Evidence Rating for Outcomes
Crime & Delinquency | Multiple crime/offense types |
Mental Health & Behavioral Health | Externalizing behavior |
Drugs & Substance Abuse | Multiple substances |
Mental Health & Behavioral Health | Psychological functioning |
Education | Academic achievement/school performance |
Date:
In general family-based treatment practices consist of a wide range of interventions that are designed to change dysfunctional family patterns that contribute to the onset and maintenance of adolescent delinquency and other problem behaviors. This practice is rated Effective for reducing recidivism, and Promising for reducing antisocial behavior and substance use, and improving psychological functioning and school performance.
Practice Goals
In general family-based interventions are designed to decrease adolescent problem and antisocial behaviors by making positive changes in their familial and social environments (Dopp et al. 2017). Specifically, these interventions focus on establishing better communication and reducing conflict between parents and adolescents, improving parenting skills, and helping adolescents better engage with their families and in their school environment (Baldwin et al. 2012). Various therapies inform the specific treatment techniques used, including but not limited to behavioral, and cognitive–behavioral therapies.
Target Population
Family-based treatment programs may target a variety of youth, including juveniles with a history of serious antisocial behavior, youth involved in the justice system, and at-risk youth exhibiting behaviors such as conduct problems, substance use, or delinquency.
Practice Activities
Family-based treatments include several types of manualized therapy models. These include Brief Strategic Family Therapy (BSFT), Functional Family Therapy (FFT), Multidimensional Family Therapy (MFT), Multisystemic Therapy (MST), and Treatment Foster Care Oregon (TFCO; formerly known as Multidimensional Treatment Foster Care). Other types of family-based treatment include short-term family intervention, parent skills training, adolescent diversion programs that include a family condition, and intensive home-based services.
These interventions share common components in theoretical framework and service delivery. Generally, family-based interventions are designed to address the specific characteristics of youth and their social systems (i.e., family, peers, school, and neighborhood) that are associated with antisocial and offending behavior. Therefore, family-based treatment conditions always involve the participation of multiple family members in appropriate contexts such as home, school, and community (Dopp et al. 2017).
In addition, while family-based treatment can be delivered on its own, some other program examples included targeted case management as part of the family-based treatment condition or participation in juvenile drug court in addition to treatment (Dopp et al. 2017). Furthermore, setting for services, number of sessions, and length of treatment may vary by therapy type and individual case.
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Crime & Delinquency | Multiple crime/offense types
Across five studies, Woolfenden, Williams, and Peat (2002) found a statistically significant decrease in the rate of rearrest 1 to 3 years later (SMD = -0.56) indicating that youth who participated in family-based treatment programs were less likely to be rearrested, compared with youth who did not participate in a family-based treatment program. Conversely, Baldwin and colleagues (2012) found that, across four studies of family-based treatment, there was a nonsignificant effect on adolescent delinquency for treatment participants, compared with the participants in a no-treatment control group. |
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Mental Health & Behavioral Health | Externalizing behavior
Dopp and colleagues (2017) examined 89 effect sizes from 28 studies and found that family-based treatment had statistically significant positive effects on antisocial behavior for treatment participants (d = 0.25), compared with the control groups. This finding indicates that youth who were exposed to family-based treatment interventions exhibited less antisocial behavior, compared with control group youth. |
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Drugs & Substance Abuse | Multiple substances
Dopp and colleagues (2017) examined 24 effect sizes from 10 studies and found that family-based treatment had statistically significant positive effects on substance use or abuse for treatment participants (d = 0.41), compared with control groups. This finding indicates that youth who were exposed to family-based treatment interventions reported less substance use or abuse, compared with control group youth. |
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Mental Health & Behavioral Health | Psychological functioning
Dopp and colleagues (2017) examined 59 effect sizes from 16 studies and found that family-based treatment had a statistically significant positive effect on psychological functioning in treatment participants (d = 0.30), compared with control participants. This finding indicates that youth who were exposed to family-based treatment interventions demonstrated improved psychological functioning, compared with control group youth. |
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Education | Academic achievement/school performance
Dopp and colleagues (2017) examined 10 effect sizes from 6 studies and found that family-based treatment interventions had statistically significant positive effects on the school performance of treatment participants (d = 0.29), compared with control participants. This finding indicates that youth who were exposed to family-based treatment interventions demonstrated improved school performance, compared with control group youth. |
Literature Coverage Dates | Number of Studies | Number of Study Participants | |
---|---|---|---|
Meta Analysis 1 | 1990-2013 | 28 | 5564 |
Meta Analysis 2 | 1973-1997 | 8 | 749 |
Meta Analysis 3 | 2013-2013 | 28 | 5564 |
Dopp and colleagues (2017) conducted a meta-analysis on family-based treatments for serious and violent juveniles (up to age 18). Studies were eligible if they 1) focused on one or more family-based treatments; 2) included a sample of juvenile who have committed offenses; 3) used a prospective research design, including at least one comparison condition); 4) included at least one outcome measure of antisocial behavior of targeted youth; and 5) included a published or unpublished English-language report of the study by January 1, 2014. Electronic databases searched included PsycINFO and Medline (via PubMed) to identity eligible studies. Reference lists from published reviews of youth psychosocial treatments was also conducted to identify relevant studies. In addition, websites of certain organizations were consulted and a hand search of the tables of contents of several journals that regularly published studies of psychosocial treatments was also conducted. Specific searches were also conducted to identify unpublished studies.
