Multidimensional Family Therapy: Evidence Base for Transdiagnostic Treatment Outcomes, Change Mechanisms, and Implementation in Community Settings

Abstract

This article summarizes the 30+-year evidence base of Multidimensional Family Therapy (MDFT), a comprehensive treatment for youth substance abuse and antisocial behaviors. Findings from four types of MDFT studies are discussed: hybrid efficacy/effectiveness randomized controlled trials, therapy process studies, cost analyses, and implementation trials. This research has evaluated various versions of MDFT. These studies have systematically tested adaptations of MDFT for diverse treatment settings in different care sectors (mental health, substance abuse, juvenile justice, and child welfare), as well as adaptations according to treatment delivery features and client impairment level, including adolescents presenting with multiple psychiatric diagnoses. Many published scientific reviews, including meta-analyses, national and international government publications, and evidence-based treatment registries, offer consistent conclusions about the clinical effectiveness of MDFT compared with standard services as well as active treatments. The diverse and continuing MDFT research, the favorable, multi-source independent evaluations, combined with the documented receptivity of youth, parents, community-based clinicians and administrators, and national and international MDFT training programs (U.S.-based organization is MDFT International, www.mdft.org; and Europe-based organization is www.mdft.nl) all support the potential for continued transfer of MDFT to real-world clinical settings.

Family therapy and systemic interventions for child‐focused problems: the current evidence base

“…The effects were greatest for families of adolescents with severe problems. These meta‐analytic results are consistent with those from previous meta‐analyses and narrative reviews (Filges et al ., ; Liddle, ; Rowe and Liddle, ), notably that of Liddle (), who concluded that Multidimensional Family Therapy has positive short‐ and long‐term effects in multiple domains including delinquency and drug misuse, and leads to significant cost‐savings.…”

H.Liddle, Multidimensional Family Therapy: A Research‐Proven, Innovative Treatment for Adolescent Substance Abuse. Microtraining Associates, 2014, 75 minutes (DVD), US$199. To be available on www.mdft.org.

“…Multidimensional family therapy (MDFT) is an evidence‐based family‐centred treatment for adolescent substance use and anti‐social behaviours (Liddle, ), developed by Liddle and his team in the US. This DVD features Liddle's work with a 16‐year‐old adolescent, Christian, arrested for purchasing cannabis, his mother, a single parent, and Christian's school counsellor.…”

Specialty addiction and psychiatry treatment initiation and engagement: Results from an SBIRT randomized trial in pediatrics

“…Sterling & Weisner, 2005; Subramaniam & Volkow, 2014; Wu, Gersing, Burchett, Woody, & Blazer, 2011). For those with more severe problems or significant psychiatric comorbidity, specialty addiction or psychiatry treatment can be effective (Godley, Godley, Dennis, Funk, & Passetti, 2002; Godley, Godley, Dennis, Funk, & Passetti, 2007; Liddle, 2016), yet most patients who could benefit from specialty treatment do not receive it, even if they are referred. It is estimated that little more than a third of adolescents in need of specialty treatment for mental health or substance use problems actually start treatment (Merikangas et al, 2011).…”