Functional Family Therapy (FFT)

Evidence Rating  
Evidence rating: Scientifically Supported

Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.

Health Factors  
Decision Makers
Date last updated

Functional Family Therapy (FFT) serves youth with delinquency, violence, or substance abuse problems, youth involved in the juvenile justice system, and their families1. FFT focuses on strengths, challenges, protective factors, and risk factors that affect clients and their family systems. Through an average of 12 sessions, therapists establish a credible relationship with family members, motivate clients, explore family dynamics, work to change behavior patterns, and empower families with relapse plans and links to community resources2.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Reduced recidivism

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Reduced substance abuse

  • Reduced delinquent behavior

  • Reduced violence

  • Improved family functioning

What does the research say about effectiveness?

There is strong evidence that Functional Family Therapy (FFT) reduces recidivism among delinquent youth1, especially when therapists adhere strictly to the program’s model3.

FFT can improve family functioning and prevent siblings of FFT participants from entering the criminal justice system1. FFT may also lead to long-term reductions in youths’ delinquent and violent behavior4 and reduce the likelihood of later adult criminality1. The program may also reduce participants’ drug and alcohol use in some circumstances5, 6, especially for males7.

An evaluation of FFT for youth with behavioral problems indicates that participants have fewer emotional and behavioral problems, and less risky behavior than non-participating peers8; both mandatory and voluntary participants benefit from the program9. Hispanic youth appear to have the greatest benefits when matched with Hispanic therapists. Pairing youth with therapists of the same background appears less important for white youth10.

A Washington, D.C.-based analysis estimates that FFT cost about $3,600 per youth in 2012, with an average net benefit of $6,900 per participant from averted juvenile crime11.

How could this strategy impact health disparities? This strategy is rated no impact on disparities likely.
Implementation Examples

Functional Family Therapy (FFT) is available in almost every state2.

Implementation Resources

FFT - Functional Family Therapy (FFT). FFT LLC: The model's training and dissemination organization. Seattle, WA.

Addictions-Family therapy - Addictions.com. Family therapy.

FFT Partners - Functional Family Therapy Partners (FFT Partners). Improving the lives of families and communities through alliance-based partnerships.

Footnotes

* Journal subscription may be required for access.

1 Blueprints - Center for the Study and Prevention of Violence (CSPV). Blueprints for healthy youth development.

2 FFT - Functional Family Therapy (FFT). FFT LLC: The model's training and dissemination organization. Seattle, WA.

3 Sexton 2010 - Sexton T, Turner CW. The effectiveness of functional family therapy for youth with behavioral problems in a community practice setting. Journal of Family Psychology. 2010;24(3):339-48.

4 Sawyer 2015 - Sawyer AM, Borduin CM, Dopp AR. Long-term effects of prevention and treatment on youth antisocial behavior: A meta-analysis. Clinical Psychology Review. 2015;42:130-144.

5 Campbell-Filges 2015 - Filges T, Andersen D, Jørgensen AMK. Functional Family Therapy (FFT) for young people in treatment for non-opioid drug use: A systematic review. Campbell Systematic Reviews. 2015:14.

6 Waldron 2008 - Waldron HB, Turner CW. Evidence-based psychosocial treatments for adolescent substance abuse. Journal of Clinical Child & Adolescent Psychology. 2008;37(1):238-61.

7 Slesnick 2009 - Slesnick N, Prestopnik JL. Comparison of family therapy outcome with alcohol-abusing, runaway adolescents. Journal of Marital & Family Therapy. 2009;35(3):255-77.

8 Celinska 2013 - Celinska K, Furrer S, Cheng CC. An outcome-based evaluation of functional family therapy for youth with behavioral problems. OJJDP Journal of Juvenile Justice. 2013;2(2):23-36.

9 Celinska 2015 - Celinska K. Effectiveness of functional family therapy for mandated versus non-mandated youth. Juvenile and Family Court Journal. 2015;66(4):17-27.

10 Flicker 2008 - Flicker SM, Barrett Waldron H, Turner CW, Brody JL, Hops H. Ethnic matching and treatment outcome with Hispanic and Anglo substance-abusing adolescents in family therapy. Journal of Family Psychology. 2008;22(3):439-47.

11 Urban-Taxy 2012 - Taxy SA, Liberman AM, Roman JK, Downey PM. The costs and benefits of functional family therapy for Washington, D.C. Washington, D.C.: Urban Institute, District of Columbia Crime Policy Institute (DCPI); 2012.