Sarah Sussman

Brief Overview

Founded by Dr. James

Alexander in the 1970s

• Short-term, culturally sensitive, strengths based treatment

strategy

• Focuses on motivating at-risk youth and strengthening the

families through:

(a) Crime prevention

(b) Prevention of Community victimization

Rationale

EBP that successfully remedies adolescent delinquency within the community

Functional Family Therapy (FFT) addresses behavioral and/or emotional issues in the adolescent population

Juvenile offenses, violent behaviors, and substance abuse are all areas in which FFT can be applied

“Evidence-based programs have been

shown to successfully treat delinquent

youth in the community & decrease out of

home placement cost between $1300 and

$5,000 per family per year, while

incarcerating just one youth will cost over

$50,000 per year with the likelihood of

poorer outcomes for both the youth &

their family.”

Evidence Based Practices for Juvenile Justice Reform in

Louisiana, (2010).

Need for concern?

Social workers should

be concerned because:

• at-risk population

needs an effective,

evidence based

intervention model

that can serve as a

blueprint to

formulate an

effective model in

any community

Society should be

concerned because:

• at risk population

jeopardizes their

safety and also costs

them money via the

costs of incarcerating

the delinquent youth

that live within their

community

Synopsis of the Program

Functional Family Therapy is comprised of FIVE main

concepts:Engagement

Motivation

Relational assessment

Behavior change

Generalization

There are particular interventions and tactics utilized to

assist in the accomplishment of the goals specific to each

area within the FFT program.

Demonstration Videos

Dr. James Alexander, the creator of Functional Family

therapy, gave a presentation in Utah in February of 2013.

While the entire video is interesting. at 37:40, he

demonstrates what Functional Family Therapy is all

about.

https://www.youtube.com/watch?v=8a_RmrcwpDM

Professor Sexton offers an example of the type of

children Functional Family Therapy works with at 12:10

of this video:

https://www.youtube.com/watch?v=a7Ohnv8SRqk

Assessment from the

Originator

According to Professor James Alexander, “it’s a

therapy for MOST people and it is designed to help

the greatest number of people at the lowest cost”

It is a universal technique; however, it requires

individualization

Regarding efficacy and efficiency: there 36 published

studies, most of which were done by independent

people who have replicated Dr. James Alexander’s

work

Secondary Assessment

According to Dr. Michael Robbins, Senior Scientist at

the Oregon Research Institute and Director of

Research for Functional Family Therapy, Inc, FFT

“works”.

He reports the use of FFT demonstrates that 80-90%

of families not only are engaged but are also

successfully treated compared to the 70% that were

not getting a full dose of treatment prior to FFT

Third Assessment

According to Professor Sexton, “Somewhere in

the world, everyday, FFT is done in one of 8 or

9 different languages. That’s kind of a

remarkable accomplishment for a psychological

therapy, most of which (most of them are)

culturally and language based. The reason that

FFT has been able to that is because the

process of it is not about the content of what

people say, it’s about the process of what goes

on between people. And it seems that those

processes between people are universal”

My Assessment

Functional Family Therapy is:

Flexible delivery (in-home or in-community)

Culturally Competent

Evidenced-Based

I find FFT to be a useful blueprint, if you will, for work with

families, adolescents, and even communities; however, I

believe the key to success is the ability to individualize the

program for the needs of the particular case at hand

FFT & Child Abuse/Neglect

FFT is effective in engaging and motivating both adolescents

and families, including adults.

There is evidence supporting FFT’s effectiveness in keeping

adults out of the criminal system.

FUNCTIONAL FAMILY THERAPY WORKS TO:

• Developing family communication and supportiveness

• Improving school performance and behavior in the home

• Decreasing negative feelings and reducing blame

• Understanding the importance of respecting all family

members

• Making positive changes and promoting effective solutionsCHR, 2014

Verdict…

The vast majority of research demonstrates the

effectiveness of FFT with adolescent behavior issues;

however, FFT has been used with children who report

physical and/or sexual abuse.

In fact, when asked about what “target populations” FFT

serves, James Alexander explains that in just one of their

projects, approximately 50% of the children come in with

documented instances of either physical or sexual abuse.

Where?

This program is being implemented both in-community

and in-home.

Specifically, FFT has been implemented state-wide in the

following places: Washington (juvenile parole and

probation), Florida (Florida Redirections project),

Louisiana, and Pennsylvania.

County programs include locations like Ohio (South

Community Behavioral Healthcare) and New York (The

Catholic Charities of Broome County).

FFT has also been implemented in Norway at the Center

for Child and Behavioral Development

Evaluation of FFT

Because FFT is often tailored for specific issues and

populations, the evaluation of outcomes and success

differs among programs

However, some means of evaluation include:

Assessing completion rates

Measuring re-arrest and recidivism rates

Calculating the amount of money taxpayers save as a

result of the program

Statewide Program Outcome Examples

FFT ‘s Washington State Project

continues to improve the cost

benefit to taxpayers of

Washington State. For every

dollar spent on FFT $18.98 is

saved through reductions in

felony recidivism.

