Children and teens have unique and often complex behavioral health needs. Functional family therapy (FFT) is often used to address behavioral concerns in juveniles aged 11-18 years. Here is an overview of FFT and how it works.
What does Functional Family Therapy involve?
Developed by Drs. James Alexander and Bruce Parsons, FTT is a short-term intervention that involves the whole family in addressing adolescent behavior problems.
FFT involves a series of five progressive phases:
Engagement: The therapist(s) work to demonstrate responsiveness and establish credibility with family members. Therapists are highly involved and available to the family, helping prevent youth and families from dropping out of the program.
Motivation: This phase encourages motivation and lasting change by working to reduce family hostility and blame, increase hope, and build healthier family relationships.
Assessment: The therapist helps identify patterns within a family through observation and questioning. This phase transitions from focusing on an individual problem to a more relational point of view. This helps prepare participants for the next phases of FTT.
Behavior Change: The therapist guides family members through communication training, parenting skills, and youth compliance and skill building. This helps improve family and individual functioning. This phase may include other therapeutic approaches, including cognitive-behavioral strategies.
Generalization: This final phase applies the improvements made in the Behavior Change phase to other areas. Therapists help participants plan for future challenges to prevent relapse. This phase often incorporates other community systems and members, such as probation officers or teachers, into the treatment process.
FTT usually lasts about 30 hours, in about 12-14 sessions over 3-5 months.
Proponents recommend that a team of master’s level therapists, under the oversight of a licensed clinical therapist, participate in this type of therapy.
All youths who participate in and complete FTT must also have at least one adult caregiver who is willing to be engaged in treatment and provide support during the process.
Who is Functional Family Therapy for?
Research indicates that FFT can help low- to high-risk youths with behavior problems and substance abuse. Individuals who participate in FFT also may have additional behavioral health concerns, including anxiety and depression.
FFT can benefit youth with multiple serious offenses, including felonies. FFT participants have been referred from multiple sources, such as juvenile justice, child welfare, mental health providers, and schools.
How effective is Functional Family Therapy?
Several studies have found that FTT is effective in reducing behavioral risk factors, substance use, and recidivism.
One Utah study found that families who participate in FFT significantly improved rates of reoffense and recidivism among serious delinquent youth. The same study found improvements in the juvenile court records of siblings of targeted youth, indicating that the family overall, beyond the targeted individuals, can benefit from FTT.
FFT has been endorsed by the Center for Disease Control and Prevention and the U.S. Department of Justice, according to Pennsylvania State University’s EPISCenter.
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