22ndnd Annual FFT Symposium, April 23 & 24, 2009 Annual FFT Symposium, April 23 & 24, 2009Cricket Mitchell, PhDCricket Mitchell, PhD

Research Associate, Child and Families Team, CIMHResearch Associate, Child and Families Team, CIMH

California FFT California FFT Outcome EvaluationOutcome Evaluation

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Overview of SymposiumOverview of Symposium

• Recent FFT Community Development Recent FFT Community Development Team Dashboard ReportTeam Dashboard Report– Spring 2009– Estimated distribution: May 2008

• ElementsElements– Who’s served– Service delivery information– Program outcomes

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Recent FFT Outcome Evaluation Recent FFT Outcome Evaluation Dashboard Report Dashboard Report

(handout)(handout)

Spring 2009 Outcome Spring 2009 Outcome Evaluation Dashboard ReportEvaluation Dashboard Report

• CSS data download February 2009CSS data download February 2009– Reflecting youth served from each program’s

inception thru 1/31/09

• 29 sites29 sites

• 133 active therapists133 active therapists– Active at the time of the CSS data download

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FFT Dashboard Report Spring 2009 FFT Dashboard Report Spring 2009 Who is ServedWho is Served

• Table 1: FFT StatusTable 1: FFT Status– “Entry Rate”

• The proportion of youth referred for FFT who have at least one session.

– “Dropout Rate”• The proportion of youth who started FFT and did

not advance to the generalization phase.

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FFT Dashboard Report Spring 2009 FFT Dashboard Report Spring 2009 Who is ServedWho is Served

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Table 1. FFT Status – Clients Referred to Active FFT Therapists (N=2473)

Entry Rate Dropout Rate

94.5%(n=2337)

36.3%(n=849)

FFT Dashboard Report Spring 2009 FFT Dashboard Report Spring 2009 Who is ServedWho is Served

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FFT Dashboard Report Spring 2009 FFT Dashboard Report Spring 2009 Service Delivery InformationService Delivery Information

• Table 3: FFT Process DataTable 3: FFT Process Data– Families with at least one session in Behavior

Change• At least one pre-FFT YOQ (youth self-report,

mother, and/or father)• At least one CPQ completed in Engagement &

Motivation and/or Behavior Change (youth self-report, mother, and/or father)

– Indicates therapist adherence to FFT protocol

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FFT Dashboard Report Spring 2009FFT Dashboard Report Spring 2009Service Delivery InformationService Delivery Information

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Table 3. FFT Process Data – Youth Served by Active Therapists Who Had At Least One Session in the Behavior Change Phase (n=1647)

Families With At Least One Completed Youth Outcome

Questionnaire (YOQ) Prior to FFT (Pre-YOQ)

Families With At Least One Completed Counseling Process

Questionnaire (CPQ) in Engagement & Motivation and/or

Behavior Change

76.6%

(n=1262)

65.3%

(n=1076)

FFT Dashboard Report Spring 2009 FFT Dashboard Report Spring 2009 Service Delivery InformationService Delivery Information

• Table 4: FFT Process Data Table 4: FFT Process Data (slide 1 of 2)(slide 1 of 2)

– “Completed FFT”• At least one session in Generalization

AND• At least one outcome measure (TOM, COMs,

YOQs, any informant)

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FFT Dashboard Report Spring 2009 FFT Dashboard Report Spring 2009 Service Delivery InformationService Delivery Information

• Table 4: FFT Process Data Table 4: FFT Process Data (slide 2 of 2)(slide 2 of 2)

– For youth who have Completed FFT • Average number of sessions in each phase• CPQ data, by informant, for the Generalization

Phase– Average score for core items 1-16 (7-point Likert scale)– The percent improvement in scores from item 17 to 18

(“How good or bad were things when you first started coming” compared to “How good or bad are things now”)

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FFT Dashboard Report Spring 2009FFT Dashboard Report Spring 2009Service Delivery InformationService Delivery Information

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Table 4. FFT Process Data – Youth Served by Active Therapists Who Completed FFT (n=884)

Average Number of Sessions

Counseling Process Questionnaire (CPQ) Data:

Generalization Phase

Total E & M B. C. Gen.

Mother Report Father Report Youth Report

Avg

1-16

% ↑

17-18

Avg

1-16

% ↑

17-18

Avg

1-16

% ↑

17-18

14.3 4.9 5.8 3.5 6.2 180% 5.9 141% 6.0 138%

FFT Dashboard Report Spring 2009 FFT Dashboard Report Spring 2009 Program OutcomesProgram Outcomes

• Table 5: FFT Outcome DataTable 5: FFT Outcome Data– For youth who have Completed FFT

• Percent improvement in YOQ & YOQ-SR total scores from pre- to post-FFT (mother, father, youth client)

• Possible YOQ/YOQ-SR total scores range -16 to 240• Clinical cutpoint YOQ = 47• Clinical cutpoint YOQ-SR = 46

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FFT Dashboard Report Spring 2009FFT Dashboard Report Spring 2009Program OutcomesProgram Outcomes

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Table 5. FFT Outcome Data – Youth Served by Active Therapists Who Completed FFT (n=884)

Youth Outcome Questionnaire (YOQ) –

Percent Improvement Pre/Post

Mother Father Youth

27.0%**(n=536)

[pre=65.6]

19.4%**(n=163)

[pre=64.0]

21.1%**(n=620)

[pre=52.2]

**A statistically significant improvement, p<.01.

Interpreting FFT Outcomes Interpreting FFT Outcomes Reported in Spring 2009Reported in Spring 2009• On average, for youth who participate in On average, for youth who participate in

California’s FFT programs…California’s FFT programs…– Mothers report a 27% improvement and

fathers report a 19% improvement in their overall mental health functioning (as assessed by the Youth Outcome Questionnaire©).

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Interpreting FFT Outcomes Interpreting FFT Outcomes Reported in Spring 2009Reported in Spring 2009• On average, youth who participate in On average, youth who participate in

California’s FFT programs…California’s FFT programs…– Self-report a 21% improvement in their overall

mental health functioning (as assessed by the Youth Outcome Questionnaire–Self-Report©).

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Interpreting FFT Outcomes Interpreting FFT Outcomes Reported in Spring 2009Reported in Spring 2009• FFT is performing equally well across FFT is performing equally well across

gender and ethnicity in California’s gender and ethnicity in California’s programsprograms– Follow-up analyses of aggregate data

revealed no significant differences in FFT entry rate, dropout rate, or program outcomes by gender or ethnicity

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Questions & DiscussionQuestions & Discussion

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The EndThe End

For More InformationFor More Information•Contact Cricket Mitchell, PhDContact Cricket Mitchell, PhD

•Email: cmitchell@cimh.org•Cell phone: 858-220-6355