This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
This document was printed from the website of the California Evidence-Based Clearinghouse for Child Welfare (CEBC), which you can access at http://www.cebc4cw.org/
Note: FFT did not respond to the request to participate in the CEBC review process. The following information was obtained from publicly available sources (website, articles, etc.).
Scientific Rating:
2
Supported Research Evidence
See scale of 1-5
Relevance to Child Welfare Rating:
2
Medium
See scale of 1-3
Child Welfare Outcomes: Child and Family Well-Being
Brief Description:
Functional Family Therapy (FFT) has been rated by the CEBC in the area of Substance Abuse Treatment (Adolescent). FFT is a family intervention for at-risk youth ages 10 to 18 whose problems range from acting out to conduct disorders to alcohol and/or substance abuse. Often these families tend to have limited resources, histories of failure, a range of diagnoses, and multi-system exposure.
FFT is a short-term intervention program with an average of 12 sessions over a 3-4 month period. Services are conducted in both clinic and home settings, and can also be provided in a variety of settings including schools, child welfare facilities, probation and parole offices/aftercare systems, and mental health facilities.
FFT is a strength-based model. At its core are a focus on and an assessment of those risk and protective factors that impact the adolescent and his or her environment. Specific attention is paid to both intrafamilial and extrafamilial factors, and how they present within, and influence, the therapeutic process.
Manual and Training section:
The publicly available information indicates that there is a manual and training available for FFT. Please contact Holly DeMaranville, Phone: 206-369-5894, Email: hollyfft@comcast.net for more details.
Relevant Published, Peer-Reviewed Research:
Family Functional Therapy (FFT) is rated a "2 - Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one rigorous randomized controlled trial with a sustained effect of at least 6 months. For more information on the rating of a "2 - Supported by Research Evidence," please see the Scientific Rating Scale.
Alexander J. F., & Parsons, B. V. (1973). Short-term behavioral intervention with delinquent families: Impact on family process and recidivism. Journal of Abnormal Psychology, 81(3), 219-225.
Type of Study: Randomized controlled trial
Number of participants: 86 families
Population:
Location/Institution: Family Clinic, University of Utah
Summary: (To include comparison groups, outcomes, measures, notable limitations) This study examined the impact of a short-term behavioral intervention (Functional Family Therapy) on the recidivism rates of delinquent teenagers and their families. Families were randomly assigned to either the short-term behavioral family intervention program (Functional Family Therapy) or to one of three comparison groups: client-centered family groups program, psychodynamic family program (Mormon church-sponsored), or a no-treatment control group. Juvenile court records were examined following termination to assess recidivism, i.e. referral for behavioral offense. Results showed that the no-treatment control group had a 50% recidivism rate, the client-centered family group had a 47% rate, the psychodynamic family treatment group had a 73% rate, and the short-term family behavioral treatment (Functional Family Therapy) had a 26% rate. Limitations of the study include the small sample size in each group and the lack of specific substance use related outcome.
Length of post-intervention follow-up: 6-18 months.
Waldron, H. B., Slesnick, N., Brody, J. L., Peterson, T. R., & Turner, C. W. (2001). Treatment outcomes for adolescent substance abuse at 4- and 7-month assessments, Journal of Consulting and Clinical Psychology, 69(5), 802-813.
Type of Study: Randomized controlled trial
Number of participants: 114 (demographic breakdown below reflects initial 120 participants)
Population:
Location/Institution: University of New Mexico Center for Family and Adolescent Research, NM
Summary: (To include comparison groups, outcomes, measures, notable limitations) Participants were randomly assigned to one of four treatment conditions: Functional Family Therapy (FFT), individual Cognitive Behavioral Therapy (CBT), a combination of FFT and CBT (joint), or a psychoeducational group. Measures to assess substance abuse included the Timeline Follow-Back (TLFB) interview, as well as collateral reports from parents and siblings of adolescents, and urinalyses. In order to assess problem behaviors that may be associated with substance abuse, the Problem Oriented Screening Instrument for Teenagers (POSIT) and Child Behavioral Checklist (CBCL) were used. Adolescents in both of the family therapy conditions (FFT and joint CBT/FFT) had significant reductions in heavy marijuana use from pretreatment to the 4-month assessment, and this reduction persisted until the 7-month assessment. The initial changes in those in the CBT condition from pretreatment to 4 months, however, did not persist through the 7-month assessment. All of the interventions in this study demonstrated some degree of treatment efficacy. Limitations include an unequal number of sessions across treatments, as well as the self-report nature of substance use.
