been met and sustained;
• the EA has few significant behavioral health and justice-related problems;
• the EA can effectively manage any recurring problems and functions reasonably well for at least 3 to 4 weeks;
• the EA is making reasonable educational/vocational efforts;
• the EA is involved with prosocial peers and is not involved with, or is minimally involved with problem peers; and
• the therapist and supervisor feel the EA has the knowledge, skills, resources, and support needed to handle subsequent problems.

Discharge from MST-EA may also occur when few of the Overarching Goals have been met, but despite consistent and repeated efforts by the therapist and supervisor to overcome the barriers to further success, the treatment has reached a point of diminishing returns for the additional time invested.

• MD Department of Juvenile Services
• Baltimore County Detention Center
• Baltimore County Court System
• Baltimore County Office of the Public Defender
• Baltimore County Department of Social Services
• Community Solutions, Inc.
• Prologue, Inc.

MST-EA is a manualized treatment that is an adaptation of the evidence-based treatment, Multi-Systemic Therapy (MST). MST-EA treatment targets are achieved by changing how clients function in their natural settings (home, school, community), leveraging the client’s strengths, pulling in positive supports, and developing the client’s skills and resources to overcome barriers to success.  Evidence-based interventions (e.g., cognitive behavioral therapy, behavioral interventions, motivational interviewing, affective education) are used to address treatment needs.

(Annual FY): The annual target percentage for youth/young adults completing the full course of treatment is 65%.  During HFY2, a total of 100% or 5 of 5 unduplicated youth/young adults completed the full course of treatment.

MST EA Reasons for Non-Completion of Treatment

1. Moved from Baltimore County
2. Lack of Engagement
3. Placed in detention for event prior to MST EA involvement
4. Placed in detention for event occurring at the very beginning of MST EA involvement

Definitions:

**Client Discharge: 

Discharge Criteria

The determination to discharge an EA from MST-EA is based upon evidence of intervention effectiveness as evaluated from multiple perspectives (e.g. EA, social network members, school, probation officer) indicating that:

• a majority of the Overarching Goals for the case have been met and sustained;
• the EA has few significant behavioral health and justice-related problems;
• the EA can effectively manage any recurring problems and functions reasonably well for at least 3 to 4 weeks;
• the EA is making reasonable educational/vocational efforts;
• the EA is involved with prosocial peers and is not involved with, or is minimally involved with problem peers; and
• the therapist and supervisor feel the EA has the knowledge, skills, resources, and support needed to handle subsequent problems.

Discharge from MST-EA may also occur when few of the Overarching Goals have been met, but despite consistent and repeated efforts by the therapist and supervisor to overcome the barriers to further success, the treatment has reached a point of diminishing returns for the additional time invested.