Topic: Alcohol/Drugs/Tobacco, Antisocial Behavior, Behavioral Problems, Parenting
Target Population: Adolescents, Parents
Sector: Community-Based, School-Based
This program is for youth, ages 11 to 18, who could be at risk for or who have prior history relating to substance use, delinquency, behavioral problems, and conduct disorders and their parents.
Functional Family Therapy (FFT), a community- or school-based family treatment program, is designed to prevent youth from committing violent and criminal acts by strengthening family relationships and supportive interactions and reducing unhealthy behaviors and attitudes through family therapy.
A number of randomized controlled trials (RCTs) have evaluated FFT, and results have been mixed. Independent evaluations have indicated lower recidivism rates and drug use among court-referred adolescents who had entered the juvenile justice system as compared to those who received other types of services. These effects appear to persist into adulthood for many program participants. However, one RCT was conducted in London in which participants were randomized to management as usual (MAU) or treatment (FFT+MAU). Results indicated large reductions in all measures of offending and antisocial behavior in both groups over time. There were no differences between groups at an 18-month follow-up on self-reported delinquency, police records of offending, symptoms of diagnoses of conduct disorders, parental monitoring or supervision, directly observed child negative behavior, or parental positive or negative behavior. Youth in the FFT group showed lower levels of directly observed positive behavior at 18 months compared to youth in MAU. There were no changes over time in either group in parenting behavior or the parent-child relationship. An RCT was conducted in Singapore, and youth offenders who were placed on community-based probation were randomized to treatment as usual (TAU) or FFT+TAU. Results indicated significant improvements in mental well-being in the FFT+TAU group, compared to TAU. However, there were no differences between groups in family functioning. An RCT was conducted in Norway, and youth referred to Child Welfare Services were randomized to TAU or FFT. Results indicated no intervention effect for FFT compared to TAU from pretest to posttest. There were significant improvements in both groups in parent-reported aggressive and rule-breaking behavior, internalizing problems, and social skills and on youth self-reported delinquency. However, between posttest and 18-month follow-up, there was a significant intervention effect in favor of TAU for parent-reported youth internalizing problems. Youth in both groups demonstrated significant improvements between posttest and follow up on parent- and teacher-reported aggressive behavior.
FFT centers on keeping youth out of the criminal justice system by teaching youth to modify their behaviors, incorporating parental involvement, and promoting protective factors within youth. This program is versatile and can be implemented in the community, in the school environment, in the home, or in a clinical setting. Youth and parents or guardians participate in all sessions, which are divided into five phases:
Probation officers and mental health professionals implement this program and utilize this sequence of phases to help prevent future violent behavior and other forms of crime from being committed by the youth.
The FFT program began as a study in 1971 and is currently delivered in 45 U.S. states, Europe, New Zealand, and the Republic of Singapore.
This program is facilitated by master's level therapists. Training is required for facilitators and their supervisors when a new site initiates the FFT program. Professionals who facilitate the program receive training for 12 to 18 months. Supervisors must receive a certification, which takes 12 months to obtain. After these requirements are met, ongoing training is required to maintain program integrity. Training costs are included in annual fees that are associated with implementing FFT. Please use details in the Contact section for more information.
Considerations for implementing this program include understanding each implementation site must purchase a license which may be expensive, acquiring participant buy-in, obtaining qualified facilitators, ensuring facilitators are committed and realize training is extensive, and finding a location and convenient times for parents and youth to attend therapy sessions.
The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
If you are interested in implementing FFT, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu
Youth and their parents or guardians attend 1-hour sessions once a week for approximately 12 weeks. Program length depends on family needs and problem severity; however, treatment is short-term.
Implementation costs will vary. For more details on current costs, please use details in the Contact section. Cost-effectiveness is determined by the Washington State Institute for Public Policy. For every dollar spent on the implementation of FFT, there is a return on investment of $8.92 through reductions in felony recidivism.
To move FFT to the Effective category on the Clearinghouse Continuum of Evidence, at least one to two additional evaluations should be performed demonstrating positive effects when compared to a control group that last at least two years from the beginning of the program or at least one year from program completion.
The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu
You may also contact FFT LLC by mail 3490 Piedmont Rd. NE Suite 304, Atlanta, GA 30305, phone 1-206-369-5894, email fft@fftllc.com, or visit https://www.fftllc.com/contact-us
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