Functional Family Therapy for Adolescent Behavior Problems

Adolescents with disruptive behavior problems represent one of the most difficult and recalcitrant treatment populations. These youth and their parents often enter treatment unwilling or unable to try new behaviors.

This book explains how to provide Functional Family Therapy (FFT), an empirically supported, highly successful family intervention for delinquent and substance-using adolescents. FFT systematically alters important risk and protective factors associated with the problem behaviors.

The FFT therapist first increases family members’ motivation to change by disrupting and replacing their dysfunctional attributions about themselves and each other. The therapist then works with the family to eliminate the problem behaviors and generalize new skills and interaction patterns to broader community relations.

James F. Alexander, PhD, created the core elements of Functional Family Therapy (FFT) in 1971 and has been researching and helping others implement the model since then. He provides training and supervision to FFT therapists across the United States and worldwide. In addition to his work with FFT, Dr. Alexander has enjoyed being a professor at the University of Utah for 40 years.
 
Dr. Alexander has had fellowships with APA Divisions 12 (Society of Clinical Psychology) and 43 (Society for Family Psychology) and has served as president of Division 43. He has received several awards for his contributions to family therapy and research from APA, the American Association for Marriage and Family Therapy, the American Family Therapy Academy, and the University of Utah. Most notably, he received the APA Presidential Citation for Lifetime Contributions to Psychology in 2009. He has also been honored for his teaching at the University of Utah.
 
Dr. Alexander has served on the editorial board for several family-related journals, including as senior consulting editor for The Family Psychologist. He has received training and research grants from the National Institute of Mental Health, the National Institute on Drug Abuse, and the University of Utah. He has published three books on FFT and more than 80 articles and chapters and has given hundreds of presentations and webinars nationally and internationally.
 
Holly Barrett Waldron, PhD, is a senior scientist at the Oregon Research Institute (ORI) and director of the ORI Center for Family and Adolescent Research. She has been involved with FFT clinical development and research for over 30 years, including the early efforts of the FFT team at the University of Utah and later the development of the FFT Blueprint for Violence Prevention model for the University of Colorado Center for Violence Prevention. She began training FFT therapists in the clinical psychology and licensure for alcohol and drug abuse counseling programs at the University of New Mexico in 1988.
 
Dr. Waldron also established a program of research evaluating FFT through a series of clinical trials funded by the National Institutes of Health. To date, she has conducted more than a dozen randomized clinical trials and other investigations examining the efficacy and effectiveness of FFT. Her research and clinical efforts have focused on the implementation of FFT for adolescent substance use disorders, delinquency, depression, and HIV risk behaviors.
 
The investigations she and her colleagues at ORI have conducted have led to innovations in FFT, including specialized behavior change technologies for substance abuse and depression, evidence-based strategies for integrating motivational incentives into FFT to promote abstinence, and strategies for reducing drug use relapse and recidivism through an FFT aftercare program. She is currently directing research to evaluate FFT supervision using observational training methods and evaluating the delivery of FFT to rural families via a web-based video link.
 
As a scientist–practitioner, Dr. Waldron is actively engaged in FFT dissemination and has extensive experience training and supervising FFT therapists in community settings. She has developed a Spanish-language training system for FFT and has trained FFT therapists working with Spanish-speaking families in the United States and in Latin America.
 
Dr. Waldron is currently disseminating FFT through Leading Implementations in Functional Family Therapy Co. (LIFFT). The primary focus of LIFFT is to expand the adoption and reach of the FFT model nationally and internationally, with an emphasis on treating drug abuse and related problems.
 
Michael S. Robbins, PhD, completed his doctorate in clinical psychology at the University of Utah and a clinical internship at the University of Miami School of Medicine. He served as research associate professor in the Department of Psychiatry and Behavioral Sciences at the University of Miami School of Medicine for 15 years. He is currently a senior scientist at the Oregon Research Institute and research director for Functional Family Therapy, LLC.
 
Dr. Robbins has many publications in the area of family therapy for adolescents with behavior problems. He has extensive experience conducting clinical research on family therapy with drug-using, delinquent adolescents and their families, including innovative process studies that involve the examination of in-session processes across three empirically validated family interventions as well as large multisite trials examining the impact of family therapy in real-world settings. He has directly overseen the training of hundreds of family therapists both nationally and internationally.
 
Dr. Robbins is a frequent lecturer and consultant and is recognized as a leader in the areas of process and outcome research in adolescent drug abuse treatment.
 
Andrea A. Neeb, MS, received her master of science degree from Nova Southeastern University in 2001 and became a licensed mental health counselor in 2004. Over the past 10 years, she has worked with Functional Family Therapy, LLC, as a trainer and consultant. She has been involved in the dissemination and training of the FFT model to organizations throughout the United States and Europe. Ms. Neeb's primary focus of work has been in the clinical development of therapists in their practice of the FFT model with diverse client populations and settings.
 

Adolescents with disruptive behaviour problems represent one of the most difficult and recalcitrant treatment populations. These youth and their parents often enter treatment unwilling or unable to try new behaviours. Family interactions are laced with blame, hostility, hopelessness, and rejection, all of which create a context that interferes with adaptive change. This book explains how to provide Functional Family Therapy (FFT), an empirically supported, highly successful family intervention for delinquent and substance-using adolescents. FFT systematically alters important risk and protective factors associated with the problem behaviours. The FFT therapist first increases family members' motivation to change by disrupting their dysfunctional attributions about themselves and each other and replacing them with more positive and adaptive perceptions. The therapist then works with the family to eliminate the problem behaviours and generalise new skills and interaction patterns to broader community relations. Robust yet flexible, the FFT model has been replicated successfully in juvenile justice, mental health, and child welfare settings, as well as traditional substance treatment and school-based programs. Given FFT's high success rate and ability to fit an array of settings, this book is ideal for all therapists and administrators who work with troubled youth and their families. Readers will learn the therapy goals and techniques for each phase of FFT, as well as recommendations for supervision and administration.

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