Functional Family Therapy and Evidence-Based Treatments for Delinquent Youth

Introduction

• Speaker: Dr. Dianne Gehart
• Focus: Functional Family Therapy (FFT) and evidence-based treatments for delinquent youth and their families.
• Textbooks: Mastering Competencies in Family Therapy and Theory and Treatment Planning in Family Therapy, available through Cengage.

Overview of Functional Family Therapy (FFT)

• FFT is an evidence-based, manualized treatment for adolescents with conduct behavior issues and their families.
• Widely adopted by government agencies.
• Based on systemic, structural foundations with influences from cognitive-behavioral concepts.
• Focus on the function of behavior within family systems.

Key Concepts of FFT

• Function of Behavior: Behavior serves adaptive functions in the system.
  • Relational Connection: Balance of closeness and independence in families.
  • Relational Hierarchy: Influence and control dynamics within the family.
• Goal: Change the expression of dysfunctional behaviors without reorganizing the family system entirely.
• Therapist's Role: Identify functions of problem behaviors and provide alternative solutions.

Contributions to the Field

• Importance of multi-systemic conceptualization for conduct disordered youth.
• Emphasis on family, peer, school, and community systems rather than individual problems.
• Group treatment for troubled youth can exacerbate antisocial behaviors.

Treatment Phases in FFT

1. Early Phase: Engagement and motivation; reduce resistance and create trust.
2. Middle Phase: Behavioral change; modify cognitive sets, attitudes, and behavior.
3. Later Phase: Generalize changes to larger social systems (school, peers, extended family).

Therapeutic Relationship

• Critical to develop strong alliances with all family members.
• Build trust, reduce resistance, and engage family in treatment.
• Therapist expected to handle complex dynamics and exhibit credibility.

Case Conceptualization

• Assess the relational function of symptoms.
• Analyze risk and protective factors across multiple systemic levels (family, school, community).
• Emphasize strengths and resiliency.

Goal Setting

• Initial Phase: Reduce family risk factors and blame; increase family alliances.
• Working Phase: Increase behavioral competencies; address relational functions.
• Closing Phase: Generalize improvements across systems; maintain gains.

Interventions

• Develop Family-Focused Problem Description: Reframe problems into family-focused rather than blame-focused.
• Interruption and Diversion: Actively manage conflicts and redirect negative interactions.
• Parental Skill Training: Emphasize clear expectations, monitoring, and consistent reinforcement.
• Mutual Problem Solving: Collaborative resolution with parents and teens.
• Conflict Management and Communication Skills: Teach effective problem resolution and communication techniques.

Working with Diverse Families

• FFT respects cultural norms and versatile family structures.
• Can be used with both collectivist and individualist value systems.
• Adapt goals based on cultural norms and family dynamics.

Evidence-Based Treatment

• FFT is a manualized, evidence-based treatment with proven effectiveness for conduct disorder and substance abuse.
• Internationally recognized with superior outcomes compared to traditional treatments.
• Therapist adherence to the FFT model reduces recidivism and relapse.

Conclusion

• FFT provides a structured, evidence-based approach to addressing conduct disorders in youth, emphasizing systemic and relational functions within family dynamics.