What Works
youth. Originally developed in 1969 by James Alexander and Bruce Parsons at the University of Utah, FFT focuses on the multiple systems within which adolescents and their families live.150 The overarching goal is to prevent anti-social behavior
and other problems by engaging the family, developing family strengths and counteracting risk factors for problem behavior. FFT was designed to help diverse populations of at-risk youth, many of which are underserved and labeled as treat- ment resistant. The program specifically targets 11-18 year-olds and their families, including youth engaging in delinquency, violence or substance abuse.
The FFT model has three distinct phases: engagement and motivation, behavior change, and generalization. Each phase has distinct goals and objectives, and each addresses differ- ent risk and protective factors. Engagement and motivation is designed to break down barriers and prepare youth and families for positive change. Behavior change focuses on skill building and the development and implementation of appropriate short- and long-term behavior change plans. Generalization is aimed at relapse prevention and helping families to sustain change by applying what has been learned to future situations.
FFT has been applied in a variety of contexts. It can be delivered as a home, clinic or school-based intervention, and it has been used in diversion, probation and reentry set- tings.151 On average, participating youth and families attend
8 to 12 one hour sessions over a 3 month period, but up to 30 hours of service may be involved. FFT sessions are deliv- ered by one or two highly trained therapists, with therapists’ caseloads averaging 12-16 families.
FFT programs are currently operating in more than 20 states and at least two foreign countries. Dissemination, training and technical assistance are provided by FFT Inc., in Seattle, Washington. FFT is recognized as a model program by the Center for the Study and Prevention of Violence at the University of Colorado.
Multidimensional Treatment Foster Care
Multidimensional Treatment Foster Care (MTFC) is a pro- gram for youth displaying serious and chronic anti-social behavior or emotional disturbance who are in need of out-of-home placement. It serves as an alternative to group or residential treatment, incarceration or hospitalization. Developed by Patricia Chamberlain at the Oregon Social Learning Center (OSLC) in 1983, the MTFC model is based on the principles of social learning theory and research conducted by Gerald Patterson and John Reid at the OSLC in the 1970s.
MTFC provides short-term (6-9 months), highly structured care and supervision in the foster family setting. Foster par- ents are recruited, trained, and supported by the program, and they provide youth with close supervision, a supportive relationship, and reduced contact with antisocial peers. Adolescents under MTFC typically engage in social and aca- demic skills-building, as well as other therapeutic activities that are matched to the individual’s age and need. MTFC also provides family therapy to biological parents and/or other aftercare resources. Academic support, psychiatric consultation and medication management are also provided when needed.
Foster parents receive 12 -14 hours of training and a vari- ety of support services, including access to MTFC staff 24 hours a day/7 days a week. The MTFC treatment team, which meets weekly, includes a supervisor, a family thera- pist, an individual therapist, a child skills trainer, and a daily telephone contact person. The program supervisor provides intensive support to the foster parents and oversees inter- ventions delivered by MTFC team members and others in home, school and other settings.
The MTFC adolescent program has been implemented in at least 35 locations throughout the country and in several for- eign countries. Youth are referred from a variety of sources, including probation and the juvenile courts. Most referrals have been involved in numerous prior treatment efforts and have failed at least one prior out-of-home placement. Since the early 1980’s, the MTFC model has been expanded to serve youth in other age groups as well. Today, there is a version of MTFC for children 3-5 years of age as well as the one for adolescents. A version of MTFC for children 6-11 years of age is in development.
The MTFC program is disseminated through TFC Consultants, Inc. in Eugene, Oregon. TFC provides com- plete implementation services, including training and technical assistance. TFC also has a MTFC certification process to help ensure that programs are implemented with fidelity and integrity. At least one provider in Colorado was receiving MTFC implementation services from TFC as of January, 2008. MTFC is recognized as a model program by the Center for the Study and Prevention of Violence at the University of Colorado.
Multi-Systemic Therapy
Multisystemic Therapy (MST) is a community-based inter- vention for serious and chronic juvenile offenders who are at risk of out-of-home placement. It was developed in the late 1970s based on the premise that individual, family and