Functional Family Therapy (FFT)

FFT is a short-term, high quality program with a strength-based multi-phase intervention model that focuses on identifying risk and protective factor that impact the adolescent and their environment, with specific attention paid to both interfamilial and extrafamilial factors.

functional-family-therapyThe FFT intervention is an evidence-based, culturally sensitive family therapy model for at risk and delinquent youth. Its first randomized clinical trial was completed in 1971 and demonstrated significant reductions of youth recidivism and sibling entry into youth service systems. The practice has an average of 12 sessions over a 3-4 month period. Services are conducted in both clinic and home settings, and can also be provided in a variety of settings including schools, child welfare facilities, probation and parole offices/aftercare systems, and mental health facilities.

At the core of FFT core is a focus and assessment of those risk and protective factors that impact the adolescent and his or her environment, with specific attention paid both intrafamilial and extrafamilial factors, and how they present within and influence the therapeutic process.

The Intervention Program

The intervention program itself consists of five major components in addition to pretreatment activities: Engagement in change; Motivation to change; Relational/Interpersonal Assessment and planning for Behavior change; Behavior Change; and Generalization across behavioral domains and multiple systems.

The goals of this phase involve responsive and timely referrals, a positive “mindset” of referring sources, and immediacy. Activities include establishing collaborative relationships with referring sources, ensuring availability, appraising multidimensional (e.g., medical, educational, justice) systems already in place, and reviewing referral and other formal assessment data.

The goals of this phase involve enhancing perception of responsiveness and credibility; demonstrating a desire to listen, help, respect, and “match;” and addressing cultural competence. The main skills required are demonstrating qualities consistent with positive perceptions of clients, persistence, cultural /population sensitivity and matching. Therapist focus is on immediate responsiveness and maintaining a strength-based relational focus. Activities include high availability, telephone outreach, appropriate language and dress, proximal services or adequate transportation, contact with as many family members as possible, “matching” and respectful attitude.

The goals of this phase include creating a positive motivational context, minimizing hopelessness and low self-efficacy, and changing the meaning of family relationships to emphasize possible hopeful experience. Required phase skills consist of relationship and interpersonal skills, a nonjudgmental approach, plus acceptance and sensitivity to diversity. Therapist focus is on the relationship process; separating blaming from responsibility while remaining strength-based. Activities include the interruption of highly negative interaction patterns and blaming (e.g. divert and interrupt), changing meaning through a strength-based relational focus, pointing process, sequencing, and reframing of the themes by validating negative impact of behavior, while introducing possible benign / noble (but misguided) motives for behavior. Finally, the introduction of themes and sequences that imply a positive future are important activities of this phase.

The goals of relational assessment include eliciting and analyzing information pertaining to relational processes, as well as developing plans for Behavior Change & Generalization. The skills of perceptiveness and understanding relational processes and interpersonal functions are required. The focus is directed to intrafamily and extrafamily context and capacities (e.g., values, attributions, functions, interaction patterns, sources of resistance, resources, and limitations). Therapist activities involve observation, questioning; inferences regarding the functions of negative behaviors, and switching from an individual problem focus to a relational perspective.

Behavior Change goals consist of skill building, changing habitual problematic interactions and other coping patterns. Skills such as structuring, teaching, organizing, and understanding behavioral assessment are required. Therapists focus on communication training, using technical aids, assigning tasks, and training in conflict resolution. Phase activities are focused on modeling and prompting positive behavior, providing directives and information, developing creative programs to change behavior, all while remaining sensitive to family member abilities and interpersonal needs.

The primary goals in the Generalization phase are extending positive family functioning; planning for relapse prevention and incorporating community systems. Skills include a multisystemic/systems understanding and the ability to establish links, maintain energy, and provide outreach. The primary focus is on relationships between family members and multiple community systems. Generalization activities involve knowing the community, developing and maintain contacts, initiating clinical linkages, creating relapse prevention plans, and helping the family develop independence.

Additional Resources

The mission of FFT LLC is to assure each FFT therapist, supervisor, team, and organization is supported at the highest level of expertise to implement, achieve and sustain the best possible outcomes for youth and families. FFT has developed a case management model for probation and parole officers and is currently implementing this model. gives girls reliable, useful information on the health issues they will face as they become young women, and tips on handling relationships with family and friends, at school and at home. Their tagline is “Be Happy. Be Healthy. Be You. Beautiful.” It focuses on the idea that being yourself—finding what makes you smile and how to live well—is what makes you “you.” And that is beautiful!

The mission of the National Runaway Switchboard (NRS) is to help keep America’s runaway and at-risk youth safe and off the streets. The organization serves as the federally designated national communication system for runaway and homeless youth.

Researchers at the Ohio Department of Mental Health and Addiction Services identify questions of importance to the agency and the public behavioral health system and lead studies that can inform planning priorities, disparities and quality of care. Major statewide research has been conducted on services and outcomes for adults with serious mental illness, as well as children/adolescents with serious emotional disturbances, and youth and young adults in transition.

The Substance Abuse and Mental Health Services Administration (SAMHSA) is the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance the behavioral health of the nation. SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on America’s communities.

The Behavioral Health Juvenile Justice (BHJJ) initiative, a shared effort of the Ohio Department of Mental Health and Addiction Services (OhioMHAS) and the Ohio Department of Youth Services (DYS), was created to enhance local options for providing services to juvenile offenders with serious behavioral healthcare needs. Pilot projects that started in a few Ohio counties in early 2000 have grown into a statewide initiative with strong support from additional state and local stakeholders. The projects are designed to transform child-serving systems by enhancing their assessment, evaluation, and treatment of multi-need, multi-system youth and their families. In addition, they provide the Juvenile Court judges an alternative to incarceration.


Richard Shepler, PhD