Functional Family Therapy is modeled in Houston, TX and Los Angeles, CA

The California Institute for Mental Health (CIMH) has, for the last 10 years, collaborated with FFT LLC to implement Functional Family Therapy in over 45 sites across California mental health, child welfare and juvenile justice service systems. Our bi-annual evaluation results continue to show positive outcomes across gender and ethnicity, and we hear frequent reports from our sites that the FFT model is providing lasting positive effects that help change the lives of California youth and their families, when other services have failed them.

-Pam Hawkins, CIMH Statewide FFT Coordinator

Functional Family Therapy for juvenile offenders is a short-term therapy program that helps at-risk youth to overcome adolescent behavior problems. Therapists work with families to assess family relationships that affect delinquent behavior. This program reduces recidivism and substance abuse among participants.

The program typically consists of 12 to 14 sessions over three to five months and has five components:

Engagement: Establishing and maintaining a strengths-based relationship with clients and their families.

Motivation: Concentrating on the relationship process between adolescents and their family. Creating a motivational context that concentrates on decreasing negativity, such as hopelessness and low self-efficacy.

Relational Assessment: Analyzing the relational processes of the family. Emphasis shifts from an individual problem to a relational perspective.

Behavior Change: Reducing and eliminating the problem behaviors and accompanying family relational patterns.

Generalization: Increasing the family’s capacity to use community resources and to engage in relapse prevention in order to plan for future challenges.

We modeled the impact of the Functional Family Therapy program for 10-16 year olds who, in the past 12 months, were released to parole, put on probation, or given supervisory caution after encountering the juvenile justice system.

Learn more about a similar program that relies on individual accountability and flawed thinking processes that led to delinquent behavior, known as Cognitive Behavioral Therapy.

The process for certification in Functional Family Therapy is well-documented on their website. Training through the organization is required to practice the program. 

To estimate the impact of a program or policy, we use systematic literature reviews to determine causal pathways and effect sizes. Well-researched interventions that have robust, high-quality evaluations allow us to model the impact of an intervention with greater certainty. However, sometimes interventions have limited evidence and not all of the outcomes that are likely to be associated with the intervention have been studied. In those cases, we can only model what is available in the evidence base. We urge future research to take the following gaps into consideration.

Mortality and Morbidity - Although we suspect reducing the number of arrests in the juvenile population will lead to reductions in mortality and morbidity, both in the present and as the cohort transitions into adulthood, we were not able to find evidence in the literature quantifying the impact of Functional Family Therapy specifically. We did find some evidence suggesting an increase in mortality rates for the recently released incarcerated population. However, when we ran the effect through our model, the outcome was fairly small so we chose not to include it in this analysis.

Sexual Abuse - We do model a linkage between reducing future incarceration leading to reduced likelihood of sexual abuse that would otherwise occur during the incarceration period. 

Teen Pregnancy - We did not find evidence for Functional Family Therapy leading to reduced instances of teen pregnancy among the eligible population.

Mental Health - We did not find evidence linking functional family therapy with improved mental health outcomes among the eligible population. However, it's very likely that the program would affect this outcome, particularly among the individuals of the eligible population who would otherwise end up incarcerated either as a juvenile or an adult.