A total of 28 studies (which included 324 effect sizes) were included in the meta-analysis. The studies together included 5,565 youth participants. Of these studies, 19 were randomized controlled trials, and 9 were non-randomized. The majority of studies (n = 21) were conducted in the United States, and the others were conducted in Europe (n = 6) or Canada (n = 1). The average age for participants at the start of treatment was 15.0 years. The majority of the sample was male (72.0 percent) and identified as white (58.3 percent). The sample also included a significant number of Black (30.6 percent), Hispanic (9.5 percent); and Asian, American Indian, or multiracial (8.0 percent) youth. Of the total sample, an average of 4.34 had committed pretreatment offenses, and others had committed one or more felony (72.5 percent), violent offense (50.0 percent), or sexual offense (10.7 percent).
Of the 28 studies, 19 examined the effectiveness of MST, 4 examined Treatment Foster Care Oregon (formerly MTFC), 3 examined FFT, 1 examined BSFT, and 1 looked at intensive home-based services. Across the studies, these programs lasted for an average of 25.9 weeks and involved 50.8 hours of contact with the youth and/or family members.
Effect sizes were calculated using Cohen’s d, so that a positive number represented a beneficial effect for the family-based treatment group relative to the comparison group. Potential moderators (e.g., characteristics of samples, treatments, methods, and measures) were entered as fixed effects in the meta-analytic model.
Meta Analysis 2Woolfenden, Williams, and Peat (2002) conducted a meta-analysis to examine the effectiveness of family-based treatment intervention programs on delinquency and other problem behaviors in adolescents (ages 10–17). Studies were eligible for review if they were randomized controlled trials of family and/or parenting interventions for children and adolescents aged 10–17 with conduct disorder and/or delinquency. Conduct disorder was defined by a standardized psychological assessment (such as the Child Behavior Checklist) or a psychiatric diagnosis, and delinquency was defined by a referral from a juvenile justice or other legal system for a child/adolescent who committed a serious crime or offended on at least two occasions. Studies that only included sex or drug offenses were excluded. Literature was electronically searched (including Cochrane Controlled Trial Register, Medline, EMBASE, CINAHL, PsycINFO, SocioFile, ERIC, and HealthStar) through July 1999; published and unpublished work was included.
Eight randomized controlled designed studies were included in the review. The studies together included 749 youth participants. The studies were conducted in the United States, with the exception of one study from Australia. The study samples were predominantly male, with one study sample including a slightly greater number of girls than boys. Seven of the studies included youth referred to treatment by the juvenile justice system; the other focused on youth referred to treatment by schools, parents, or other youth agencies. The included studies used a number of different family and parenting interventions, including short-term family therapy, parent training, MST, multidimensional intervention foster care (MTFC), and an adolescent diversion project that included a family condition and a multi-focus condition. Researchers used a weighted mean difference to calculate the time in institutions, a relative risk ratio to measure adolescents’ risk of rearrests, and a standardized mean difference to calculate their rate of rearrest at 1 to 3 years later.
