Evidence was required from randomised controlled trials and a


high level of analysis was expected – not something that every early intervention programme has up its sleeve. If there is one thing, however, that US-based programmes are good at, it is justifying their existence. The US models of family therapy come well prepared with evidence to demonstrate their effectiveness. Of the 19 most promising intervention programmes, Functional


Family Therapy (FFT) and Multisystemic Therapy (MST) both focus on family capacity and intervention. MST is an intervention for young people that focuses on addressing delinquency issues. FFT is a family- based intervention that aims at reducing risk factors in families.


Functional Family Therapy FFT originated in America and is a relationship-based approach that targets youth behaviour problems. It focuses on the strengths of families as well as targeting the issues they have. It acknowledges that behaviour cannot always be eradicated but its negative effects can be reduced and it seeks to address risk and build in protective factors to help achieve this. FFT is tailored to the family. Each stage in the therapy is informed


by the relationships that exist and the needs of the family unit as well as individuals. Although each programme might be unique, there is a very clear structure to it. This is a feature of many family therapy interventions. They must adapt to individual circumstances while applying the same principles and structures across them all. The therapy lasts for three to four months and involves between eight


to 12 sessions. There are six phases in the programme: n Pre-treatment – relationships are developed, organisational features are agreed.


n Engagement – credibility is gained with the client and a level of high availability and respect is aimed for.


n Motivation – focuses around building self-esteem and being positive about family relationships, issues of blame are addressed.


n Relational – plans are developed for the next stages and there are observations and questioning sessions built in. Activities include switching from the problem to the relationships.


n Behaviour change – building skills, changing habits and finding alternative coping patterns.


n Generalisation – identifying what to do if things go wrong in the future and helping to develop independence away from the programme. The intention is not to change relational functions but to change the


strategies used by individuals to achieve relational functions. So, for example, if a child acts up to get attention, FFT does not aim to eliminate their need for attention but instead changes the means through which they seek to gain it. Although FFT is still strongly based in the US it has been implemented


“If a child is behaving badly the family therapist might look for ways within


the resources of the family to deal with this rather than tracking back to the emotional reasons for why it is occurring”


in the UK in pioneering areas for some time. For example, it was introduced in Brighton in 2007 with support from the US. That this type of approach has just made the headlines does not mean its roots are not already firmly planted. Examples of the emergent focus on families are clearly identifiable in the Family Intervention Projects (FIPs).


Family Intervention Projects FIPs had already been introduced by the previous government. Targeted at households with extreme anti-social behaviour they provided enhanced support to families. This usually took place in the family home and included the involvement of different agencies. Although it is a multi-agency programme it is coordinated by one key worker who is the


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