The Effectiveness of Functional Family Therapy for Adolescent Behavioral and Substance Misuse Problems: A Meta‐Analysis

Abstract

A systematic review of published and unpublished English language articles identified 14 studies containing 18 comparisons between functional family therapy (FFT) and another condition in the treatment of adolescent disruptive behavior and substance use disorders. In 11 of these comparisons, assignment to conditions was random, while nonrandom assignment occurred in seven studies. For both random and nonrandom comparisons, separate meta-analyses were conducted for subgroups of studies depending on the type of comparison group used. Data from studies of untreated control groups (CTL), treatment as usual (TAU), and well-defined alternative treatments (ALTs) were analyzed separately. Effect sizes from these six meta-analyses were as follows: random assignment FFT versus CTL (k = 3, d = 0.48, p < .01); random assignment FFT versus TAU (k = 3, d = .20, ns); random assignment FFT versus ALT (k = 5, d = .35, p < .05); nonrandom assignment FFT versus CTL (k = 2, d = .90, ns); nonrandom assignment FFT versus TAU (k = 2, d = .08, ns); and nonrandom assignment FFT versus ALT (k = 3, d = .75, p < .001). These results provide support for the effectiveness of FFT compared with untreated controls and well-defined ALTs, such as cognitive behavior therapy, other models of family therapy, and individual and group therapy for adolescents.

The Implementation of Functional Family Therapy (FFT) as an Intervention for Youth Probationers in Singapore

“…Positive findings, in the form of reduced reoffending rates, have been reported in Norway (Thøgersen, 2012), and Sweden (Hansson, Cederblad, & H€ o€ ok, 2000). Two studies in Ireland (Graham, Carr, Rooney, Sexton, & Wilson Satterfield, 2014;Hartnett, Carr, & Sexton, 2016) reported success in implementation, as well as significant, sustained reductions in youth behavioral problems. However, a recent RCT conducted in the United Kingdom did not find any differences in reoffending rates or self-reported delinquency between youth who received FFT, relative to those in a comparison group (Humayun et al, 2017).…”

“…These include truancy (Slesnick & Prestopnik, ), violence (White, Frick, Lawing, & Bauer, ), and substance use (Rhoades, Campbell, & Bumbarger, ). A meta‐analytic study of randomized‐controlled trial (RCT) and quasi‐experimental studies showed support for FFT's overall robustness in mitigating youth delinquent behavior (Hartnett, Carr, Hamilton, & O'Reilly, ). Findings from non‐US sites, however, yield mixed findings.…”

Moderated Mediation of the Link between Parent-Adolescent Conflict and Adolescent Risk-Taking: the Role of Physiological Regulation and Hostile Behavior in an Experimentally Controlled Investigation

“…Indeed, greater adolescent hostility is related to more externalizing behavior over time (Fosco et al 2014;Glatz et al 2019), which researchers hypothesize may be due to adolescents' hostility influencing parents' interaction style as well, negatively impacting bidirectional family relationships (Glatz et al 2019). For more aversive, chronic conflict, intervention strategies that involve parents or other caregivers are critical to changing both individual behavior and the environment (Hartnett et al 2017).…”

Family Therapy for Adolescents: A Research‐informed Perspective

“…In a meta‐analysis of 14 studies, Hartnett, Carr, Hamilton, and O'Reilly () concluded that FFT was effective in significantly reducing conduct problems and recidivism rates compared with control conditions or alternative treatments. In a systematic review of 27 clinical trials, Alexander et al.…”

“…In a meta-analysis of 14 studies, Hartnett, Carr, Hamilton, and O'Reilly (2016) concluded that FFT was effective in significantly reducing conduct problems and recidivism rates compared with control conditions or alternative treatments. In a systematic review of 27 clinical trials, Alexander et al (2013) concluded that compared with routine services, FFT was effective in reducing therapy dropout, conduct problems, drug misuse, placement in foster care, and recidivism in adolescents from a variety of ethnic groups over follow-up periods of up to 5 years.…”