Functional family therapy

Domain V · Systemic, relational, group & community · James F. Alexander · 1969 · University of Utah, USA

What it is

Functional Family Therapy (FFT) is a short-term, manualised family programme for young people aged about 11–18 (some sources say 10–18). It targets externalising behaviour, delinquency, violence and substance use, and also internalising problems that show up as behaviour, plus parent–youth…

Format

• Format and dose
• Who attends. Conjoint family sessions with one therapist per family. The "major players" are invited: the members the referrer sees as the problem

Who practises it, and how they are trained or regulated

• The sources differ on where assessment sits. Alexander lists "relational then behavioral assessment" as a phase. One FFT site presentation places the relational assessment grid inside Engagement & Motivation. Sexton treats assessment as ongoing and spread across all phases. In practice the therapist assesses relational functions from the first contact. Formal change planning against those functions happens before…
• Certification and fidelity
• Site-based implementation. FFT LLC delivers it in three phases: Phase 1, clinical training: kickoff and implementation training

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• Does it use a device, heat, cold, water or a physical procedure? Has a medical professional checked that it is safe for you?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• letting a harmful exchange run on. Use 4.10.
• time-outs used for avoidance or as punishment.
• tasks too big for the family's current motivation.
• psychoeducation that implicitly blames one member.
• fixed attributions softening into "maybe" statements.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.