Meta Analysis 3Dopp and colleagues (2017) conducted a meta-analysis on family-based treatments for serious and violent juveniles (up to age 18). Studies were eligible if they 1) focused on one or more family-based treatments; 2) included a sample of juvenile who have committed offenses; 3) used a prospective research design, including at least one comparison condition); 4) included at least one outcome measure of antisocial behavior of targeted youth; and 5) included a published or unpublished English-language report of the study by January 1, 2014. Electronic databases searched included PsycINFO and Medline (via PubMed) to identity eligible studies. Reference lists from published reviews of youth psychosocial treatments was also conducted to identify relevant studies. In addition, websites of certain organizations were consulted and a hand search of the tables of contents of several journals that regularly published studies of psychosocial treatments was also conducted. Specific searches were also conducted to identify unpublished studies.
A total of 28 studies (which included 324 effect sizes) were included in the meta-analysis. The studies together included 5,565 youth participants. Of these studies, 19 were randomized controlled trials, and 9 were non-randomized. The majority of studies (n = 21) were conducted in the United States, and the others were conducted in Europe (n = 6) or Canada (n = 1). The average age for participants at the start of treatment was 15.0 years. The majority of the sample was male (72.0 percent) and identified as white (58.3 percent). The sample also included a significant number of Black (30.6 percent), Hispanic (9.5 percent); and Asian, American Indian, or multiracial (8.0 percent) youth. Of the total sample, an average of 4.34 had committed pretreatment offenses, and others had committed one or more felony (72.5 percent), violent offense (50.0 percent), or sexual offense (10.7 percent).
Of the 28 studies, 19 examined the effectiveness of MST, 4 examined Treatment Foster Care Oregon (formerly MTFC), 3 examined FFT, 1 examined BSFT, and 1 looked at intensive home-based services. Across the studies, these programs lasted for an average of 25.9 weeks and involved 50.8 hours of contact with the youth and/or family members.
Effect sizes were calculated using Cohen’s d, so that a positive number represented a beneficial effect for the family-based treatment group relative to the comparison group. Potential moderators (e.g., characteristics of samples, treatments, methods, and measures) were entered as fixed effects in the meta-analytic model.
Dopp and colleagues (2017) reported on moderator analyses of family-based treatments for serious and violent juveniles (up to age 18). The results showed significant moderating effects across several domains, including the study sample characteristics and treatment providers. When looking at sample characteristics, results indicated that family-based treatments had greater positive effects in studies with a larger percentage of Hispanic youth and in studies in which participants had a higher average number of pretreatment total offenses. When considering the treatment provider, results indicated that family-based treatments had greater positive effects in studies in which the treatment was delivered by providers with mental health training versus those delivered by nonmental health professionals.
These sources were used in the development of the practice profile:
Dopp, Alex R., Charles M. Borduin, Mark H. White, and Sofie Kuppens. 2017. “Family-based Treatments for Serious Juvenile Offenders: A Multilevel Meta-Analysis.” Journal of Consulting and Clinical Psychology 85(4):335–54.
Woolfenden, S.R., K. Williams, and J.K. Peat. 2002. “Family and Parenting Interventions for Conduct Disorder and Delinquency: A Meta-Analysis of Randomized Controlled Trials.” Archives of Disease in Childhood 86(4):251–56.
https://adc.bmj.com/content/86/4/251.longDopp, Alex R., Charles M. Borduin, Mark H. White, and Sofie Kuppens. 2017. “Family-based Treatments for Serious Juvenile Offenders: A Multilevel Meta-Analysis.” Journal of Consulting and Clinical Psychology 85(4):335–54.
These sources were used in the development of the practice profile:
Latimer, J. 2001. “A Meta-Analytic Examination of Youth Delinquency, Family Treatment, and Recidivism.” Canadian Journal of Criminology:237–53. (This meta-analysis was reviewed but did not meet CrimeSolutions criteria for inclusion in the overall outcome rating.)
Following are CrimeSolutions-rated programs that are related to this practice:
Age: 10 - 19
Gender: Male, Female
Race/Ethnicity: White, Black, Hispanic, American Indians/Alaska Native, Asian/Pacific Islander, Other
Targeted Population: Alcohol and Other Drug (AOD) Offenders, Families, High Risk Offenders, Serious/Violent Offender, Young Offenders
Setting (Delivery): School, Other Community Setting, Home
Practice Type: Academic Skills Enhancement, Alcohol and Drug Therapy/Treatment, Alcohol and Drug Prevention, Conflict Resolution/Interpersonal Skills, Diversion, Family Therapy, Parent Training, Violence Prevention, Wraparound/Case Management
Unit of Analysis: Persons