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

• Types of Maltreatment: Physical Abuse, Physical Neglect, Emotional Abuse, Exposure to Domestic Violence
• Target Population: Adults with drug abuse and dependence, as well as other co-existing problems such as depression, family dysfunction, trauma, child maltreatment, noncompliance, and poor communication skills.

FBT for Adults 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 for Adults’ 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 for Adults is designed to be used with adults, 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. Family Behavior Therapy for Adolescents (FBT) has also been rated on this website, please click on the program name to be sent to its separate page.

Treatment Components:

• A structured Program Orientation that includes prompts to assist in gaining feedback from clients about the obtained assessment results, and provides 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 for Adults 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 for Adults 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 for Adults 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 for Adults.
• Forms Relevant to Client Record Keeping include standardized progress notes, treatment plans, log of contacts, monthly client progress reports to outside parties (e.g., caseworker, judges), termination reports, etc. that correspond to FBT for Adults 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 for Adults.

Family Behavior Therapy for Adults (FBT) was not designed with a child component.

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

• Alcohol and drug misuse, depression, school/work attendance problems, parenting stress, poor child management and communication skills, family dysfunction, HIV prevention, child abuse and neglect, home hazards, management of emergencies, and conduct problems in children.

Treatment Involves Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: FBT for Adults has treatment components directly related to raising children such as communication skills training and 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.

Family Behavior Therapy for Adults (FBT) was designed with an adult component that addresses the following presenting problems and symptoms:

• Alcohol and drug misuse, depression, work attendance problems, poor communication skills, and management of emergencies.

Family Behavior Therapy for Adults (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 fades in frequency 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 (e.g., population, setting, intensity of treatment plan, effort) that are determined by the client, client's family, and treatment provider.

This program is typically conducted in a(n):

• Birth Family Home
• Community Agency
• Foster Home
• Outpatient Clinic
• Residential Care Facility

Family Behavior Therapy for Adults (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 Adults (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., & Allen, D. A. (2011). Family Behavior Therapy: A step-by-step approach to adult 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 should 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 may occur at the treatment agency. Other training sites are currently available in Pennsylvania, Nevada, California and Kentucky.

Number of days/hours:

The process begins with conference calls and questionnaires to learn about the unique needs of the agency wishing to be trained. Several training options are available. The full FBT training package includes 3 modules:

1. Substance Abuse/Problem Behavior interventions
2. Family Relationship Building interventions
3. Job-Getting and Financial Management

The full package is conducted across a 4-day workshop, a 2-day booster workshop, and 33 on-going telephone training sessions. When less intensive training is desired, the modules can be separated. The Substance Abuse/Problem Behavior module requires a 2-day workshop w/ 19 on-going telephone training sessions; the Family Relationship Building module, as well as the Job-Getting and Financial Management modules each require a 1-day workshop with 7 on-going telephone training sessions.

Additional Resources:

There currently are additional qualified resources for training:

Several agencies have received training, and have indicated availability to assist in training. A current list of these agencies is available from Dr. Brad Donohue (see above contact information). Dr. Donohue has agreed to provide cost-free assistance in the identification of training services from agencies for which he receives no financial compensation as well as other publicly available resources relevant to the program.

Since Family Behavior Therapy for Adults (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