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Family Effectiveness Training

Ages 6-12

Rating: Level 3

Intervention

Family Effectiveness Training (FET) is a family-based program for Hispanics that targets family factors known to place children at risk. FET helps Hispanic immigrant families with children ages 6 to 12, particularly when the child is exhibiting behavior problems, associating with deviant peers, or experiencing parent–child communication problems. The goal of FET is to strengthen families by increasing their ability to adapt to new situations, particularly developmental and cultural challenges the family will face. The program consists of three components: Family Development, Bicultural Effectiveness Training, and Brief Strategic Family Therapy. FET uses two primary strategies to initiate change: 1) didactic lessons and participatory activities that help parents master effective family management skills and 2) organized discussions in which the therapist/facilitator intervenes to correct dysfunctional communications between or among family members. The training sessions last for 13 weeks, are 1½ to 2 hours long, and are tailored to each individual family.

Evaluation

FET was evaluated using a Solomon Group Four design with a clinical extension. Seventy-nine Hispanic families were randomized either to receive FET or to a minimum contact control condition. To control for a testing bias in the results, some members of the treatment group and some members of the control group were not given a pretest. Posttest assessments were conducted at about 13 weeks (around the time the FET condition was completed). Those in the control group had the opportunity to receive the treatment after the 13-week posttest was administered. A follow-up was conducted 6 months after the posttest. Families assigned to FET received 13 lessons, at a rate of one lesson a week. Families assigned to the control group had only minimal contact with program staff.

Outcome

Youths who received FET had significantly fewer behavioral, personality, and inadequacy problems and reported greater improvement in their feelings about themselves at the termination of treatment, compared with the control group. FET significantly improved the family structure, functioning, resonance, developmental stage, and conflict resolution.

Risk Factors

Individual

  • Anti-social behavior and alienation/Delinquent beliefs/General delinquency involvement/Drug dealing
  • Early onset of aggression and/or violence
  • Favorable attitudes toward drug use/Early onset of AOD use/Alcohol and/or drug use
  • Poor refusal skills

Family

  • Family management problems/Poor parental supervision and/or monitoring
  • Parental use of physical punishment/Harsh and/or erratic discipline practices
  • Pattern of high family conflict

Protective Factors

Individual

  • Healthy / Conventional beliefs and clear standards
  • High expectations
  • Perception of social support from adults and peers
  • Self-efficacy
  • Social competencies and problem-solving skills

Family

  • Effective parenting
  • Good relationships with parents / Bonding or attachment to family
  • Having a stable family
  • High expectations
  • Opportunities for prosocial family involvement
  • Rewards for prosocial family involvement

Endorsements

  • SAMHSA: Model Programs

References

Hervis, Olga E., and José Szapocznik. 1986. Un Enfoque Estrategico y Estructural a la Terapia Familiar [A Strategic and Structural Approach to Family Therapy]. Washington, DC: Pan American Health Organization.

Perrino, T.; A. Gonzalez–Soldevilla; H. Pantin; and José Szapocznik. 2000. “The Role of Families in Adolescent HIV Prevention: A Review.” Clinical Child and Family Psychology Review 3(2):81–96.

Szapocznik, José, and Olga E. Hervis. 2001. “Brief Strategic Family Therapy: A Revised Manual.” In National Institute on Drug Abuse Manual. Rockville, Md.: NIDA.

Szapocznik, José, and W.M. Kurtines. 1989. Breakthroughs in Family Therapy With Drug-Abusing and Problem Youth. New York, N.Y.: Springer.

Szapocznik, José, W.M. Kurtines, F.H. Foote, A. Perez–Vidal, and Olga E. Hervis. 1983. “Conjoint Versus One-Person Family Therapy: Some Evidence for Effectiveness of Conducting Family Therapy Through One Person.” Journal of Consulting and Clinical Psychology 51:889–99.

———. 1986. “Conjoint Versus One-Person Family Therapy: Further Evidence for the Effectiveness of Conducting Family Therapy Through One Person.” Journal of Consulting and Clinical Psychology 54(3):395–97.

———. 1989. “One-Person Family Therapy.” In R.A. Wells and V.J. Giannetti (eds.). Handbook of the Brief Psychotherapies. New York, N.Y.: Plenum Press, 493–510.

Szapocznik, José, A. Perez–Vidal, A.L. Brickman, F.H. Foote, D. Santisteban, Olga E. Hervis, and W.M. Kurtines. 1988. “Engaging Adolescent Drug Abusers and Their Families Into Treatment: A Strategic Structural Systems Approach.”Journal of Consulting and Clinical Psychology 56(4):552–57.

Szapocznik, José, A. Perez–Vidal, Olga E. Hervis, A.L. Brickman, and W.M. Kurtines. 1989. “Innovations in Family Therapy: Strategies for Overcoming Resistance to Treatment.” In R.A. Wells and V.J. Giannetti (eds.). Handbook of the Brief Psychotherapies. New York, N.Y.: Plenum Press, 93–114.

Szapocznik, José, A.T. Rio, and W.M. Kurtines. 1991. “University of Miami School of Medicine: Brief Strategic Family Therapy for Hispanic Problem Youth.” In L.E. Beutler and M. Crago (eds.). Psychotherapy Research: An International Review of Programmatic Studies. Washington, DC: American Psychological Association, 123–32.

Szapocznik, José, A.T. Rio, E. Murray, R. Cohen, M.A. Scopetta, A. Rivas–Vasquez, Olga E. Hervis, and V. Posada. 1989. “Structural Family Versus Psychodynamic Child Therapy for Problematic Hispanic Boys.” Journal of Consulting and Clinical Psychology 57(5):571–78.

Szapocznik, José, and R.A. Williams. 2000. “Brief Strategic Family Therapy: 25 Years of Interplay Among Theory, Research, and Practice in Adolescent Behavior Problems and Drug Abuse.” Clinical Child and Family Psychology Review 3(2):117–35.

Contact

Lila Smith, M.D.
University of Miami School of Medicine
1425 Northwest 10th Avenue, Third Floor
Center for Family Studies
Miami, FL 33136
Phone: (305) 243-7585
Fax: (305) 243-2320
E-mail: lsmith@med.miami.edu
Web site: http://www.cfs.med.miami.edu