Multidimensional Family Therapy (MDFT) Gayle A. Dakof, Ph.D., MDFT International

“We overinvest in attempting to remediate the problems of disadvantaged adolescents and underinvest in the early years of disadvantaged children.” James Heckman, Ph.D., 2011, Daedelis

Evidence-based educational/vocational programs and behavioral treatment programs, like MDFT, produce meaningful and lasting change in the lives of teenagers

Help Youth:  Reduce or eliminate substance use  Reduce or eliminate criminality  Complete high school/GED  Obtain employment  Live healthy and productive lives.

 Chronic unemployment  Unstable relationships  Single parenthood  Victimization  Imprisonment  Death

 Proven effectiveness in over 10 randomized clinical trials  Improvements last beyond treatment discharge  Effective even with the most complex cases, with the most severe problems  Worldwide recognition from many governments and other independent organizations

Multidimensional Family Therapy has proven, lasting beneficial effects on adolescent and adult outcomes.

 Urban and rural  Various ethnic and racial groups  Youth from 11 – 24  Multiple countries  Substance abuse problems  Co-occurring mental health problems  Juvenile justice involved teens  Child welfare involved families  Parents with mental health, criminal justice, or substance abuse problems

Substance Use/ Delinquency  MDFT more likely to abstain from drug use  MDFT more significant decrease in frequency of drug use  MDFT more significant decrease in drug use problems  MDFT more significant decrease in delinquent/criminal behaviors  MDFT more significant decrease in aggression and violence  MDFT less likely to be arrested or placed on probation  MDFT more likely to decrease felony arrests and serious/violent crimes Mental Health Symptoms  MDFT more significant decrease in overall mental distress, internalizing disorders, symptoms of depression and anxiety  MDFT more significant decrease in parent reports of youth internalizing disorders Family  MDFT more significant increase in positive family interactions  MDFT increase in positive parenting practices (monitoring, authoritative practices)  MDFT reduces family conflict, hostility & violence Peer  MDFT more significant decrease in affiliation with delinquent peers School  MDFT more significant improvements in academic and conduct grades  MDFT more significant decreases in absences

 Over 90% retained in treatment  50% - 75% reduction in marijuana use  Over 75% reduction in hard drug use  50% reduction in psychiatric hospitalizations  Over 70% reduction in family violence  30% - 60% improvement in school grades  40% - 75% reduction in arrests  Over 90% remain in the home at treatment discharge

MDFTGroup Percentage Arrested During 12 Month Follow-up Percentage Placed on Probation During 12 Month Follow-Up

MDFT and CBT Average Change in Hard Drug Use Intake to 12 Month Follow-Up

Change in Self-Reported Mental Health Symptoms

Percent in Out Of Home Placement at Follow-up over Study Phases

 Easy to learn —95% who start training successfully complete it  Fits into existing clinical settings —in-home, outpatient, day treatment, residential, detention centers, drug courts, diversion programs, child welfare  Clinicians like it —in a survey, 85% of clinicians report MDFT training made them a better therapist

 Sustainable —Over 90% of programs are sustained for 2 years or longer (and still counting). Over 85% have been sustained for 5 years of longer (and still counting)  Lowers service costs —1/3 the cost of residential treatment  Fosters autonomy in clinicians and programs —Among the lowest training costs of available EBPs. Offers a Train-the Trainers option.

 United States: CaliforniaOhio ConnecticutOregon FloridaPennsylvania GeorgiaWisconsin Iowa Maryland Michigan Nevada New York North Carolina

 Europe: Belgium Estonia Finland France Germany Netherlands Switzerland

“People don’t realize how much better MDFT is than other things. The word needs to get out. I mean I don’t think it is even close in comparison to the other ones, and I know because I have been trained in other EBPs. MDFT Is the Mercedes Benz, the BMW, of all treatment models for adolescent problems.”

“I think MDFT produces the optimal comprehensive outcomes. It has a multipronged approach: the flexibility to work with people in the family as individuals, as a family unit, and in dyads. Some other programs are a lot more rigid than MDFT. A lot of other models don’t have a focus on substance abuse as does MDFT. There is a broader range of outcomes that we get more consistently in MDFT. There is a deeper emotional change that we get from MDFT.”

“The training of MDFT has been wonderful: comprehensive and accessible ever since we started. The program manual is extremely well developed--it is a wonderful backup. When the consultants come on site they work with the therapists and the supervisors, families are brought in for live supervisions, they watch DVDs of our work. There is not one negative thing about the training.”

“It makes our programs for adolescents and families better. It strengthens the services for adolescents. “

ADOLESCENT DOMAIN Decrease/eliminate substance abuse Improve the teen's communication, emotional regulation, coping, and problem solving skills Improve school performance and reduce/eliminate criminal behavior PARENT DOMAIN Improve parenting skills & parental teamwork Rebuild emotional connection with youth Enhance parents' individual functioning FAMILY DOMAIN Improve family communication and problem solving skills Improve family interactions about day-to-day and big picture issues Enhance feelings of love and connection among family members COMMUNITY DOMAIN Improve family members' relationships with school, court, legal system, workplace, and neighborhood Build family members' capacity to access and obtain needed resources

 Over 90% retained in treatment  67% reduction in hard drug use  41% reduction in alcohol/marijuana  55% reduction in delinquent behaviors  37% improvement in family functioning  31% improvement in grades  74% met most or all treatment goals

 91% living in the home  74% in school/working  83% no new arrests  83% stable mental health  83% stable family functioning  61% little or no alcohol/marijuana use  87% no hard drug use

Multidimensional Family Therapy (MDFT): Evidence Based Program (EBP) for Adolescent Behavior Problems, Substance Abuse, Delinquency, and Mental Health