Adapting and Implementing an Evidence‐Based Treatment with Justice‐Involved Adolescents: The Example of Multidimensional Family Therapy

Abstract

For over four decades family therapy research and family centered evidence-based therapies for justice-involved youths have played influential roles in changing policies and services for these young people and their families. But research always reveals challenges as well as advances. To be sure, demonstration that an evidence-based therapy yields better outcomes than comparison treatments or services as usual is an accomplishment. But the extraordinary complexity embedded in that assertion feels tiny relative to what we are now learning about the so-called transfer of evidence-based treatments to real world practice settings. Today's family therapy studies continue to assess outcome with diverse samples and presenting problems, but research and funding priorities also include studying particular treatments in nonresearch settings. Does an evidence-based intervention work as well in a community clinic, with clinic personnel? How much of a treatment has to change to be accepted and implemented in a community clinic? Perhaps it is the setting and existing procedures that have to change? And, in those cases, do accommodations to the context compromise outcomes? Thankfully, technology transfer notions gave way to more systemic, dynamic, and frankly, more family therapy-like conceptions of the needed process. Implementation science became the more sensible, as well as the theoretically and empirically stronger overarching framework within which the evidence-based family based therapies now operate. Using the example of Multidimensional Family Therapy, this article discusses treatment development, refinement, and implementation of that adapted approach in a particular clinical context-a sector of the juvenile justice system-juvenile detention.

Family‐Based HIV and Sexually Transmitted Infection Risk Reduction for Drug‐Involved Young Offenders: 42‐Month Outcomes

“…Behavioral interventions with adolescents can increase condom use, increase safe sex practices, and reduce incident STIs (Johnson, Scott‐Sheldon, Huedo‐Medina, & Carey, ). However, serious questions remain about the impact of existing interventions on the most vulnerable youth (Lightfoot, ), including ethnic minorities and those with highest familial and behavioral risk (Jackson, Geddes, Haw, & Frank, ; Liddle, ; Prado, Lightfoot, & Brown, ). HIV prevention programs for adolescents that do not address systemic risk factors have shown small effects on behavioral change and rarely sustain improvements beyond 1 year (DiClemente, Salazar, & Crosby, ; Noar, ; Pedlow & Carey, ).…”

Editorial: Family Resilience

“…It is remarkable, even within our own recent articles, how many emphasize the process of family resilience across diverse foci such as gender variance (Gray, Sweeney, Randazzo, & Levitt, ), Latino families (Killoren, Wheeler, Updegraff, Rodríguez de Jésus, & McHale, ; Updegraff & Umaña‐Taylor, ), having family members with schizophrenia (Olson, ), unmarried fathers (Marczak, Becher, Hardman, Galos, & Ruhland, ), living in nations at war (Charlés, ), preventing externalizing in teenagers (Holtrop, McNeil Smith, & Scott, ), and cardiac risk reduction (Sher et al., ). Most recent family treatment models typically also center on engaging family resilience (Dickerson, ; Imber‐Black, ; Liddle, ; Madsen, ; Roberts et al., ; Sexton & Datchi, ), in contrast to the earlier family deficit gestalt. The move from a deficit focus to one centered on resilience numbers (along with the development of evidence‐based practice and an increased emphasis on gender and culture) as one of the central advances in family studies and family therapy in the last quarter century.…”

Editorial: Funding Couple and Family Research

“…The change is most pronounced in the United States, where a combination of less overall funds for science in the federal budget, combined with principal relevant funding agencies’ focus on biological investigation (most especially, brain functioning) has resulted in very little funding remaining available for family research and almost none for research on couple and family therapies. One simply has to look at reviews of the literature in our field to find that in several areas most of the citations now are growing fairly old (Darwiche & de Roten, ; Grácio, Gonçalves‐Pereira, & Leff, ; Lebow, Chambers, Christensen, & Johnson, ; Liddle, ; Lucksted, McFarlane, Downing, & Dixon, ; Retzlaff, von Sydow, Beher, Haun, & Schweitzer, ; Rohrbaugh, ; Sexton & Datchi, ; von Sydow, Retzlaff, Beher, Haun, & Schweitzer, ), meaning that in many areas new research is not accruing at the same pace as previous decades.…”