Functional Family Therapy:
Looking to Families for Hope for Our Youth

EB-Advocate - Fall 2007 Issue

Problems with juvenile delinquents and their crimes are serious issues in many communities. These problems can range from truancy and trespassing to serious offenses like drug abuse and violence. What stems from these issues can be overwhelming personal, economic and social costs. Until many sources started to identify evidence-based intervention programs, the majority of these kids were handed punishments like incarceration as communities tried to address juvenile crime. We now know that such approaches are ineffective. Removing youth from their families and their communities causes more harm than good and the results become more difficult to address in the long-run.

Functional Family Therapy (FFT) is an outcome-driven and highly successful family intervention program for at-risk youth ages 10-18 and their families from a variety of ethnic and cultural groups. The FFT model is appealing because of its welldefined phases that organize family change in a coherent manner. An FFT clinician works with families for an average of 12 sessions over a three to four-month period. Services are conducted in both clinical and home-based settings and can be provided in a variety of contexts, including schools, child welfare, probation, parole/aftercare, mental health, and as an alternative to incarceration or out-of-home placement. Regardless of the target population, FFT emphasizes the importance of respecting all family members on their own terms.

FFT was developed by James F. Alexander, PhD more than 30 years ago and has been implemented as part of statewide projects in California, Florida, Washington, Pennsylvania and New York. During phase one of its development (1971-1997), FFT was characterized by an evolving efficacy/ effectiveness database, clinical training protocol, research examining therapists’ skills with youth and families, and independent replications. This first phase of FFT as an evidence-based model culminated in its selection as a “model project” program by Blueprints for Violence Prevention at the Center for the Study and Prevention of Violence in Boulder, Colorado.

Phase two (1998-2006) of FFT involved, also with support of the Blueprints project, an approach to multi-site dissemination and accountability involving specific intervention agencies, states, and even countries. By the end of 2006 FFT had 250 active sites, 750 therapists, and worked with close to 30,000 families per year. During this time, independently published research continued to expand the evidencebase of FFT to explore as well as changes to therapists’ in-session systems.

Currently in what FFT considers their third phase (2007-current), the program continues its commitment to be a strengthbased interpersonal model with the change process grounded firmly in the relationship between the therapist and the family. This relationship is integral to the success of the program and it is important that the therapist engages the family as people of great worth with dignity and nobility instead of a family characterized by inappropriate behaviors or disfunction.

The heavy focus on engaging families is a purposeful one. In 2003, Alan Kazdin, renowned Yale University Professor and researcher found that the traditional rates of retention of families in therapy were 50 percent. In a study across FFT sites ranging in locations from Idaho, Washington and Florida in both office and home-based settings, the engagement and retention rates with FFT were 79-90 percent. When the engagement process is done with adherence, families start and complete the therapy process. This allows them to build hope, reduce clinical symptoms and empower themselves for long-term stability.

The results of more than 30 years of clinical research suggest that by following their principles, FFT can reduce recidivism and/ or prevent the onset of delinquency. These results can be accomplished with treatment costs well below those of traditional services and other interventions. For these reasons, FFT is a sound and economically-viable alternative to incarceration or out-of-home placement of youth.