Skip to main content
SpringerLink
Log in

Family-Based Interventions with Older, At-Risk Youth: From Promise to Proof to Practice

  • Published:
Journal of Primary Prevention Aims and scope Submit manuscript

Abstract

The paper reviews a group of family-based interventions, which have received strong empirical support, with respect to intervention with older and more seriously at-risk youth. With such family-focused interventions it is not uncommon for the risk factors experienced by youth who already express clear behavioral problems to exist also for their siblings who may not yet show any of the negative behavior patterns, but nonetheless may be at high risk. Thus, a “treatment” program that effectively changes the ongoing maladaptive family processes surrounding the already dysfunctional youth will at the same time be changing the risk factors for the siblings who is not yet behaving problematically. As such, the program will simultaneously represent a treatment and a primary prevention program.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  • Alexander, J. F. (1973). Defensive and supportive communications in family systems. Journal of Marriage and the Family, 35(4), 613–617.

    Google Scholar 

  • Alexander, J. F., & Barton, C. (1995). Family therapy research. In R. H. Mikesell, D. D. Lusterman, & S. McDaniel (Eds.), Integrating family therapy: Handbook of family psychology and systems therapy. Washington DC: American Psychological Association.

    Google Scholar 

  • Alexander, J. F., Barton, C., Schiavo, R. S., & Parsons, B. V. (1976). Systems-behavioral intervention with families of delinquents: Therapist characteristics, family behaviors, and outcome. Journal of Consulting and Clinical Psychology, 44, 656–664.

    Google Scholar 

  • Alexander, J. F., Holtzworth-Munroe, A., & Jameson, P. B. (1993). Research on the process and outcome of marriage and family therapy. In A. E. Bergin & S. L. Garfield (Eds.). Handbook of psychotherapy and behavior change (4th edition), New York: John Wiley & Sons.

    Google Scholar 

  • Alexander, J. F., & Parsons, B. V. (1973). Short-term behavioral intervention with delinquent families: Impact on family process and recidivism. Journal of Abnormal Psychology, 81, 219–225.

    Google Scholar 

  • Alexander, J. F., & Parsons, B. V. (1982). Functional Family Therapy: Principles and procedures. Carmel, CA: Brooks & Cole.

    Google Scholar 

  • Alexander, J. F., Pugh, C., & Parsons, B. (1998). Functional Family Therapy. In D. Elliott (Series Ed.) Book Three: Blueprints for Violence Prevention, Golden, CO: Venture Publishing & Denver, CO.: C & M Press.

    Google Scholar 

  • Alexander, J.F., Sexton, T.L.,& Robbins, M.A. (in press). The developmental status of family therapy in family psychology intervention science. In H. A. Liddle, Family Psychology Intervention Science. American Psychological Association Press: Washington, DC.

  • Barton, C. (1998). Program replication in a mental health setting. In Alexander, J. F., Pugh, C., & Parsons, B. (1998). Functional Family Therapy. In D. Elliott (Series Ed.) Book Three: Blueprints for Violence Prevention, Golden, CO: Venture Publishing & Denver, CO.: C & M Press.

    Google Scholar 

  • Barton, C., Alexander, J. F., Waldron, H., Turner, C.W.,& Warburton, J. (1985). Generalizing treatment effects of Functional Family Therapy: Three replications. American Journal of Family Therapy, 13, 16–26.

    Google Scholar 

  • Baumrind, D. (1991). Effective parenting during the early adolescent transition. In P. A. Cowan & M. Heatherington (Eds.). Family transitions (pp. 111–163). Hillsdale, New Jersey: Lawrence Erlbaum.

    Google Scholar 

  • Baumrind, D. (1991). The influence of parenting style on adolescent competency and substance abuse. Journal of Early Adolescence, 11(1), 56–95.

    Google Scholar 

  • Block, J., Block, J. H., & Keyes, S. (1988). Longitudinally foretelling drug usage in adolescence: Early childhood personality and environmental precursors. Child Development, 59, 336–355.

    Google Scholar 

  • Chamberlain, P., Patterson, G. R., Reid, J. B., Kavanagh, K., & Forgatch, M. S. (1984). Observation of client resistance. Behavior Therapy, 15, 144–155.

    Google Scholar 

  • Diamond, G., & Liddle, H. A. (1996). Resolving a therapeutic impasse between a parent and an adolescent in family therapy. Journal of Consulting and Clinical Psychology, 64, 481–488.

    Google Scholar 

  • DiGiuseppe, R., Linscott, J.,& Jilton, R. (1996). Developing the therapeutic alliance in child-adolescent psychotherapy. Applied & Preventive Psychology, 5(2), 85–100.

    Google Scholar 

  • Dobson, K. S., & Shaw, B. F. (1986). The training of cognitive therapists: What we have learned from treatment manuals? Psychotherapy, 30, 573–577.

    Google Scholar 

  • Eaton, T. T., Abeles, N., & Gutfreund, M. J. (1988). Therapeutic alliance and outcome: Impact of treatment length and pretreatment symptomatology. Psychotherapy, 25, 536–542.

    Google Scholar 

  • Elliott, D. S. (1998). Editor's Introduction. In Functional Family Therapy. In D. Elliott (Series Ed.) Book Three: Blueprints for Violence Prevention, Golden, CO: Venture Publishing & Denver, CO.: C & M Press.

    Google Scholar 

  • Friedlander, M. L., Wildman, J., Heatherington, L., & Skowrow, E. A. (1994). What we do and don't know about the process of family therapy. Journal of Family Psychology, 8, 390–416.

