Multisystemic therapy (MST) is an empirically supported intervention for young people presenting with antisocial behaviour. This study explored the process of sustaining positive outcomes following MST from caregiver perspectives. Semi‐structured interviews were carried out 5–21 months post‐MST with 12 caregivers. A grounded theory methodology was used to analyse the data. Caregivers in this study identified the following themes as contributing to sustaining change; improvements in their relationship with their child, shifting how they viewed difficulties and solutions and feeling personally strengthened and resilient. The therapeutic alliance in MST was described as important in initiating these changes. Clinical implications and how the themes from this study fit into the existing model of change in MST are discussed. Practitioner points Caregivers validated the therapeutic alliance as key to the MST approach. Experiencing a positive therapeutic alliance was also identified as important in improving relationships within the family even after therapy was completed. Positive experiences of MST developed caregivers’ experiences of feeling more resilient in the face of later difficulties helping sustain positive outcomes. 多系统治疗之后的变化维持：照料人的视角 多系统治疗是针对具有反社会行为的年轻人的实证支持的干预手段。本研究从照料人的角度探索了多系统治疗之后维持积极治疗效果的过程。在治疗结束后的5－21个月期间, 对12位照料人进行了半结构式访谈, 并采用扎根理论的方法进行了数据分析。研究中的照料人识别了如下一些有助于维持变化的主题：他们与孩子关系的改善, 他们看待困难和解决办法的方式的改变, 以及自我感觉更有力量和复原力。多系统关系中的治疗同盟被描述为促成这些改变的重要的因素。本文讨论了该研究的临床学意义以及研究结果中的主题在多系统治疗的已有改变框架中的位置。 对实务工作者的启示 照料人证实了治疗同盟对于多系统治疗手段的重要性。 经历积极的治疗同盟也被认为是促进家庭内部关系改善的重要因素, 其影响甚至持续到治疗结束之后。 在多系统治疗中的积极体验帮助照料人发展了在今后的困难面前迅速适应和恢复的体验, 这有助于维持积极治疗效果。 关键词：多系统治疗；质性研究；服务使用者角度；变化过程；扎根理论