Your browser does not support JavaScript!
U.S. Department of Justice
Office of Justice Programs, Innovation -  Partnerships – Safer Neighborhoods
Office of Juvenile Justice and Delinquency Prevention (OJJDP) Serving Children, Families and Communities
OJJDP Model Programs Guide
top navigation spacer top background spacer top background spacer top background spacer spacer spacer

Family Therapy

The family is often a key factor in the prosocial development of youth. Several literature reviews (Henggeler, 1989; Loeber and Dishion, 1983; Loeber and Stouthamer–Loeber, 1986; and Snyder and Patterson, 1987) support the contention that family functioning provides an early and sustained impact on family bonding, conduct disorders, school bonding, choice of peers, and subsequent delinquency.

The family is of critical importance because it is the primary social unit during the formative years of early childhood. It is the primary and sometimes sole source of emotional support, learning opportunities, moral guidance, self esteem, and physical necessities. But when the family fails to fulfill these responsibilities, the children often suffer the consequences (Kumpfer and Alvarado, 1997). Family dysfunction (family history of violence, favorable attitudes toward problem behaviors, poor socialization, poor supervision, poor discipline, family disorganization, family isolation, or family disruptions) is an important influence on future delinquent and antisocial behavior. Family dysfunction provides children with models and opportunities to engage in problem behavior. For example, family drug use is consistently linked to adolescent drug use (Newcomb and Bentler, 1988); children living in homes in which the marital relationship has been disrupted by divorce or separation are likely to display problem behaviors (Wells and Rankin, 1991), particularly depending on how much satisfaction they derive from their relationship with the parents (Videon, 2002); and family management practices such as failure to set clear expectations for children’s behavior, poor monitoring and supervision, and severe and inconsistent discipline consistently predict later delinquency and substance abuse (Capaldi and Patterson, 1996; Hawkins, Arthur, and Catalano, 1995).

This research suggests that improving family functioning should reduce problem behaviors. Today, there are several major categories of interventions designed to strengthen family functioning and thus prevent future problem behaviors. These family strengthening interventions include family skills training, family education, family therapy, family services, and family preservation programs. This section generically refers to family intervention programs as family therapy.

THEORETICAL CONTEXT
The family can wield tremendous influence on an adolescent’s risk for delinquency because it is the primary socialization context for children (Simons et al., 1998; Patterson, Reid, and Dishion, 1992). The theoretical foundation for this relationship is generally grounded in theories of social control believing that delinquent acts are more likely to occur when an individual’s bond to society is weak or broken (Hirschi, 1969). Under this perspective, the family acts as a socializing agent by introducing and endearing children to conventional norms and values. It argues that a strong affectionate tie between child and parent is one of the fundamental means for establishing this societal bond and thus for insulating adolescents from delinquency and other problem behaviors (Brook, Whiteman, Finch, and Cohen, 1998). Unfortunately, poor family functioning or nontraditional family structures can decrease or inhibit the development of parental attachment and thus break the bond with society, leaving individuals without the internal controls that discourage criminal behavior. Gottfredson and Hirschi (1990) argue that as a result of inept parenting some adolescents tend to be impulsive, defiant, physical, and risk-taking (Stewart et al., 2002; Conger, Patterson, and Ge, 1995). Such youths are more strongly attracted to delinquent acts than are those who have been socialized to possess strong internal controls. However, ineffective parenting is seen as a result of two factors (Thornberry, 1987; Simons, Chao, and Conger, 2001). First, parents and children tend to be similar in their temperament, personality, and cognitive abilities (Plomin, Chipuer, Loehlin, 1990). Thus, there is a tendency for impulsive, aggressive children to have parents who also possess these characteristics, and these characteristics tend to interfere with effective parenting. Second, recent research indicates that parent–child interaction is a reciprocal process. In other words, not only does ineffective parenting increase the probability of child conduct disorders, but also hostile, obstinate child behavior often elicits negative parenting behavior—resulting in a reduction in effective parenting (Patterson, Reid, and Dishion, 1992). Thus the personal characteristics of the parents combine with the difficult behavior of the child to create a volatile mixture of antagonistic relationships.

Consequently, it is imperative that delinquency prevention programs reinforce the parent– child bond as a means of preventing delinquent behavior. One way of reinforcing the parent–child relationship is to decrease risk factors and increase protective factors for delinquent behavior through parent training and family strengthening programs. These programs address important family protective factors such as parental supervision, attachment to parents, and consistency of discipline (Huizinga, Loeber, and Thornberry, 1995). They also address some of the most important family risk factors such as poor supervision, excessive family conflict, family isolation, sibling drug use, and poor socialization (Kumpfer and Alvarado, 1995).

EVIDENCE OF IMPACT
This section examines the scientific research regarding family strengthening programs. These programs concentrate on changing the maladaptive patterns of interaction and communication in families in which youths already exhibit behavioral problems. In addition, some family strengthening programs use multicomponent interventions, including behavioral parent training, child social skills training, and family therapy. These multicomponent programs are known as family skills training. Family strengthening programs typically are implemented with youths diagnosed with mild emotional and behavioral problems such as conduct disorder, depression, and school or social problems. The program is usually conducted by trained therapists in clinical settings with the parents and child. Kumpfer (1999) identifies several types of family strengthening techniques. They include the following:

■ Structural family therapy (Minuchin, 1974; Szapocznik et al., 1983; Powell and Dosser, 1992) stresses families’ coping skills and strategies as well as learning new ways to respond.

