The Evolution of Functional Family Therapy

More than 30 years ago, it became apparent to FFT progenitors that although the rate and severity of juvenile delinquency, violence, and drug abuse were growing at a frightening pace, intervention programs remained seriously underdeveloped (Alexander and Parsons, 1973). In 1969, researchers at the University of Utah’s Psychology Department Family Clinic developed FFT to serve diverse populations of underserved and at-risk adolescents and their families. These populations lacked resources, were difficult to treat, and often were perceived by helping professionals as not motivated to change. Although these underserved populations were diverse in terms of family organization, relational dynamics, presenting problems, and cultures, they often shared a common factor: They had entered the school counseling, mental health, or juvenile justice systems angry, hopeless, and/ or resistant to treatment.

The developers of FFT recognized that successful treatment of these populations required service providers who were sensitive to the needs of these diverse families and competent to work with them, and who understood why the families had traditionally resisted treatment. Over the past 30 years, FFT providers have learned that they must do more than simply stop bad behaviors; they must motivate families to change by uncovering family members’ unique strengths, helping families build on these strengths in ways that enhance self-respect, and offering families specific ways to improve.

Since its development, FFT has been a dynamic clinical system. It has retained its core principles while adding clinical features that improve successful outcomes in the diverse communities in which it has been implemented. More than two decades ago, FFT began focusing on therapist characteristics and in-session processes from an integrated perspective that combines research and practice. This perspective, in turn, has contributed to the training of therapists for subsequent interventions by identifying specific step-by-step interventions and their impact on youth and other family members.

In the late 1990’s, FFT further articulated its clinical change model by refining the phases of intervention (Sexton and Alexander, 1999; see table), developing a systematic approach to training and program implementation, and adding a comprehensive system of client, process, and outcome assessment. The system is implemented through a computer-based client tracking and monitoring system known as the Functional Family Therapy–Clinical Services System (FFT–CSS). This most recent iteration of FFT helps clinicians identify and implement goals for therapeutic change in a way that promotes accountability through process and outcome evaluation. As a result, FFT has matured into a clinical intervention model that includes systematic training, supervision, process, and outcome assessment components—all directed at improving the delivery of FFT in local communities.

Source: Sexton and Alexander, 1999.

Functional Family Therapy	Juvenile Justice Bulletin • December 2000