The Effectiveness of Functional Family Therapy for Adolescent Behavioral and Substance Misuse Problems: A Meta‐Analysis

• DOI: http://doi.org/10.1111/famp.12256
• Published date: 01 September 2017
• Author: Alan Carr,Elena Hamilton,Dan Hartnett,Gary O'Reilly
• Date: 01 September 2017

The Effectiveness of Functional Family Therapy for

Adolescent Behavioral and Substance Misuse

Problems: A Meta-Analysis

DAN HARTNETT*

ALAN CARR*

ELENA HAMILTON*

GARY O’REILLY*

A systematic review of published and unpublished English language articles identified

14 studies containing 18 comparisons between functional family therapy (FFT) and

another condition in the treatment of adolescent disruptive behavior and substance use dis-

orders. In 11 of these comparisons, assignment to conditions was random, while nonran-

dom assignment occurred in seven studies. For both random and nonrandom comparisons,

separate meta-analyses were conducted for subgroups of studies depending on the type of

comparison group used. Data from studies of untreated control groups (CTL), treatment as

usual (TAU), and well-defined alternative treatments (ALTs) were analyzed separatel y.

Effect sizes from these six meta-analyses were as follows: random assignment FFT versus

CTL (k=3, d=0.48, p<.01); random assignment FFT versus TAU (k=3, d=.20, ns);

random assignment FFT versus ALT (k=5, d=.35, p<.05); nonrandom assignment

FFT versus CTL (k=2, d=.90, ns); nonrandom assignment FFT versus TAU (k=2,

d=.08, ns); and nonrandom assignment FFT versus ALT (k=3, d=.75, p<.001). These

results provide support for the effectiveness of FFT compared with untreated controls and

well-defined ALTs, such as cognitive behavior therapy, other models of family therapy, and

individual and group therapy for adolescents.

Keywords: Meta-Analysis; Functional Family Therapy; Evidence-Based Practice; Family

Therapy

Fam Proc 56:607–619, 2017

INTRODUCTION

Disruptive behavior and substance misuse disorders are among the most commonly

diagnosed problems of adolescence. International epidemiological studies suggest

that up to 24% of adolescents experience clinically significant behavioral diff iculties, while

approximately 5% meet the criteria for a substance misuse disorder (Costell o, Mustillo,

Keeler, & Angold, 2004; Merikangas, Nakamura, & Kessler, 2009). True levels of impair-

ment, however, are likely to be higher as adolescents who remain below diagnostic thresh-

olds can nonetheless suffer significant difficulties (Kazdin, 2003). Behavioral and

substance misuse problems in adolescence are problematic in that they can set in motion a

sequence that results in a host of problems, such as increased exposure to health risks,

delinquency, comorbid psychiatric difficulties, and an array of negative long-term negative

*School of Psychology, University College Dublin, Dublin, Ireland.

Correspondence concerning this article should be addressed to Dan Hartnett, School of Psychology,

University College Dublin, Belfield, Dublin 4. Ireland, D04 V1W8. E-mail: daniel.hartnett@ucdconnect.ie.

607

Family Process, Vol. 56, No. 3, 2017 ©2016 Family Process Institute

doi: 10.1111/famp.12256