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This article summarizes the evolution of functional family therapy (FFT) based upon four decades of clinical practice and scientific scrutiny through research evidence. FFT research has evolved from an initial focus upon clinical process research, which examined sequential exchanges between therapists and family members. A key element of this research has been an examination of the way in which clinicians acquire, consolidate, and maintain the skills needed to implement FFT effectively with youth and families. Many randomized efficacy and effectiveness studies have evaluated the impact of FFT across diverse clinical populations. Subsequent research investigated factors that influence the effectiveness of implementation across more than 300 clinical settings in which more than 2,500 trained clinicians have provided service to nearly 400,000 families. Another important set of investigations concerned the cost-effectiveness of the interventions., (© 2016 Family Process Institute.)

This study examined the relationship between alliance and retention in family therapy. Alliance was examined at the individual (parent, adolescent) and family level (within-family differences) for families that either dropped out or completed family therapy. Participants were 31 Hispanic adolescents and their family members who received brief strategic family therapy for the treatment of adolescent drug use. Videotapes of first sessions were rated to identify parent and adolescent alliances with the therapist. Results demonstrated that Completer cases had significantly higher levels of alliance across all family members than Dropout cases, and Dropout cases had significantly higher unbalanced alliances than Completer cases. Clinical implications are discussed.

In response to a series of national policy reports regarding what has been termed the "quality chasm" in health and mental health care in the United States, in January 2003, the American Association for Marriage and Family Therapy convened a task force to develop core competencies (CC) for the practice of marriage and family therapy (MFT). The task force also was responding to a call for outcome-based education and for the need to answer questions about what marriage and family therapists do. Development of the CC moves the field of MFT into a leading-edge position in mental health. This article describes the development of the CC, outcomes of the development process for the competencies, and recommendations for their continued development and implementation.

The authors examined the relations between adolescent-therapist and mother-therapist therapeutic alliances and dropout in multidimensional family therapy for adolescents who abuse drugs. The authors rated videotapes of family therapy sessions using observational methods to identify therapist-adolescent and therapist-mother alliances in the first 2 therapy sessions. Differences in adolescent and mother alliances in families that dropped out of therapy and families that completed therapy were compared. Results indicate that both adolescent and mother alliances with the therapist discriminated between dropout and completer families. Although no differences were observed between the 2 groups in Session 1, adolescents and mothers in the dropout group demonstrated statistically significantly lower alliance scores in Session 2 than adolescents and parents in the completer group. These findings are consistent with other research that has established a relationship between therapeutic alliance and treatment response., (Copyright 2006 APA, all rights reserved.)

This study examined the relationship between alliance and retention in family therapy. Alliance was examined at the individual (parent and adolescent) and family levels (within-family differences). Participants were 34 families who received functional family therapy for the treatment of adolescent (aged 12-18 years) behavior problems. Families were classified as treatment dropouts (n=14) or completers (n=20). Videotapes of the first sessions were rated to identify parent and adolescent alliances with the therapist. Results demonstrated that individual parent and adolescent alliances did not predict retention. However, as hypothesized, dropout cases had significantly higher unbalanced alliances (parent minus adolescent) than did completer cases. These findings highlight the importance of alliances in functional family therapy and suggest that how the alliance operates in conjoint family therapy may be a function of systemic rather than of individual processes., (((c) 2003 APA, all rights reserved))

This study compared the immediate impact of therapist reframing, reflection, and elicit-structure interventions on family-member defensive communications in the initial session of family therapy with a delinquent adolescent. Defensive statements included family-member statements that criticized, blamed, or disagreed with other family members. Sequences of behaviors following defensive family-member statements were examined to determine which therapist interventions were the most effective in disrupting defensive family interactions. Thus, every sequence included a defensive family-member behavior, a therapist intervention, and a family-member response (sequence: family defensive-->therapist intervention-->family response). Results indicated that therapist reframing is more effective than other therapist interventions in reducing family-members' defensive statements. Moreover, adolescents responded more favorably to reframes than did fathers.

This paper discusses family therapy research in applied settings and highlights those methodological issues relevant to the program evaluator as compared to those relevant to the basic researcher. Four general methodological issues are discussed: design adequacy, issues related to dependent measures, situational factors, and issues of generalization and duration of treatments. Two specific, well-validated applications of family therapy are elaborated; and finally several conclusions are drawn regarding future research strategies.

Parents' data were evaluated in three studies of families with a delinquent adolescent. Families were provided with different forms of a positive versus negative interactional (attributional) context. Study 1 demonstrated that the negative context elicited significantly more negative behaviors than did the positive context when parents interacted with each other and with their delinquent adolescent. Study 2 demonstrated that the dispositional attributions of parents were influenced by the manipulation of set, with a dissatisfied set producing negative blaming attributions and a satisfied set producing nonblaming, positive attributions. Study 3 demonstrated that parents' negative sets regarding their adolescent's negative behaviors, once established and discussed by the family for 5 min, were unresponsive to a subsequent positive reattribution regarding those behaviors. Taken together, the data provide some support for reattribution techniques such as relabeling. Yet, the data question the ease with which such techniques can be successful and challenge proponents of such techniques to develop methodologically sound empirical demonstrations of their effectiveness.