There are pre-implementation materials to measure organizational or provider readiness for Multisystemic Therapy for Youth with Problem Sexual Behaviors (MST-PSB) as listed below:

MST Associates completes a comprehensive site assessment when launching a new MST-PSB team. A number of specific assessment and planning forms/tools are utilized in the site assessment process. These include, but are not limited to, tools and forms that:

• Ensure agency readiness to embrace program fidelity
• Identify and assess community stakeholders and the level of needed support
• Assess economic sustainability
• Assess for stakeholder support and/or any barriers to success of program.

In addition, an MST-PSB consultant is available for telephonic stakeholder interviews to assess for support and/or to identify any barriers to success of program. Inquiries into delivering MST- PSB can be directed to Richard J. Munschy, PsyD, Clinical Training Director, MSTA (contact information in training section). Initial feasibility assessment, including needs assessment and organizational readiness among others, is conducted by phone and supported by specific assessment tools at that time.

There is formal support available for implementation of Multisystemic Therapy for Youth with Problem Sexual Behaviors (MST-PSB) as listed below:

The comprehensive site assessment mentioned above includes, but is not limited to:

• Ensuring a clear and comprehensive understanding of the fidelity and organizational requirements of delivering the model
• Identifying key stakeholders who will be involved or impacted by the project
• Formulating specific treatment population parameters and referral processes
• Establishing benchmarked outcome measures
• Supporting fiscal projections and budgets
• Supporting effective staff selection and recruitment
• Providing a community presentation prior to team launch
• Facilitating stakeholder meetings to establish the goals and guidelines of the program

Once the team has been launched, MSTA provides ongoing weekly clinical consultation for the team (via phone) designed to provide ongoing support and training and to ensure model fidelity. In addition, separate support/training calls are delivered to the team supervisors to enhance supervisor skills, ensure fidelity at the therapy supervisory and organizational level, and to continue training within the model.

In addition to the initial orientation training provided to the team (seven full days: five days of standard MST Orientation and two days of MST-PSB Orientation Training), booster trainings are delivered onsite quarterly. Six-Month Program Implementation Reports are generated in collaboration with the team supervisor to report on fidelity measures, outcomes, and utilization. Careful analysis of these findings are coupled with specific recommendations designed to pursue high fidelity and superior outcomes.

There are fidelity measures for Multisystemic Therapy for Youth with Problem Sexual Behaviors (MST-PSB) as listed below:

MST- PSB utilizes standard MST fidelity measures and protocols. These include the following instruments:

• The Therapist Adherence Measure-Revised (TAM- R) which is completed by the caregivers of the referred youth and is designed to assess the therapist's fidelity to the MST treatment principles
• The Supervisor Adherence Measure (SAM) a 36-item measure that evaluates the MST Supervisor's adherence to the MST model of supervision as reported by MST Therapists. This measure is based on the principles of MST and the model of supervision presented in the MST Supervisor's Manual
• The Consultant Adherence Measure (CAM), a 23-item measure that evaluates the MST Consultant's adherence to the MST model of consultation as reported by MST Therapists and Supervisors. This measure is based on the principles of MST and the model of consultation presented in the Multisystemic Therapy Consultation Manual.

In addition, fidelity to organizational practices is reviewed consistently and reported upon every six months via the required and recommended program practice section of the Program Implementation Review Report.

All MST- PSB teams' fidelity measure scores and treatment outcomes are stored in an international database maintained by the MST Institute. This allows for rapid comprehensive assessment of fidelity and outcome trends at any given time and real time quality assurance/intervention.

There are implementation guides or manuals for Multisystemic Therapy for Youth with Problem Sexual Behaviors (MST-PSB) as listed below:

The site assessment and program launch process are clearly outlined in detail in an MST consultation manual. Each site receives step-by-step instruction and support for the complete assessment and implementation process from an MST-PSB consultant. Ongoing program implementation is guided by the MST Organizational Manual and informed by the Six-month Program Implementation Reports.

Research has not been conducted on how to implement Multisystemic Therapy for Youth with Problem Sexual Behaviors (MST-PSB).