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Functional Family Therapy (FFT) is an empirically-grounded, family-based intervention
program for acting-out youth. A major goal of Functional Family Therapy is to improve family
communication and supportiveness while decreasing the intense negativity so often characteristic of these
families. Other goals include helping family members adopt positive solutions to family problems, and
developing positive behavior change and parenting strategies. Although originally designed to treat middle
class families with delinquent and pre-delinquent youth, the program has recently included poor,
multi-ethnic, multi-cultural populations, with very serious problems such as conduct
disorder, adolescent drug abuse, and violence.
The program is conducted by family therapists working with each individual family in a clinical setting,
which is standard for most family therapy programs; more recent programs with multiproblem families involve
in-home treatment. The model includes four phases: (1) an introduction/ Impression Phase; (2) a
Motivation (Therapy) Phase; (3) a Behavior Change Phase; and (4) a Generalization (more multisystem focused)
Phase. Each phase includes assessment, specific techniques of intervention, and therapist goals and qualities.
The intervention involves a strong cognitive/attributional component which is integrated into systemic
skill-training in family communication, parenting skills, and conflict management skills.
The FFT model has been evaluated many times beginning in 1971. The model's effectiveness has been
independently demonstrated with a between-groups design, and its impact asserted at additional
performance sites. FFT has demonstrated a significant reduction in recidivism when compared to alternative
treatments and no treatment conditions. With less serious offenders, reductions ranged from
50-75%, and with very severe cases a 35% reduction in re-offense rate. These
outcomes have also been associated with dramatically reduced treatment costs. In addition to outcome
evaluations, FFT has focused on in-session therapist characteristics and family interaction
processes, which are predictive of positive change. The most notable process changes appear to be in family
communications patterns, especially the negative/blaming communications patterns. Process and outcome data
demonstrate that therapists must be relationally sensitive and focused, as well as capable of clear
structuring, in order to produce significantly fewer drop-outs and lower recidivism.
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Implementation Costs:
Implementation costs for Functional Family Therapy in one working group are approximately $20,000 for all
first year and start up costs (not including travel). Given caseloads of FFT therapists the project cost per
family, including training and implementation, is approximately $2,000 per family. After the first year of
implementation, a small yearly fee is required for certification of site compliance.
Training Costs:
Functional Family Therapy has a systematic training and implementation model for community agencies hoping
to implement FFT as a clinical model. The training and implementation model is based upon clinical training
for all staff, advanced clinical training team leaders, follow-up visits, and ongoing supervision.
The entire training/implementation process takes one year to complete.
The training components involve: A 3-day clinical training for all FFT therapists in a working group; an
externship training for one working group member (will become the clinical lead for the working group); 3
follow-up visits/year (2 days each on-site); and supervision consultations (4 hours
of monthly phone consultation). FFT is also supported by a systematic assessment, tracking and outcome
assessment system. Contact the program developer for more information.
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