Functional Family Therapy (FFT) - for delinquent young people and their families
At a glance
Country of origin
- USA
Level(s) of intervention
- Targeted intervention
Functional Family Therapy (FFT) is a short-term (approximately 30 hours), family-based therapeutic intervention for delinquent young people at risk of institutionalisation and their families. FFT is designed to improve within-family attributions and family communication and supportiveness while decreasing intense negativity and dysfunctional patterns of behaviour. Parenting skills, youth compliance and the complete range of behavioural domains (cognitive, emotional and behavioural) are targeted for change based on the specific risk and protective factor profile of each family. FFT should be implemented by a team of 3-8 master’s level therapists, with caseloads of 10-12 families, overseen by a licensed clinical therapist.
Keywords
No dataLinks to this programme in other registries
Implementation Experiences
Read the experiences of people who have implemented this programme.Contact details
Professor James F. Alexander, PhD
University of Utah Department of Psychology
380 South 1530 East, Room 502
Salt Lake City
Utah 84112-0251
United States of America
Phone: 1 (801) 550-4131
Email: jfafft[a]aol.com
Website: www.fftinc.com
Thomas Sexton, PhD
FFT Partners, LLC
Email: tom[a]functionalfamilytherapy.com
Website: www.functionalfamilytherapy.com
Overview of results from the European studies
Studies overview
There is some evidence that the programme is effective in reducing behaviour problems among young people.
The programme has been evaluated in two quasi-experimental studies in Europe, respectively in Sweden (Hansson et al., 2000) and in the Netherlands (Eeren et al., 2018). Furthermore, two randomised controlled trials have been conducted in Sweden (Hansson et al., 2004) and in Ireland (Carr et al., 2014).
The quasi-experimental study in Sweden (Hansson et al., 2000) found statistically significant positive effects on child psychiatric symptoms at post-test.
In the second Quasi-experimental study in the Netherlands (Eeren et al., 2018), 697 adolescents with an average age of 15 years, were allocated to either the FFT intervention or the MST intervention according to the Risk-Need-Responsivity model. The FFT intervention is thereby seen as the control group. In this aspect, results of the comparison showed no significant differences between outcomes. Only the engagement in school or work after the treatment was higher in the group who completed MST.
The randomised controlled trial in Sweden (Hansson et al., 2004), involving young people with an average age of 15 arrested for serious offences, found statistically significant positive effects on behaviour (recidivism and internalising and externalising behaviour) at the two-year follow-up.
The study in Ireland (Carr et al., 2014) was conducted with children with an average age of 14 years who met the clinical cut-off for Total Difficulties on the parent-reported Strengths and Difficulties Questionnaire (SDQ). It found statistically significant effects at post-test (3 months) favouring the intervention on participants’ parent- and self-reported problem behaviour (based on some but not all measures).
The programme has been rated as Model by Blueprints for Healthy Youth Development database based on a review of studies conducted world-wide.
Countries where evaluated
- Netherlands,
- Ireland,
- Sweden
Characteristics
Protective factor(s) addressed
- Individual and peers: clear morals and standards of behaviour
- Individual and peers: interaction with prosocial peers
- Individual and peers: Problem solving skills
- Individual and peers: refusal skills and decision making
- Individual and peers: skills for social interaction
Risk factor(s) addressed
- Individual and peers: anti-social behaviour
- Individual and peers: early initiation of drug/alcohol use
- Individual and peers: favourable attitude towards alcohol/drug use
- Individual and peers: favourable attitudes towards anti-social behaviour
- Individual and peers: hyperactivity
- Individual and peers: rebelliousness and alienation
Outcomes targeted
- Relations with parents
- Alcohol use
- Use of illicit drugs
- Crime
Description of programme
Functional Family Therapy (FFT) is a short-term (approximately 30 hours) prevention/intervention programme for young people who have demonstrated a range of maladaptive, acting-out behaviours and related syndromes. Intervention services consist primarily of direct contact with family members, in person and by telephone; however, services may be coupled with support system services such as remedial education, job training and placement, and school placement. Some young people are also assigned ‘trackers’, who advocate for them for a period of at least three months after release.
FFT should be implemented by a team of 3-8 master’s level therapists, with caseloads of 10-12 families, overseen by a licensed clinical therapist. FFT is a phased programme with steps that build on each other. These phases are:
- Engagement: designed to emphasise to young people and their families the factors that protect young people and their families from dropping out of the programme early.
- Motivation: designed to change maladaptive emotional reactions and beliefs, and increase alliance, trust, hope, and motivation for lasting change.
- Assessment: designed to clarify individual, family system and larger system relationships, especially the interpersonal functions of behaviour and how they relate to change techniques.
- Behaviour change: consists of communication training, specific tasks and technical aids, parenting skill building, contracting and response-cost techniques, and youth compliance and skill building.
- Generalisation: during which family case management is guided by individualised family functional needs, their interface with environmental constraints and resources, and the alliance with the FFT therapist/family case manager.
