At a glance
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.
Overview of results from the European studies
There is some evidence that the programme is effective in reducing behaviour problems among young people.
The programme has been evaluated in one quasi-experimental study and one randomised controlled trial in Sweden, and one randomised controlled trial in Ireland.
The quasi-experimental study in Sweden found statistically significant positive effects on child psychiatric symptoms at post-test.
The randomised controlled trial in Sweden, 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 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 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.
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.