FFT worked with The Norwegian

Center for Child Behavioral

Development over the last four years

to provide FFT to an ethnically diverse

population of youth. Since its

inception, completion rates have

increased by 22%, and 2011 saw a

reduction in risk level from 13.0

(moderate range) to 5.8 (low range) as

measured on the Youth Level of

Service (YLS).

When the Commonwealth

invests in FFT, it receives a cost

benefit of $14.56 for every dollar

spent on its program, a potential

statewide economic benefit of

$136 million. For 2010, 1642

youth were served in FFT, an

economic benefit of $67 million

The historical recidivism rate for

Louisiana juveniles has been

approximately 50%. FFT’s

Louisiana FFT programs have a

6% re-arrest rate and an 84%

completion rate.

County/Local Program Outcome Examples

FFT has been partnering with

The Catholic Charities of

Broome County, Binghamton

NY to provide FFT since 2003.

60% of the youth served have a

mental health disorder in

addition to probation

involvement. This site has seen

a 94% average placement

prevention rate since 2007.

2011 saw 99% with no new

felony offenses and 89% with no

new misdemeanor offenses.

In 2006, FFT and South

Community Behavioral

Healthcare came together to

become part of a multi-agency

collaborative in Montgomery

County’s LIFE Program. This

program utilized FFT to provide

home based mental health

services in conjunction with

juvenile justice programming to

youth and families. Of the 634

youth the LIFE Program has

served since its program

inception, only (0.9%) were sent

to an Ohio Department of Youth

Services facility at any time

following their enrollment.

Community Interest?Through the Redirection

program implementing FFT,

Florida is already seeing

decreased numbers of youth

being detained or committed

across the state since the

implementation of FFT. The

Department of Juvenile Justice

reported, “an 11% decrease in

youth being placed on

probation from 2009-2011.”

Since 2007, FFT has increased

completion rates by 31%.

Currently 80% of families who

enter FFT complete the

program, and recidivism rates

are 8% lower. (Quarterly Update Report,

R

Redirection Program Facts:

-Youth Served Since 2004: 7,149

-Males Served: 71%

-Females Served: 29%

Capacity: Approximately 1,250

youth per year

Total Cost Avoidance: $193

Million

Summarization of Thoughts

Prevention and Intervention Program for adolescents and

families both in-home and in-community

Functional Family Therapy successfully works with

behavior problems and juvenile delinquency, including

drug abuse and violence.

It is cost effective, culturally competent, and unique in

nature

It serves as an effective blueprint for a variety of

community programs

It is evidence based and systematic in nature

ReferencesAlexander, J. (2009, May 13). Jim Alexander functional family therapy.

(YouTube Video). Retrieved from

https://www.youtube.com/watch?v=bcyhb85RQxc

Alexander, J. (2013, February 28). Professor Jim Alexander on functional

family therapy. (YouTube Video). Retrieved from

https://www.youtube.com/watch?v=8a_RmrcwpDM

Alexander, J., & Sexton, T. (2000, December). Functional family therapy.

Office of Juvenile Justice and Delinquency Prevention: Juvenile Justice

Bulletin. Retrieved from

https://www.ncjrs.gov/html/ojjdp/jjbul2000_12_4/contents.html

Baglivio, M., Greenwald, M., Jackowski, K., & Wolff, K. (2014, September).

Comparison of multisystemic therapy and functional family therapy

effectiveness: A multiyear statewide propensity score matching analysis of

juvenile offenders. Criminal Justice and Behavior 41(9), 1033-1056. doi:

10.1177/0093854814543272

CHR. (2014). Functional family therapy. Retrieved from

http://www.chrhealth.org/uploads/FINAL%20CHR%20FFT%200711.pdf

Davey, A., Davey, M., & Duncan, T. (2010, December). Transporting

functional family therapy into community-based programs. The Family

References (continued)

Functional Family Therapy, LLC. (n.d.). About FFT training. Retrieved from http://www.fftllc.com/about-fft-training/project-outcomes.html

Janer, N. (2012). Quarterly Update Report. Retrieved from http://www.fftllc.com/documents/redirectionQ4_11.pdf

Onedera, J. (2006, June). Functional family therapy: An interview with Dr. James Alexander. The Family Journal 14(3), 306-311. doi: 10.1177/1066480706287802

Robbins, M. (2013, March 14). Functional family therapy. (YouTube Video). Retrieved from https://www.youtube.com/watch?v=VFHGM7bHOH0

Sexton, T. (2013, March 26). Prof. Tom Sexton on functional family therapy. (YouTube Video). Retrieved from https://www.youtube.com/watch?v=a7Ohnv8SRqk

Sexton, T., & Turner, C. (2010, June). The effectiveness of functional family therapy for youth with behavioral problems in a community practice setting. Journal of Family Psychology 24(3), 339-348. doi: 10.1037/a0019406