The information in this program outline is provided by the program representative and edited by the CEBC staff. The Family Behavior Therapy for Adolescents (FBT) program has been rated by the CEBC in the area of: Substance Abuse Treatment (Adolescent).

• Types of Maltreatment: Physical Abuse, Physical Neglect, Emotional Abuse, Exposure to Domestic Violence
• Target Population: Youth (11-17) with drug abuse and dependence, as well as other co-existing problems.

FBT includes more than a dozen treatments including management of emergencies, treatment planning, behavioral goals, contingency management skills training, communication skills training, child management skills training, job-getting skills training, financial management, self-control, stimulus control, home safety tours, and tele-therapy to improve session attendance. Therapies are consumer-driven and culturally sensitive. FBT’s goal is to result in positive outcomes in such areas as alcohol and drug use, depression, conduct problems, family dysfunction, and days absent from work/school. FBT is designed to be used with youth, multiple ethnicities, differing types of substance abuse (alcohol, marijuana, and hard drugs), and across genders. Drafts of standardized client record keeping forms and quality assurance may be customized to fit agency needs.

Treatment Components

• A structured Program Orientation that includes prompts to assist in gaining feedback from clients about the obtained assessment results, and providing opportunities to review issues that are common to the target population.
• Assurance of Basic Necessities in which potential or impending emergencies are endorsed by clients from a list, and a self-control procedure is taught to keep the family safe.
• A list of commonly experienced triggers to problem behaviors that when endorsed by clients may be quickly switched into pre-established Behavioral Goals that are anchored to rewards that are provided by family members.
• Treatment Planning options that are anchored to specific FBT components and prioritized by the client and family.
• Communication Skills Training exercises in which clients and their families share what they love, admire, and respect about one another, learn to make positive requests, and develop conflict resolutions skills.
• Child Management Skills Training in which parents learn to discipline their children by catching them being good, positive practice learning exercises, and when necessary, provision of firm directives and undesired consequences.
• Job-getting Skills Training to teach clients and family how to solicit and do well in job interviews.
• A Financial Management intervention in which clients and their family learn to use a standardized worksheet with common methods of earning and saving extra income and reducing expenses.
• A Self-Control intervention in which clients and their family learn to identify and manage triggers to problem behaviors, such as child neglect, HIV risk, drug abuse, and anger in imaginary trials.
• A Stimulus Control intervention in which clients and their family learn to restructure their environment to eliminate or manage negative emotions and things in the environment that cause them to engage in troublesome behaviors, such as substance abuse, child maltreatment, arguments, etc.
• Tele-therapy with clients and their significant others to assure therapy assignments and treatments are being reviewed as prescribed, and increase therapy session attendance.

Contextual Programming

• Structured Pre-Training Questionnaires to be completed by therapists and administrators of the treatment agency to customize the FBT training experience to fit the unique needs of the agency’s culture.
• Published and Non-Published Training Manuals include brief overviews and rationales of each of the intervention approaches, client worksheets and homework assignment forms, and methods of implementing the therapy components.
• Protocol Checklists depict how to implement the FBT treatment components, and include step-by-step instructions for therapists to utilize during their intervention sessions.
• Training/Supervision Protocol Checklist depicts steps involved in maintaining on-going training and supervision protocol that are consistent with FBT.
• Forms Relevant to Client Record Keeping include standardized progress notes, treatment plans, log of contacts, monthly client progress reports to outside parties (i.e., caseworker, judges), termination reports, etc. that correspond to FBT components.
• Quality Assurance Monitoring forms to assure adequacy of client charting and clinic procedures.
• Data Management System that may be used to organize program related outcome data that is relevant to FBT.

FBT has a family component where siblings/children are treated at the same time as the substance abuser.

Family Behavior Therapy for Adolescents (FBT) was designed with a child component that addresses the following presenting problems and symptoms:

• Alcohol and drug misuse, depression, school/work attendance problems, problem solving skills, conduct problems, and problems in the family relationship.

