Functional family therapy (FFT) is one of an emerging generation of empirically supported treatments for child and adolescent behavioral problems. As such, sophisticated efforts are underway to disseminate and study the effectiveness of FFT in community-based clinical settings. Preliminary findings from a large-scale FFT dissemination trial indicate that only about half of the community therapists trained to implement FFT were able to demonstrate a basic level of competence in the model, and that competence in FFT was clearly related to clinical effectiveness. Given the number of FFT dissemination projects which are either underway or planned for the near future, the time is ripe for clinical-process studies to more closely examine the manual-prescribed therapist behaviors necessary to implement FFT competently and effectively. Toward this objective, the purpose of the proposed a project is to develop an observational-process research instrument for rating the extensiveness with which manualized clinical interventions are implemented across phases and stages of FFT. The project will include four components. First, a preliminary FFT extensiveness rating instrument will be developed based on an exhaustive review of the FFT manual and supporting materials, including existing instruments for rating therapist adherence in FFT. Second, a panel of experts in FFT will convene for a two-day meeting to review the preliminary instrument and provide feedback on its accuracy, completeness, and face validity. Third, the FFT extensiveness rating instrument will be revised and finalized based on feedback and decisions made by the expert panel. Finally, a small-scale implementation of the newly developed FFT extensiveness rating instrument will assess its feasibility, and explore its reliability and validity. The instrument will be designed to pinpoint the manual-prescribed therapist skills and behaviors associated with effective implementation of FFT. The detailed clinical information provided by the instrument will help generate guidelines for training therapists, thereby facilitating the dissemination and effectiveness of FFT in community settings.
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