Guide to Effective Programs
for Children and Youth

Multidimensional Family Therapy (MDFT)

OVERVIEW

Multidimensional Family Therapy (MDFT) is a family-based treatment for adolescents with substance abuse problems. The program consists of outpatient, multi-component therapy provided by trained therapists in both individual and family settings. Topics addressed by MDFT include the adolescent’s perceptions of drugs’ harmfulness, emotional regulation processes, parents’ parenting, and interactional patterns. Results from an experimental evaluation of the program showed that it decreased drug use, increased academic performance, and improved family functioning relative to two other treatment approaches.

DESCRIPTION OF PROGRAM

Target population: Adolescents with drug abuse problems

The program has been used over 16 years and validated in areas such as San Francisco, Illinois, and Philadelphia. It functions as an outpatient, family-based treatment, providing adolescents with individual and family therapy. The program focuses on both the adolescent as an individual, as a member of a family, and as a member of a peer group. Along with the adolescent, parents and family members are examined as individuals and in relation to the adolescent. The therapists who lead the sessions are trained through reading about the therapy, watching videos of other therapists in session, and live supervision of sessions. Therapy takes place in weekly sessions over a 3 to 6 month period.

EVALUATION(S) OF PROGRAM

Liddle, H. A., Dakof, G. A., Parker, K., Diamond, G. S., Barrett, K., & Tejada, M. (2001). Multidimensional Family Therapy for Adolescent Drug Abuse: Results of a Randomized Clinical Trial. American Journal of Drug and Alcohol Abuse, 27(4), 651-688.

Evaluated population: A total of 182 adolescents, ages 13-18 years, using any illegal substance not including or in addition to alcohol three or more times per week. Of the adolescents, 80% were male and 51% were white, non-Hispanic, 18% African American, and 15% Hispanic.

Approach: Adolescents were randomly assigned to one of three treatment groups; Multidimensional Family Therapy (MDFT), Multifamily Educational Intervention (MEI), and Adolescent Group Therapy (AGT). Sixteen sessions of MDFT were delivered in an office setting on a weekly basis. Both individual and family sessions were often used in a single treatment session. The therapist made the content of the session personally meaningful to the parent and teen by exploring all areas of the teen’s life and history. Therapists then focused session work on the teen’s communication skills, decision making, and problem solving. The therapist also helped parents distinguish between exerting influence or control over their child. The final month of therapy focused on applying skills learned in therapy to real-world environments.

The Multifamily Educational Intervention (MEI) treatment involved three to four families together in a session. The families engaged in group discussions that consisted of skill building exercises, individual family problem solving, stress reduction, risk and protective factors, improving family organization, limit setting, and family communication. Families were encouraged to celebrate the meeting of goals with each other. During sessions, adolescents would be involved, with parents present but only listening, and vice versa. Individual therapy sessions were available upon request of the family or therapist in case of emergencies, but were limited to two per family.

Adolescent Group Therapy (AGT) emphasized the development of individual communication, self-control, self-acceptance, and problem solving. Two therapists led groups of six to eight adolescents in 90 minute sessions. Participation and trust were built through group discussions and skill-building exercises. Activities in therapy and homework assignments were given to adolescents to improve social skills. Maintenance of skills and relapse prevention issues were discussed among the adolescents.

The therapists in the three conditions were recruited from local professional organizations and community clinics. Eighty per cent had obtained master’s degrees and 20% had doctoral degrees.

Results: Adolescents in each of the three treatments demonstrated improvement, and parent reports indicated the same. The MDFT group showed the largest reduction in drug use and maintained the reduced rate through six- and twelve-month follow-ups. Along with reduced drug use, the MDFT group improved on measures of academic achievement and family functioning. The AGT group also had a constant decline in drug use from intake to follow-up. However, the AGT group’s dropout rate (48%) was higher than MDFT (30%) and MEI (34%). The AGT group’s impact on drug use was not as strong as the effect observed in the MDFT treatment, but there was a decrease in overall drug use. MEI had the weakest impact in terms of drug use, school performance, and family functioning.

Findings are undermined by high numbers who never attended a single session (30) and attrition. However, program dropout was lower for MDFT than MEI and AGT.

SOURCES FOR MORE INFORMATION

References

Website: http://www6.miami.edu/UMH/CDA/UMH_Main/0,1770,51661-1;36888-3,00.html

Program categorized in this guide according to the following:

Evaluated participant ages: adolescence, youth / Program age ranges in the Guide: 12-14, 15-21

Program components: counseling/therapy, parent or family component

Measured outcomes: social and emotional health; behavioral problems; physical health

Program information last updated 11/7/07