The main objective of this secondary data analysis project is to evaluate the impact of an innovative approach, Functional Family Therapy-Child Welfare (FFTCW), on the quality of treatment and prevention services for substance abuse and problem behaviors for youth and families in a child welfare setting. Child abuse and neglect have been shown to be strong predictors of youth substance abuse and other problem behaviors such as risky sexual behavior and conduct problems. Unfortunately, due to decreased funding and increased unemployment and poverty, child welfare agencies are being overwhelmed by the challenges of providing services to meet the substance abuse and mental health needs of youth and families. As such, there is an urgent need to develop and test cost-efficient interventions for youth and families in child welfare settings. Research has provided support for the efficacy of family interventions for family conflict, adolescent substance use disorders, HIV-risk behaviors, and related problems. Unfortunately, most research has been conducted in juvenile justice or mental health settings, and there is little evidence that these interventions work in child welfare settings. Moreover, the treatments costs associated with applying family interventions to all youth and families may prohibit their widespread utilization i community agencies. FFTCW was developed as a continuum of care model in which interventions are contingently applied based on the family's initial risk status. This innovative study capitalizes on significant work that has been done to develop and implement FFTCW in a real world setting. For example, a full treatment manual and training protocol has been developed. Moreover, there is already preliminary evidence demonstrating the feasibility, acceptability (to providers and families), and clinical outcomes for the model. Perhaps most importantly, all of the training and service activities pertaining to implementing FFTCW in five boroughs with approximately 3000 youth and families have been funded, almost exclusively by the Administration for Children's Services. A comparison sample of 2000 families received services as usual (SAU) in the child welfare agency. As such, the results of this secondary analysis study would obviate the need for further treatment development of FFT (or similar family-models). Also, because FFTCW was developed with the support of a local agency and the child welfare system, the results of this study have immediate implications for the uptake and sustainability of FFTCW in real world settings. Specifically, the aims of this study are: (1) T evaluate the efficacy of FFTCW compared to services as usual (SAU) in reducing adolescent substance use and behavior problems, (2) To evaluate the efficacy of FFTCW training on the rates of recurrent abuse and neglect, duration and rate of out of home placement, and duration of child welfare service, and (3) To evaluate hypothesized moderating and mediating effects of therapists / interventionists (e.g., fidelity), organizational (e.g., support), and family (e.g., c-occurring psychological problems) on problem behaviors. Finally, we will conduct an informal cost analysis of each treatment modality.

Public Health Relevance

Evidence-based interventions are needed to reduce or prevent substance abuse problems for youth and families referred for treatment services in child welfare settings. The proposed secondary data analysis is designed to evaluate the broad impact of a family-based intervention on substance abuse and mental health outcomes for youth and family members. By examining an intervention approach that contingently provides specific interventions to youth and families based on their initial level of risk, the study findings will b immediately relevant to service providers that often have limited resources or qualified staff to work with difficult clients.

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Research Project (R01)
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Psychosocial Development, Risk and Prevention Study Section (PDRP)
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Reider, Eve
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Oregon Research Institute
United States
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Brody, Janet L; Scherer, David G; Turner, Charles W et al. (2018) A Conceptual Model and Clinical Framework for Integrating Mindfulness into Family Therapy with Adolescents. Fam Process 57:510-524
Turner, Charles W; Robbins, Michael S; Rowlands, Sylvia et al. (2017) Summary of comparison between FFT-CW® and Usual Care sample from Administration for Children's Services. Child Abuse Negl 69:85-95