Age range: 11 – 17

Developmental Delays:

This program was not developed for children with developmental delays, and has not been tested for children with developmental delays.

Family Behavior Therapy for Adolescents (FBT) was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:

• Youth in their care with alcohol and drug misuse, depression, school/work attendance problems, problem solving skills, conduct problems, and problems in the family relationship.

Family Behavior Therapy for Adolescents (FBT) was not designed to be conducted in a group setting, and has not been tested for use in a group setting.

Recommended Intensity:

Starts with 1 to 2 hour initial outpatient or home-based sessions once or twice in the first week then it varies depending on multiple factors that are determined between the client, client's family, and treatment provider (e.g., population, setting, intensity of treatment plan, effort).

Recommended Duration:

Typically 6 months to 1 year. It varies depending on multiple factors that are determined between the client, client's family, and treatment provider (e.g., population, setting, intensity of treatment plan, effort).

This program is typically conducted in a(n):

• Outpatient Clinic

Family Behavior Therapy for Adolescents (FBT) includes a homework component:

All treatment components have a therapy assignment, with most including easy-to-complete forms with fill-in-the-blank spaces, check boxes, and pictures (to assist family members who have problems reading and make the forms more exciting). Practice assignments are reviewed each session to assist clients and their families in generalizing and expediting skill acquisition. Incomplete assignments are reviewed in retrospect during session to encourage future completion.

Family Behavior Therapy for Adolescents (FBT) has materials available in a language other than English:

Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

The typical resources for implementing the program are:

• Protocol checklists to guide therapy implementation
• A private place in which to conduct therapy
• Donohue, B., & Azrin, N. H. (2011). Family Behavior Therapy: A step-by-step approach to adolescent substance abuse. Hoboken, NJ: John Wiley & Sons, Inc.

Supervisors must be state-licensed mental health professionals with an interest in supervising the intervention. They should ideally have experience in conducting evidence-based therapies, particularly cognitive-behavioral therapies, and must have professional therapeutic experience serving the population that is being targeted for treatment.

Therapists should be state-licensed mental health professionals. They should ideally have experience serving the population that is being targeted for treatment, and must have an interest in conducting therapy utilizing the intervention.

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:

• Brad Donohue, PhD
  University of Nevada, Las Vegas
  web.unlv.edu/labs/frs/index.html
  Bradley.Donohue@unlv.edu
  phone: (702) 557-5111

Training is obtained:

Training usually occurs in the treatment agency, although other arrangements can be made based on agency needs and trainer availability. The website below includes links to more information about the program, including examples of free access to films of program implementation in simulated therapy sessions, empirical studies of the program, measures that have been used to examine the program, and potential trainers.

Number of days/hours:

There are a number of persons who have received extensive training in the program, and have expressed an interest in training others for a negotiated fee. Dr. Donohue may be contacted to assist in determining potential trainers (see below). Dr. Donohue receives no financial compensation from these trainers, and will not accept financial compensation from community-based agencies for assistance he may provide relevant to the program. Although the training format may vary somewhat depending on who conducts the training, trainers utilize conference calls and questionnaires to assist trainers in learning about agency needs.

There are 4 training options available: 1) a 1-day Relationship Enhancement/Communication Skills Training workshop; 2) a 2-day Drug Use Counseling workshop; 3) a ¾ - day Job Finding/Financial Management workshop; and 4) a 3-day comprehensive workshop that includes each of the aforementioned intervention approaches.

After the respective workshop series, there are typically on-going telephone-assisted training sessions aimed at enhancing treatment implementation (integrity). These telephone calls usually last 60 to 90 minutes per week initially, and fade in their frequency thereafter. A 6-month booster workshop of 1or 2 days during the first year is highly recommended, and annual booster workshops are recommended in future years whenever possible.

Since Family Behavior Therapy for Adolescents (FBT) is highly rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

This program 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. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being