Functional Family Therapy (FFT) is a systematic, evidence-based, family-based treatment program that has proven successful in treating a wide range of problems affecting youth, and their families.
Youth treated with FFT are typically labelled as having one of three types of problems: externalising and internalising behavioural problems, and other deviant behaviours that do not fall neatly into either of these two categories. Adolescents referred to mental health and juvenile justice services are most likely to exhibit externalising behavioural problems including ODD and CD. Internalising behavioural problems include anxiety, depression and social withdrawal.
These adolescents may not attract the attention of others as readily as those exhibiting externalising behavioural problems, as they are not ‘acting out’ so their behaviour may go unnoticed. Other behaviours that may not fit the criteria for either externalising or internalising behaviour problems include truancy, drug use, bullying or running away.
FFT is based on the theory that problem behaviours in adolescence can be maintained through negative family interactions. FFT seeks to address those family interactions by helping families understand and change them. An example of this is to look at a case of an adolescent misusing drugs. Families entering treatment for adolescent drug misuse will often have already engaged in a number of confrontational exchanges without any change to the adolescent’s drug use.
What may have become lost in all of these exchanges between parents and adolescents and between parents themselves is that the two parents may have very different views on drug use during adolescence. The mother may have lost a sibling to a drug overdose and bring all of those fears to her interactions with her child heightening her anxiety levels. The father may think that a lot of teenagers experiment and believe his child will grow out of it. Neither parent can see where the other is coming from and the adolescent gets mixed messages, which could serve to perpetuate the drug use. In FFT these parents and their adolescent are helped to understand the pattern of interaction which maintains the young persons drug use, and then develop ways to change this, and maintain positive changes into the future.
FFT consists of three phases: engagement and motivation, behaviour change and generalisation. The goals of this first phase are initially to build a balanced alliance between each member of the family, to reduce negativity and blaming and allow the whole family to share responsibility for improving their situation. To create a family focus for problems is important for the family as it allows for new solution avenues to open. As well as that it helps every family member present to understand each individual within the context of the family and how the problem behaviour, or referral reason fits into their unique system.