Functional Family Therapy (FFT)

A short-term (approximately 30 hours) family therapy intervention and juvenile diversion program helping at-risk children and delinquent youth, ages 11-18, to overcome adolescent behavior problems, conduct disorder, substance abuse and delinquency. Therapists work with families to assess family behaviors that maintain delinquent behavior, modify dysfunctional family communication, train family members to negotiate effectively, set clear rules about privileges and responsibilities, and generalize changes to community contexts and relationships.

FFT should be implemented with a team of 3-8 master’s level therapists, with caseloads of 10-12 families, for 3–5 months, with oversight by a licensed clinical therapist. FFT is a phased program with steps which build upon each other. These phases consist of:

  • Engagement, designed to emphasize within youth and family 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, parenting skills, contracting and response-cost techniques, and youth compliance and skill building;
  • 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.

FFT has been evaluated in multiple studies in samples across the United States and Sweden. Study design has ranged from random assignment, to quasi-experimental designs that involved matched but not randomly assigned comparison groups, to comparisons with base rates for that population. Overall, FFT has produced statistically significant reductions in recidivism and improved family interaction problems.

In a Utah study, FFT families, 6-18 months following treatment, showed significant improvement compared to no treatment and alternative treatment groups in rates of reoffense (26% versus 47%-73%). A follow-up study with the siblings of the targeted youth found that at 2.5 to 3.5 years after intervention, significantly fewer siblings had juvenile court records (20%) compared to families receiving no or other interventions (40% to 63%).

A meta-analysis of effect size for eight evaluations of FFT reported a mean unadjusted effect size of -.59 and an adjusted mean effect size of -.32, demonstrating that FFT is a cost effective approach for reducing juvenile crime.

Read the Program Fact Sheet

Return to Blueprints Bulletin Issue 5. January 2018.