1. Multidimensional Family Therapy for Adolescent Drug Abuse: A Clinical Demonstration of Core Therapist Skills and Treatment Techniques
Elda Veloso
Center for Treatment Research on Adolescent Drug Abuse
University of Miami School of Medicine
Presented at the 2005 Joint Meeting on Adolescent Effectiveness
Society for Substance Abuse Treatment Effectiveness (SASATE)
Washington, DC, March 20-23, 2005

2. Case P05 and the MDFT Approach
Objectives:
To review the main pieces of the MDFT approach through the lens of a specific case.
To highlight the process in which MDFT therapists conceptualize and build the intervention.

3. Case PO5 Summary/Conceptualization
Having viewed the 9-minute DVD of Case PO5:
Mother’s use
Currently using alcohol
Substance abuse history – crack/cocaine
Adolescent’s use
Reported using marijuana, cocaine, Xanax and Ecstasy on a weekly basis
Adolescent was failing school; repeated 8th grade 2 times

4. Case PO5 Summary/Conceptualization
Adolescent dealing with past hurt from Mother not being around  Adolescent having to parent himself
They did not communicate with each other

5. Pieces of MDFT Approach/Intervention Targets
Given any case, the MDFT therapist will conceptualize the case through the following four areas of work:
Adolescent
Parent
Family
Extrafamilial

6. Rationale for MDFT Intervention Targets
Problems
are multidimensional
Multidimensional problems
require multidimensional
conceptualizations
Parent(s)
MDFT
Family
Adolescent
Multidimensional
conceptualizations yield
multi-systems interventions
Extrafamilial
MDFT assesses and intervenes
into multiple systems of
development and influence

7. Pieces of MDFT Approach/Intervention Targets
Family
MDFT
Parent(s)
Extrafamilial
Therapist - Adolescent
Adolescent
Self
Family
Peers

8. Pieces of MDFT Approach/Intervention Targets
Self
Overall functioning
Stress and burden
Who they are as individual
human beings
Parent
Love and commitment
Guidance and limit setting
Strong stance against drug
use and delinquency
Therapist - Parent
Parent(s)
Family
MDFT
Adolescent
Extrafamilial

9. Pieces of MDFT Approach/Intervention Targets
Healthy family relationship and
work on family functioning
Help family communicate in a
new and positive way
MDFT
Adolescent
Parent(s)
Extrafamilial
Therapist - Family
Family
GOAL: Help parents get to know the Adolescent so that they can influence him/her

10. Pieces of MDFT Approach/Intervention Targets
Family
MDFT
Adolescent
Parent(s)
School
Neighborhood
Legal (Juvenile Justice)
Social
Medical
Other – Anything outside of
the family that may impact
adolescent or parent
functioning
Extrafamilial
Therapist -Extrafamilial

11. Pieces of MDFT Approach/Intervention Targets
Family
MDFT
Parent(s)
Extrafamilial
Therapist - Parent
Therapist must be thinking at all times about the four areas of work and how work in one area impacts progress in all other areas
Adolescent
Therapist - Family
Therapist
Therapist - Adolescent
Therapist -Extrafamilial

12. MDFT: P05 Case Study
We have reviewed how the MDFT therapist approaches each case and why
We have discussed the main issues for Case P05
This is how the MDFT principles would be applied to Case P05

13. 5. Therapist–Family-Extrafamilial
MDFT: P05 Case Study
1. Therapist - Adolescent
2. Therapist – Parent(s)
Listen to mom’s
stress and burden
“You’re the medicine”
Self-care: See own
drug use as a problem
and work towards
recovery
Help adol talk
about past hurt
regarding mom not
being around
about his hopes
and changes he
wants to make –
i.e. school
“There’s something
in this for you.”
3. Therapist - Family
Help adol talk to mom about pain
she caused him
Help mom listen to adol and
apologize for the past
Help mom talk about where she is
now and what she is willing to do
to make the situation better
Facilitate negotiation about house
rules
5. Therapist–Family-Extrafamilial
Guide mom in becoming more involved in
school to help adol succeed
Help mom get assistance from court to keep
adol off drugs