Enablers and barriers to the implementation of Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) into the routine delivery of child protection services in New South Wales, Australia

Background: Multisystemic Therapy for Child Abuse and Neglect (MST-CAN) aims to reduce the likelihood of child maltreatment and out-of-home care (OOHC) entry for high-risk children aged between six and 17 years. Objective: To identify the key enablers and barriers to implementing MST-CAN into the routine delivery of child protection services. Participants/setting: Twenty MST-CAN and policy experts, and 25 service providers, involved in the delivery of MST-CAN in New South Wales (NSW), Australia. Methods: Semi-structured interviews with MST-CAN and policy experts were thematically analyzed to identify enablers and barriers to the uptake of MST-CAN. These themes were quantified using a modified Consolidated Framework for Implementation Research (CFIR) scoring approach: −2 for barriers, 0 for neutral, and 2 for enablers. The nominal group technique (NGT) identified and ranked the enablers and barriers to MST-CAN delivery perceived by service providers in two discussion groups. Results: The semi-structured interviews generated 15 themes, of which two enablers and four barriers were identified using CFIR scoring. The two NGTs identified six enablers and six barriers. Key enablers common to both interviews and NGTs were the training and supervision of therapists delivering MST-CAN in NSW, and MST-CAN's analytic approach. Key barriers included referral and adaptation challenges for the NSW context and population (including Aboriginal families), staff recruitment difficulties, and problems with the absence and interpretation of outcome data. Conclusions: Barriers to sustained implementation of MST-CAN may be overcome by revising staff qualification thresholds and data collection procedures, and improved adaptation of MST-CAN in partnership with Aboriginal organizations.