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Functional Family Therapy (FFT) is a family-based prevention and intervention program for dysfunctional youths ages 11 to 18 that has been applied successfully in a variety of multi-ethnic, multicultural contexts to treat a range of high-risk youths and their families. It integrates several elements (established clinical theory, empirically supported principles, and extensive clinical experience) into a clear and comprehensive clinical model. The FFT model allows for successful intervention in complex and multidimensional problems through clinical practice that is flexibly structured and culturally sensitive.
The model includes specific phases: engagement/motivation, behavior change, and generalization. Engagement and motivation are achieved through decreasing the intense negativity often characteristic of high-risk families. The behavior change phase aims to reduce and eliminate the problem behaviors and accompanying family relational patterns through individualized behavior change interventions (skill training in family communication, parenting, problem-solving, and conflict management). The goal of the generalization phase is to increase the family’s capacity to adequately use multisystemic community resources and to engage in relapse prevention.
FFT ranges from an average of 8 to 12 one-hour sessions for mild cases and incorporates up to 30 sessions of direct service for families in more difficult situations. Sessions are generally spread over a 3-month period and can be conducted in clinical settings as an outpatient therapy and as a home-based model.
Several evaluation studies using matched or randomly assigned control/comparison group designs were conducted between 1973 and 1997. The studies have included follow-up periods of 1, 2, 3, and 5 years. The model has been applied to populations in urban and rural settings and among many racial and ethnic groups.
For instance, in one of the first randomized trials of FFT, 86 families of delinquents were randomly assigned to one of four treatment conditions: 1) no treatment, 2) a client-centered family approach, 3) an eclectic–dynamic approach, or 4) FFT. The evaluation was developed to measure three levels of outcomes: process changes in family interaction, recidivism rates of the youths, and the rate of sibling contact with the court 2½ to 3½ years following the intervention.
In a comparison study, 27 delinquents (male and female) who had either recently been placed out of the home or for whom placement was imminent were court-referred to FFT. A comparison group of 27 lower risk delinquents received only probation. Outcomes were measured by the number and severity of offenses during 2½ years following group assignment.
In multiple evaluations of FFT, the findings show that when compared with standard juvenile probation services, residential treatment, and alternative therapeutic approaches, FFT is highly successful. The outcome findings of the research conducted during the past 30 years show that when compared with no treatment, other family therapy interventions, and traditional juvenile court services (e.g., probation), FFT can reduce adolescent re-arrests by up to 60 percent. Moreover, both randomized trials and comparison group studies show that FFT significantly reduces recidivism for a wide range of juvenile offense patterns. In addition, studies have found that FFT dramatically reduces the cost of treatment. A Washington State study, for example, shows savings of up to $14,000 per family. FFT also significantly reduces potential new offending for siblings of treated adolescents.
Alexander, James F., Christie Pugh, Bruce V. Parsons, and Thomas L. Sexton. 2000. “Functional Family Therapy.” In Delbert S. Elliott (ed.). Blueprints for Violence Prevention (Book 3), Second Edition. Boulder, Colo.: Center for the Study and Prevention of Violence, Institute of Behavioral Science, University of Colorado.
Aos, Steve, Robert Barnoski, and Roxanne Lieb. 1998. Watching the Bottom Line: Cost-Effective Interventions for Reducing Crime in Washington. Olympia, Wash.: Washington State Institute for Public Policy.
Barton, Cole, James F. Alexander, Holly Barrett Waldron, Charles W. Turner, and Janet Warburton. 1985. “Generalizing Treatment Effects of Functional Family Therapy: Three Replications.” American Journal of Family Therapy. 13(3):16–26.
Gordon, Donald A., Jack Arbuthnot, Kathryn E. Gustafson, and Peter McGreen. 1988. “Home-Based Behavioral-Systems Family Therapy With Disadvantaged Juvenile Delinquents.” American Journal of Family Therapy. 16(3):243–55.
Gordon, Donald A., Karen Graves, and Jack Arbuthnot. 1995. “The Effect of Functional Family Therapy for Delinquents on Adult Criminal Behavior.” Criminal Justice and Behavior. 22(1):60–73.
Parsons, Bruce V., and James F. Alexander. 1973. “Short-Term Family Intervention: A Therapy Outcome Study.” Journal of Consulting and Clinical Psychology. 2:195–201.
Sexton, Thomas L., and James F. Alexander. 2002. Functional Family Therapy: Principles of Clinical Intervention, Assessment, and Implementation. Seattle, Wash.: FFT LLC.
James F. Alexander
Department of Psychology
380 South 1350 East, #502
University of Utah
Salt Lake City, UT 84112
Phone: (801) 581-6538
Fax: (801) 581-5841
E-mail: jfafft@psych.utah.edu
Web site: http://www.fftinc.com
Holly DeMaranville
FFT Communications Director
1611 McGilvra Blvd. East
Seattle, WA 98116
Phone: (206) 369-5894
Fax: (206) 664-6230
E-mail: hollyfft@comcast.ne
