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Functional Family Therapy


James F. Alexander, Ph.D.
1329 Behavioral Science
University of Utah
Salt Lake City, UT 84112

(801)581-6538           Fax: (801) 581-5841

Family Therapy Speciality
6-18 years Target
Exemplary I Rating

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.


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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