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Functional family therapy

Local governments can invest in this strategy using State and Local Fiscal Recovery Funds (SLFRF) from the American Rescue Plan Act (ARPA).

  • This strategy can help promote healthy childhood environments and improve access to health services. The U.S. Department of Treasury has indicated that strategies that help achieve these outcomes are eligible for the use of Fiscal Recovery Funds.
  • Investments in this strategy are SLFRF-eligible as long as they are made in qualified census tracts or are designed to assist populations or communities disproportionately impacted by COVID-19.

Program overview

  • Addressing risk factors: Functional family therapy (FFT) is a multisystemic, family-based therapy intervention for at-risk youth. It aims to minimize behavioral issues and justice-system involvement by decreasing risk factors (e.g., family drug use) and increasing protective factors (e.g., strong support network), with a special emphasis on familial factors.

  • Designed for at-risk youth: FFT is designed for youth ages 11 to 18 who have engaged in or are at risk of justice-involvement or severe behavioral issues, like substance use and conduct disorder. Typically, youth are referred to an FFT program by their school, a social service or child welfare agency, or as part of a court diversion program. The model can be adapted to meet the specific needs of youth in the child welfare system, gang-involved youth, and youth on probation or parole.

  • Providing sustained, short-term treatment: FFT is delivered by a team of three to eight master’s-level therapists, who typically work for a nonprofit (e.g., social services organization) or government agency (e.g., a school district or court system) that directly serves at-risk youth.

  • Building trust and skills: During FFT sessions, a therapist works with the youth and their family as they identify motivations for change, learn skills to induce behavioral change (e.g., conflict resolution), and apply those skills to new situations. The intensity and length of the treatment varies depending on the participants’ needs, but an average treatment consists of 8-12 sessions over a 3-5 month period.

Multiple studies with rigorous designs demonstrate that functional family therapy is a well-supported strategy for reducing recidivism and behavioral issues in adolescents.

Note: these practices are under review.

  • Create a referral network: In some jurisdictions, communication between child welfare, juvenile justice, and other organizations that work with at-risk youth is fragmented. By convening key these stakeholders, an implementing agency can educate other organizations on FFT eligibility requirements, program goals, and referral options. This type of outreach can ensure that youth who do not interact with the implementing agency still have access to FFT.

  • Train therapists to use the FFT model: Sponsoring agencies without expertise in FFT may seek training and certification from a training organization, like FFT LLC and FFT Partners. New sites progress through a three stage process consisting of clinical training for local therapists, supervisor training, and technical assistance to ensure ongoing fidelity to the model.

  • Maintain small caseloads: As part of the FFT model, therapists work regularly with adolescents and their families (e.g., up to 30 hours of contact) over a three to five month period. To make this level of care sustainable, therapists typically have small caseloads of 10 to 12 families and are part of teams of 3 to 8 therapists overseen by a licensed clinical therapist.

  • Bring treatment to participants: Scheduling and transportation can be barriers to adolescent and family participation in FFT. Since the model allows for delivery in both clinical and at-home settings, implementing agencies may consider delivering sessions at the family’s home to minimize barriers to participation.

  • Develop relationships with community organizations: FFT is a multisystemic therapy that recognizes that youth may face risk factors for behavioral issues in their everyday environment (e.g., at school, home, and in the community). By building relationships with leaders in community organizations that regularly interact with at-risk youth (e.g., schools, court systems, religious organizations), FFT therapists can better facilitate changes to the participant's environment that may reduce behavioral risks.

Learn more:
National Institute of Justice profile of functional family therapy Functional Family Therapy: Model overview Promote-Prevent: Functional Family Therapy overview Blueprints: Functional Family Therapy