An Outcome-Based Evaluation of Functional Family Therapy for Youth with Behavioral Problems

IntroductionPractitioners, policymakers, and researchers continually seek effective interventions to reduce delinquent and predelinquent behavior among adolescents. Despite a significant reduction in juvenile arrests in recent years, their arrest rates for violent offenses remain high. In 2010 in the United States, nearly 13% of arrestees were under age 18. Data indicate that juveniles committed more than 13% of all violent crimes and nearly 23% of all property crimes (Uniform Crime Reports, 2010). Although youth are commonly believed to be more capable of behavioral changes and more amenable to intervention than are adults, many programs fail to show positive effects on delinquency. Some researchers claim that many interventions focus narrowly on youth individual characteristics and fail to address contextual sources of delinquent behavior among youth (Alexander & Sexton, 2002; Gordon, Graves, & Arbuthnot, 1995). According to Andrews and colleagues (1990), for an intervention to be successful, it should address multiple levels of needs and risks among young offenders. Lipsey (2009) reviewed 548 study samples and found that "therapeutic" interventions that included counseling or skills training were more effective than interventions that focused on deterrence and control. Both Andrews and colleagues (1990) and Lipsey (2009) reported that, overall, cognitive-behavioral therapeutic interventions based on social learning and skill building were the most effective types of interventions for adolescents. One example of such intervention is family therapy. In fact, a number of researchers believe that family therapy is the most effective and comprehensive form of therapeutic intervention for at-risk youth (Alexander & Sexton, 2002; Alexander, Pugh, Parsons, & Sexton, 2000; Gordon et al., 1995; Henggeier & Bourdin, 1990). Among the various types of family therapy approaches, Functional Family Therapy (FFT) and Multisystemic Therapy (MST) have been recognized by various governmental (Office of Juvenile Justice and Delinquency Prevention) and nongovernmental agencies (Center for the Study and Prevention of Violence at the University of Colorado) as model programs for delinquent youth. Lipsey, Howell, Kelly, Chapman, and Carver (2010) found both interventions to be effective but point out that the variations in implementation and in the characteristics of participating youth influence their effectiveness. FFT is a model clinical family intervention designed to assist at-risk adolescents and their families in preventing further delinquency and violent behavior by enhancing support and communication within the family. While FFT focuses on improving family dynamics, MST intervenes in the wider network of institutions (e.g., family, peers, school, treatment agencies, etc.) in which delinquent youth are enmeshed (Henggeler & Bourdin, 1990). This article presents the results of a quasi-experimental evaluation comparing the outcomes of at-risk youth enrolled in FFT with matched youth who were placed in individual therapy or mentoring. In our study, FFT was provided by the Children at Risk Resources and Interventions- Youth Intensive Intervention Program (CARRIYIIP), whereas individual therapy or mentoring was provided by Youth Case Management (YCM). CARRI-YIIP is a program that provides services to youth and families that include parenting education, home visits, and counseling. YCM is a management program that refers children and youth with behavioral and emotional problems to various programs within the community.The primary goals of the interventions were to prevent future delinquency by reducing the dangerous behavior of adolescents, decreasing family levels of need, and increasing the strengths of youth and their caregivers.We employed the Strengths and Needs Assessment (SNA) (Lyons, 2009; Lyons, Weiner, & Lyons, 2004; Caliwan & Furrer, 2009), an information management decision support tool, to gather information in a standardized way with a focus on youth functioning across life domains. …