Harshly, early and often!
Seriously multi stem river birch can be a big problem when they “grow up”. Structurally a mess. Ice and snow in the winter can cause the permanent bows like the one you have or even just a heavy rain in the summer. The wood is very flexible and tends to stay where it is bent but the unions created by the multi stem are not so flexible with age. The inclusions can be terrible to the point of failure.
Once we start on a RB our recommended cycle is biannually at the very least. Many times even annually until the structure and growth can be overcome (because they can put on more annually than you can reasonably take off in the right conditions).
Harshly, early and often.