Multidimensional Family Therapy (MDFT)

Gayle A. Dakof, Ph.D., MDFT International

Teenagers are Hopeless

“We overinvest in attempting to remediate the problems of disadvantaged adolescents and underinvest in the early years of disadvantaged children.”

James Heckman, Ph.D., 2011, Daedelis

This is A Mistake: Teenagers are Not Hopeless

Evidence-based educational/vocational programs and behavioral treatment programs, like MDFT, produce meaningful and lasting change in the lives of teenagers

They Are Wrong!

Help Youth:

Reduce or eliminate substance use Reduce or eliminate criminality Complete high school/GED Obtain employment Live healthy and productive lives.

Without Intervention in the Teen Years

Chronic unemployment

Unstable relationships

Single parenthood

Victimization

Imprisonment

Death

Why MDFT?

Proven effectiveness in over 10 randomized clinical trials

Improvements last beyond treatment discharge

Effective even with the most complex cases, with the most severe problems

Worldwide recognition from many governments and other independent organizations

MDFT Works

Multidimensional Family Therapy has proven, lasting beneficial effects on adolescent and adult outcomes.

Multidimensional Family Therapy

Urban and rural Various ethnic and racial groups Youth from 11 – 24 Multiple countries Substance abuse problems Co-occurring mental health problems Juvenile justice involved teens Child welfare involved families Parents with mental health, criminal

justice, or substance abuse problems

MDFT Outcomes

Substance Use/ Delinquency

MDFT more likely to abstain from drug use MDFT more significant decrease in frequency of drug use MDFT more significant decrease in drug use problems MDFT more significant decrease in delinquent/criminal

behaviors MDFT more significant decrease in aggression and violence MDFT less likely to be arrested or placed on probation MDFT more likely to decrease felony arrests and

serious/violent crimes

Mental Health Symptoms

MDFT more significant decrease in overall mental distress, internalizing disorders, symptoms of depression and anxiety MDFT more significant decrease in parent reports of youth internalizing disorders

Family

MDFT more significant increase in positive family interactions MDFT increase in positive parenting practices (monitoring, authoritative practices) MDFT reduces family conflict, hostility & violence

Peer MDFT more significant decrease in affiliation with delinquent peers

School MDFT more significant improvements in academic and conduct grades MDFT more significant decreases in absences

MDFT Outcomes

Over 90% retained in treatment

50% - 75% reduction in marijuana use Over 75% reduction in hard drug use 50% reduction in psychiatric

hospitalizations Over 70% reduction in family violence 30% - 60% improvement in school grades 40% - 75% reduction in arrests

Over 90% remain in the home at treatment discharge

Series10%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

23%

44%

Series10%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

10%

30%

MDFT Group

Percentage Arrested During 12 Month Follow-

up

Percentage Placed on Probation During 12

Month Follow-Up

MDFT and CBT Average Change in Hard Drug Use Intake to 12 Month

Follow-Up

Change in Self-Reported Mental Health Symptoms

Series10

5

10

15

20

25

30

35

40

39

8

0

Baseline

Implementation

Durability

Percent in Out Of Home Placement at Follow-up over Study Phases

Why MDFT?

Easy to learn—95% who start training successfully complete it

Fits into existing clinical settings—in-home, outpatient, day treatment, residential, detention centers, drug courts, diversion programs, child welfare

Clinicians like it—in a survey, 85% of clinicians report MDFT training made them a better therapist

Why MDFT?

Sustainable—Over 90% of programs are sustained for 2 years or longer (and still counting). Over 85% have been sustained for 5 years of longer (and still counting)

Lowers service costs—1/3 the cost of residential treatment

Fosters autonomy in clinicians and programs—Among the lowest training costs of available EBPs. Offers a Train-the Trainers option.

Over 100 Current MDFT Programs in the United States & Europe

United States:California OhioConnecticut OregonFlorida PennsylvaniaGeorgia WisconsinIowaMarylandMichiganNevadaNew YorkNorth Carolina

Over 100 Current MDFT Programs in the United States & Europe

Europe:

BelgiumEstoniaFinlandFranceGermanyNetherlandsSwitzerland

Voices from the Implementation Field

“People don’t realize how much better MDFT is than other things. The word needs to get out. I mean I don’t think it is even close in comparison to the other ones, and I know because I have been trained in other EBPs. MDFT Is the Mercedes Benz, the BMW, of all treatment models for adolescent problems.”

Voices from the Implementation Field

“I think MDFT produces the optimal comprehensive outcomes. It has a multipronged approach: the flexibility to work with people in the family as individuals, as a family unit, and in dyads. Some other programs are a lot more rigid than MDFT. A lot of other models don’t have a focus on substance abuse as does MDFT. There is a broader range of outcomes that we get more consistently in MDFT. There is a deeper emotional change that we get from MDFT.”

Voices from the Implementation Field

“The training of MDFT has been wonderful: comprehensive and accessible ever since we started. The program manual is extremely well developed--it is a wonderful backup. When the consultants come on site they work with the therapists and the supervisors, families are brought in for live supervisions, they watch DVDs of our work. There is not one negative thing about the training.”

Voices from the Implementation Field

“It makes our programs for adolescents and families better. It strengthens the services for adolescents. “

Goals within MDFT Domains

ADOLESCENT DOMAIN

• Decrease/eliminate substance abuse• Improve the teen's communication, emotional

regulation, coping, and problem solving skills• Improve school performance and reduce/eliminate

criminal behavior

PARENT DOMAIN

• Improve parenting skills & parental teamwork• Rebuild emotional connection with youth• Enhance parents' individual functioning

FAMILY DOMAIN

• Improve family communication and problem solving skills

• Improve family interactions about day-to-day and big picture issues

• Enhance feelings of love and connection among family members

COMMUNITY DOMAIN

• Improve family members' relationships with school, court, legal system, workplace, and neighborhood

• Build family members' capacity to access and obtain needed resources

2014 Contra Costa County Lincoln Child Center MDFT Outcomes: Improvement from Intake to Discharge

Over 90% retained in treatment

67% reduction in hard drug use 41% reduction in alcohol/marijuana 55% reduction in delinquent behaviors 37% improvement in family functioning 31% improvement in grades

74% met most or all treatment goals

2014 Contra Costa County Lincoln Child Center MDFT Outcomes: Status at Discharge

91% living in the home 74% in school/working 83% no new arrests 83% stable mental health 83% stable family functioning 61% little or no alcohol/marijuana use 87% no hard drug use

Promote lasting behavioral change

Multidimensional Family Therapy (MDFT):

Evidence Based Program (EBP) for Adolescent Behavior Problems,

Substance Abuse, Delinquency, and Mental Health

www.mdft.org