Despite the widespread adoption of manualized model-driven approaches to family therapy, little is known about how therapists implement and families experience the specific guiding practices involved in individual models. The aim of the present study was to use a qualitative methodology to describe therapist implementation and family experiences of the three phases of Functional Family Therapy (FFT). Five FFT therapists and four parents of families who had been treated by those therapists were interviewed and thematic analysis performed to analyse the data. Results suggest that both common factor and model-specific treatment elements, flexibility within model delivery, and strategies which aim to improve parental self-efficacy and communication are key elements of successful therapy when practised within a manualized model-driven framework. Limitations such as the retrospective nature of the study, and avenues for future research, such as the inclusion of the entire client family, are discussed.
Practitioner points• Early in FFT, combine basic therapeutic skills such as empathy, warmth and unconditional positive regard with model specific skills such as reframing • In the middle sessions of FFT, match the development of specific behaviour change skills (e.g. communication, conflict management, and emotional regulation) to families' particular goals • In later sessions of FFT, support the generalization of gains made within therapy to other contexts and future situations to prevent relapse