A data driven model Clinical Practice Training Research Implementation Dissemination Studies Effectiveness Studies Efficacy Studies Process Studies Implementation Supervision Sustainability ID: 594293
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Slide1
State of the Science in Functional Family Therapy
A data driven modelSlide2
Clinical Practice
Training
Research
Implementation / Dissemination Studies
Effectiveness Studies
Efficacy Studies
Process Studies
Implementation
Supervision
Sustainability
Basic ResearchSlide3
Example of Interplay in ActionNegativity, Blame, Family Conflict
Basic ResearchAlexander (1973): Delinquent vs. Non-Delinquent familiesBarton et al. (1988): How delinquent and Non-Delinquent families respond to different cognitive setsMorris et al. (1991): Re-attribution influencing setProcess ResearchRobbins et al. (1996; 2000): Reframing and defensive communications in treatmentNewell (1995): Content free indicators of process
Clinical Model
Change Focus
Change Meaning InterventionsSlide4
Clinical Practice
Training
Research
Implementation / Dissemination Studies
Effectiveness Studies
Efficacy Studies
Process Studies
Implementation
Supervision
Sustainability
Basic ResearchSlide5
Range of OutcomesSlide6
Clinical Practice
Training
Research
Implementation / Dissemination Studies
Effectiveness Studies
Efficacy Studies
Process Studies
Implementation
Supervision
Sustainability
Basic ResearchSlide7
BOOST STUDY
Primary Objective
To examine the effects of observation-based supervision (BOOST) versus the standard supervision as usual (SAU) approach currently used by FFT LLC on the therapists’ ability to facilitate changes in the family.
BOOST will examine the following outcomes:
adolescent
drug
use
conduct/delinquent behaviors.
engaging youth/families in treatment
enhancing therapist competence
Slide8
Family
FunctioningSupervision Condition
Adolescent Conduct /
Delinquency
Therapist
Competence
Engagement-Retention
in Treatment
AIM 1a, 1b
AIM 2
AIM 3a
Adolescent
Substance Use
Mediating Variables
Outcome Variables
AIM 3b
AIM 4
AIM 4
AIM 4
Conceptual
Model of Hypothesized RelationshipsSlide9
Random Assignment of FFT Supervision Teams
Supervision as Usual
8 Teams - 3 Therapists Each
(n=24)
Observation-Based Supervision
8 Teams – 3 Therapists Each
(n=24)
Family Referral (n=288)
Screening and Informed Consent
Baseline Assessment
Follow-Up Assessments: 5-and 12-months after Baseline
Functional Family TherapySlide10
Clinical Practice
Training
Research
Implementation / Dissemination Studies
Effectiveness Studies
Efficacy Studies
Process Studies
Implementation
Supervision
Sustainability
Basic ResearchSlide11
Innovations in
Functional Family Therapy
Adaptation, Accommodation, and SpecializationSlide12
Functional Family Therapy through Child Welfare
FFT-CWSlide13
Behavior Change Focus
Attach-
ment
Self-Concept
PARENT
Behavior in
Context
Self-Regulation
FFTCW
THERAPIST
CHILD
Cue Recognition
Decision Making
Skill /Behavioral Sets
Cognitive
Development
Social
Development
Moral
DevelopmentSlide14
Roll-Out Randomization Study:
New York FoundlingSlide15
Clinical Practice
Training
Research
Implementation / Dissemination Studies
Effectiveness Studies
Efficacy Studies
Process Studies
Implementation
Supervision
Sustainability
Basic ResearchSlide16
Ongoing Research
Outcome ResearchInternational replicationsEngland (H
igh vs. Low
R
isk
)
Belgium (
Re-entry
)
New Zealand (Maori families)
Chile (
Feasibility in a developing country)Drug useBOOST
Booster
sessionsSlide17
Ongoing Research
Adaptations / IntegrationsIntegration with CBTFFT-TraumaFFT with substance users
Integration with Contingency Management
Blue Sky—Delinquent substance users
NIDA—Substance users
FFT-Depression
Sequencing
FFT-Child Welfare
New York FoundlingSlide18
Clinical Practice
Training
Research
Implementation / Dissemination Studies
Effectiveness Studies
Efficacy Studies
Process Studies
Implementation
Supervision
Sustainability
Basic ResearchSlide19
FFT-GangsUniversity of MarylandSlide20
Primarily overlaps with core FFTAccommodations
Parents in gangsMultiple risk factorsPilot and full studyIssues in implementation
Gang AccommodationsSlide21
Aftercare in Functional Family TherapySlide22
Many of the problems we work with are chronic and recurring, such as substance abuse, depressionGeneralization and termination must include a formal plan for maintaining change
Referrals to servicesRelapse preventionComprehensive planned “booster” sessions can dramatically reduce relapseHowever, simple telephone calls (from therapist) conducted each month can be just as effective
Considerations for Providing
Aftercare ServicesSlide23
Florida DataSlide24
Tracking Data Results In:
California FFT 2011 – January 1, 2011-December 31, 2011 N=1381 familiesSlide25
Completions by CategorySlide26
Average Days In Program for Successfully Completed CasesSlide27
Average Days between Referral and First SessionSlide28
CSS usage – taken from weekly case report for active cases