■ Strategic family therapy (Haley, 1963; Szapocznik and Kurtines, 1989) is pragmatic and goal oriented.

■ Structural–strategic family therapy (Stanton and Todd, 1982), as the name implies, combines a concentration on patterns of family interactions with goal-specific approaches.

■ Behavioral family therapy programs (those with a therapist working with one family) or behavior family training (those with a therapist working with several families in a group) contain separate skill-building training for parents and children during part of the session (Rosenthal and Bandura, 1978). The family is then brought together for activities during the last part of the therapy session.

■ Functional family therapy (Alexander and Parsons, 1973; Alexander and Parsons, 1982) is a short-term approach designed to engage and motivate youths and families to change negative affect (Alexander et al., 2000).

■ Multisystemic family therapy addresses delinquent youth behavior within the context of the family, school, and community. Interventions are goal oriented and emphasize development of family strengths (Henggeler and Borduin, 1990).

According to Howell (1995), who looked at several meta-analyses and evaluations of various therapy models, early research indicates that family therapy is effective in reducing family conflict and children’s antisocial behavior. For example, Functional Family Therapy (FFT) is geared to help youths ages 11–18 who are at risk for, or are engaging in, delinquent behavior such as violence and substance abuse or who have been diagnosed with conduct disorder, appositional defiant disorder, or disruptive behavior disorder. The intervention consists of 8–12 hours of direct service for mild cases (26–30 hours for serious cases) and is delivered in several phases. Eleven matched or randomly assigned control/comparison group studies were conducted between 1973 and 1997, with follow-ups at 1, 2, 3, and 5 years. The model has been applied to populations in urban and rural settings and among many racial and ethnic groups. The results suggest that FFT has produced reductions in recidivism, out-of-home placements, or subsequent sibling referrals of at least 25 percent and as much as 55 percent (Alexander et al., 1998).

Another effective family-focused intervention is Multisystemic Therapy (MST) ,which targets chronic, violent, or substance-abusing juvenile offenders (ages 12–17) who are at risk for out-of-home placement (as are their families). MST services are delivered in the home, school, and community rather than in a clinic or residential treatment setting. Emphasis is placed on promoting behavior change in the youth’s own environment. Services are more intensive than traditional family therapies and include several hours of treatment per week rather than the traditional 50 minutes. The emphasis is on developing an indigenous support network for the family in which the family is empowered to handle difficulties with the offending youth, and the youth is empowered to cope with family, peer, school, and neighborhood problems. Four randomized clinical trials compared the effectiveness of MST with usual community treatment for juvenile offenders and their families. Offenders in the MST group showed reductions in re-arrest rates between 25 and 70 percent. There were reductions in out-of-home placements between 47 and 64 percent in the three studies where data were obtained. Drug-related arrests decreased in three sites where researchers gather data for this outcome. One site showed decreased aggression; in the other two sites there was no difference (Henggeler et al., 1998).

Multidimensional Treatment Foster Care (MTFC) is a family therapy program that targets children and adolescents ages 11–18 who have histories of chronic and severe criminal behavior and are at risk for incarceration. Community foster families are recruited and trained to provide out-of-home placements for juvenile offenders or children at risk for detention. These families are paid a stipend, and placements are usually for 6 to 9 months. The families are contacted daily by a case manager and are supported through weekly meetings. Youths receive individual therapy, and biological (or adoptive) families receive weekly family therapy. There is frequent contact, including home visits, between the youths and their biological (or adoptive) families. Emphasis is placed on teaching youths interpersonal skills and on increasing participation in positive social activities, including sports and hobbies. In a randomized treatment/control evaluation, 79 boys ages 12–17 who were mandated into out-of-home care by the juvenile court were assigned to placement in MTFC or regular group care. After 1 year from exit, the MTFC group had fewer than half as many arrests as those in group care (2.6 offenses versus 5.4). Nearly three times as many participants in group care ran away or were expelled, compared with the MTFC group (Chamberlain and Mihalic, 1998).

In summary, the research regarding family strengthening initiatives is impressive. Overall, analyses of family-based programs find that family strengthening initiatives (compared with programs that concentrate solely on parents or children) have more immediate and direct impact on improving family relationships, support, and communication and on reducing family conflict (Kumpfer and Alvarado, 1997; Szapocznik and Kurtines, 1989; Szapocznik, 1997).

Click here for 'Family Therapy' References, and to browse other references: or click one of the programs below.
 
Functional Family Therapy
Wraparound Milwaukee
Active Parenting of Teens: Families in Action
SAFE–T
Adolescent Transitions Program
Brief Strategic Family Therapy
DARE To Be You
HOMEBUILDERS
The Incredible Years
Multidimensional Family Therapy
Multidimensional Treatment Foster Care–Adolescents
Multisystemic Therapy (MST)
AMIkids Community-Based Day Treatment Services
Nurse–Family Partnership (NFP)
Parent-Child Development Center
Say It Straight
Strengthening Families Program
Families And Schools Together (FAST)
Parenting with Love and Limits®
Philadelphia Youth Violence Reduction
Strengthening the Bonds of Chicano Youth and Families
Strengthening Families Program: For Parents and Youth 10–14
SNAP® Under 12 Outreach Project
Multisystemic Therapy–Family Integrated Transitions (MST–FIT)
Connections
Family Solutions Program
Strong African American Families (SAAF)
Familias Unidas