Length of post-intervention follow-up: 3 months.
Slesnick, N., & Prestopnik, J. (2004). Office versus home-based family therapy for runaway, alcohol abusing adolescents: Examination of factors associated with treatment attendance. Alcoholism Treatment Quarterly, 22(2), 3-19.
Type of Study: Randomized controlled trial
Number of participants: 77
Population:
Location/Institution: University of New Mexico; Albuquerque
Summary: (To include comparison groups, outcomes, measures, notable limitations) This study examined predictors of treatment attendance for runaway, substance abusing youth and their families. Participants were randomly assigned to either Ecologically-Based Family Therapy (EBFT) or Functional Family Therapy (FFT). Measures included the Youth Self-Report of the Child Behavior Checklist, as well as the Form 90 Interview, which was the primary measure of quantity-frequency of adolescent substance use, yielding the total percent days, in the last 90, of all alcohol and drug use. More families assigned to home-based EBFT were both engaged and attended more sessions compared to families assigned to the office-based FFT. 76% of the EBFT families participated in four or more sessions, while only 50% of the families assigned to FFT participated in four or more sessions. Adolescents' externalizing problems was associated with increased treatment attendance in EBFT, but not in FFT. However, severity of the adolescent's alcohol and drug use did not significantly predict treatment attendance in either EBFT or FFT. Notable limitations of the study include its sole focus on shelter-residing runaway youth with primary alcohol problems, as well as the outcomes being based upon self-report data.
Length of post-intervention follow-up: None.
Slesnick, N., & Prestopnik, J. (2009). Comparison of family therapy outcome with alcohol-abusing, runaway adolescents. Journal of Marital & Family Therapy, 35(3), 255-277.
Type of Study: Randomized controlled trial
Number of participants: 119
Population:
Location/Institution: Albuquerque, NM
Summary: (To include comparison groups, outcomes, measures, notable limitations) Participants were assigned to either (a) home-based Ecologically Based Family Therapy (EBFT), (b) office-based Functional Family Therapy (FFT), or (c) service as usual (SAU) through the shelter. Measures included the Youth Self-Report of the Child Behavior Checklist, the Computerized Diagnostic Interview Schedule for Children, the Beck Depression Inventory, and the Conflict Tactics Scale. The Form 90 Interview was used to assess alcohol and drug patterns; urine toxicology screens were collected at pre- and post treatment assessment to verify self-reported illicit drug use. Findings showed that both EBFT and FFT significantly reduced alcohol and drug use compared with SAU at 15-month post baseline. Participants assigned to home-based EBFT showed a 97% decline in days of alcohol use (compared to an 83% decline for office-based FFT), and a 77% reduction in number of standard drinks consumed on drinking days (64% for FFT) at 15 months post-intake. Youth assigned to SAU showed a 59% reduction in days of alcohol use and virtually no change in number of standard drinks consumed on each drinking day. Adolescents in both family therapies (EBFT & FFT) reported a 72% reduction at 15 months follow-up, while SAU participants returned to baseline use levels. One limitation of the study is that it is difficult to conclude whether the findings are the result of the context of treatment (home vs. office) or of treatment condition (FFT vs. EBFT). Also, the study is focused solely on runaway youth in the shelter system, and may not generalize to other youth.
Length of post-intervention follow-up: 11 months after the end of treatment.
References:
Alexander, J., Barton, C., Gordon, D., Grotpeter, J., Hansson, K., Harrison, R., … Sexton, T. (1998). Functional Family Therapy: Blueprints for violence prevention, Book Three. Blueprints for Violence Prevention Series (D.S. Elliott, Series Editor). Boulder, CO: Center for the Study and Prevention of Violence, Institute of Behavioral Science, University of Colorado.
Alexander, J. F., & Parsons, B. V. (1982). Functional Family Therapy: Principles and procedures. Carmel, CA: Brooks/Cole.
Barton, C., & Alexander, J. F. (1981). Functional family therapy. In A. S. Gurman & D. P. Kniskern (Eds.), Handbook of family therapy (pp. 403-443). New York: Brunner/Mazel.
Contact Information
Contact name (and Degree) Holly DeMaranville, FFT Communications Director
Affiliation/Agency: Functional Family Therapy, Inc.
E-mail: hollyfft@comcast.net
Phone: 206-369-5894
Fax: 206-453-3631
Website: www.fftinc.com
Date review compiled: April 2010