Functional Family Therapy (FFT) is an outcome-driven prevention/intervention program for youth who have demonstrated the entire range of maladaptive, acting-out behaviors and related syndromes. FFT targets youth, aged 11–18, at risk for and/or presenting with delinquency, violence, substance use, conduct disorder, oppositional defiant disorder, or disruptive behavior disorder. FFT requires as few as 8–12 hours of direct service time for commonly referred youth and their families and generally no more than 26 hours of direct service time for the most severe problem situations. Direct services are provided by one- and two-person teams to clients in homes, clinics, and juvenile court or at time of reentry from institutional placement.
FFT effectiveness derives from emphasizing factors that enhance protective factors and reduce risk, including the risk of treatment termination. In order to accomplish these changes in the most effective manner, FFT is a phased program, with steps that build upon each other. These phases consist of:
- Engagement, designed to emphasize within youth and family the factors that protect youth and families from early program dropout.
- 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 behavior and how they relate to change techniques.
- Behavior change, which consists of communication training, specific tasks and technical aids, basic parenting skills, contracting, and response-cost techniques.
- Generalization, during which family case management is guided by individualized family functional needs, their interface with environmental constraints and resources, and the alliance with the FFT therapist/family case manager.
Clinical trials have demonstrated that FFT is capable of:
- Effectively treating adolescents with conduct disorder, oppositional defiant disorder, disruptive behavior disorder, and alcohol and other drug abuse disorders and who are delinquent and/or violent.
- Interrupting the matriculation of these adolescents into more restrictive, higher-cost services.
- Reducing the access and penetration of other social services by these adolescents.
- Generating positive outcomes with the entire spectrum of intervention personnel.
- Preventing further incidence of the presenting problem.
- Preventing younger children in the family from penetrating the system of care.
- Preventing adolescents from penetrating the adult criminal system.
- Effectively transferring treatment effects across treatment systems.
Developmental trauma exposure
Early and persistent noncompliant behavior
Low psychosocial maturity (low temperance, responsibility, and perspective)
Mental health problems
Perceived racial discrimination
Broken home/changes in caretaker
Child maltreatment (abuse or neglect)
Family history of problem behavior/criminal involvement
Family violence (child maltreatment, partner violence, conflict)
Father’s gang membership (for males only, but only with frequent contacts and maltreatment)
Foster care placement
Growing up in foster care
Having a teenage mother
High parental stress/maternal depression
Jailing or imprisonment of a household member
Lived/living with a gang member
Low parental attachment to child/adolescent
Low parental education
Mother’s gang membership (for females only)
Parental use of physical punishment/harsh and/or erratic discipline practices
Poor parental supervision (control, monitoring, and child management)
Poor parent-child relations or communication
Single parent household
Non-normative school transitions (i.e., changes due to residential moves or mid-year transfers)
Performance on standardized math assessments in the 6th and 10th grades
Leading peers in antisocial behavior and committing crimes for peer status or revenge
OJJDP Blueprints Project: Model program
Crime Solutions: Effective
OJJDP Model Programs: Effective
Alexander, J.; Barton, C.; Gordon, D.; Grotpeter, J.; Hansson, K.; Harrison, R.; Mears, S.; Mihalic, S.; Parsons, B.; Pugh, C.; Schulman, S.; Waldron, H.; and Sexton, T. (1998). Blueprints for Violence Prevention, Book Three: Functional Family Therapy. Boulder, CO: Center for the Study and Prevention of Violence.