    Google Scholar 

  • Gaston, L., Marmar, C. R., Gallagher, D., & Thompson, L.W. (1991). Alliance prediction of outcome beyond in-treatment symptomatic change as psychotherapy processes. Psychotherapy Research, 1, 104–113.

    Google Scholar 

  • Gaston, L., & Schneider, J. (1992, August). The Alliance in Group Psychotherapy. Paper presented at the meeting of the International Association of Group Psychotherapy, Montreal, Canada.

  • Gomes-Schwartz, B. (1978). Effective ingredients in psychotherapy: Prediction of outcome from process variables. Journal of Consulting and Clinical Psychology, 46, 1023–1035.

    Google Scholar 

  • Gordon, D. A. (1995). Functional Family Therapy for delinquents. In Ross, R. P. Antonowicz, D. H., & Dhaliwal, G. K. (Eds.), Going Straight: Effective Delinquency Prevention and Offender Rehabilitation. Air Training & Publications: Ottawa, Ontario, Canada, pp. 163–178.

    Google Scholar 

  • Gordon, D. A., Arbuthnot, J., Gustafson, K. E.,& McGreen, P. (1988). Home-based behavioral-systems family therapy with disadvantaged juvenile delinquents. The American Journal of Family, 16, 243–255.

    Google Scholar 

  • Gordon, D. A., Graves, K., & Arbuthnot, J. (1995). The effect of Functional Family Therapy for delinquents on adult criminal behavior. Criminal Justice and Behavior, 22, 60–73.

    Google Scholar 

  • Gurman, A. S.,& Kniskern, D. P. (1978). Research on marital and family therapy: Progress, perspective and prospect. In S. L. Garfield & A. E. Bergin (Eds.), Handbook of psychotherapy and behavior change: An empirical analysis (2nd ed.) (pp. 817–902). New York, NY: Wiley.

    Google Scholar 

  • Gurman, A. S., Kniskern, D. P., & Pinsof, W. M. (1986). Research on the process and outcome of marital and family therapy. In S. L. Garfield & A. E. Bergin (Eds.), Handbook of psychotherapy and behavior change (3rd editions) (pp. 565–624). New York: John Wiley & Sons.

    Google Scholar 

  • Hansson, K. (1998). Program replication in Sweden. Alexander, J. F., Pugh, C., & Parsons, B. (1998). Functional Family Therapy. In D. Elliott (Series Ed.) Book Three: Blueprints for Violence Prevention, Golden, CO: Venture Publishing & Denver, CO.: C & M Press.

    Google Scholar 

  • Hansson, K., Cederblad, M.,& Alexander, J. F. (1998, January). Functional Family Therapy: A method for treating juvenile delinquents-a cross cultural comparison. Paper presented to the 8th Annual International Conference on Treating Addictive Behaviors, Santa Fe, NM.

  • Harrison, R. (1998). Program replication in Clark County Family and Youth Services. Alexander, J. F., Pugh, C.,& Parsons, B. (1998). Functional Family Therapy. In D. Elliott (Series Ed.) Book Three: Blueprints for Violence Prevention, Golden, CO: Venture Publishing&Denver, CO.: C&MPress.

    Google Scholar 

  • Hawkins, J. D., Catalano, R. F., & Miller, J. Y. (1992). Risk and protective factors for alcohol and other drug problems in adolescence and early childhood: Implications for substance abuse prevention. Psychological bulletin, 112, 64–105.

    Google Scholar 

  • Hazelrigg, M. D., Cooper, H. M., & Bourduin, C. M. (1987). Evaluating the effectiveness of family therapies: An integrative review and analysis. Psychological Bulletin, 101, 428–442.

    Google Scholar 

  • Henggeler, S. W., Borduin, C. M., Melton, G. B., Mann, B. J., Smith, L. A., Hall, J. A., Cone, L., & Fucci, B. R. (1991). Effects of multisystemic therapy on drug use and abuse in serious juvenile offenders: A progress report from two outcome studies. Family Dynamics Addiction Quarterly, 1, 40–51.

    Google Scholar 

  • Henggeler, S.W., Melton, G. M., Brondino, M. J., Scherer, D. G.,& Hanley, J. H. (1997). Multisystemic treatment with violent and chronic juvenile offenders and their families: The role of treatment fidelity in successful dissemination. Journal of Consulting and Clinical Psychology, 65(5), 821–833.

    Google Scholar 

  • Henggeler, S.W., Melton, G. B., Brondino, M. J., Scherer, d. g., & Hanley, J. H. (1997). Multisystemic therapy with violent and chronic juvenile offenders and their families: the role of treatment fidelity in successful dissemination. Journal of Consulting and Clinical Psychology, 65(5), 821–833.

    Google Scholar 

  • Henggeler, S. W., Melton, G. M., Smith, L. A., Schoenwald, S. K., & Hanley, J. H. (1993). Family preservation using multisystemic treatment: Long-term follow-up to a clinical trial with serious juvenile offenders. Journal of Child and Family Studies, 2, 283–293.

    Google Scholar 

  • Henggeler, S. W., Rodick, J. D., Borduin, C. M., Hanson, C. L., Watson, S. M., & Urey, J. R. (1986). Multisystemic treatment of juvenile offenders: Effects on adolescent behavior and family interaction. Developmental Psychology, 22, 132–141.

    Google Scholar 

  • Henry, W. P. (1998). Science, politics, and the politics of science: The use and misuse of Empirically Validated Treatment Research. Psychotherapy Research, 8, 126–140.

    Google Scholar 

  • Henry, W. P., Strupp, H. H., Schacht, T. E., & Gaston, L. (1994). Psychodynamic approaches. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed.) (pp. 467–508). New York, NY: Wiley.

    Google Scholar 

  • Horvath, A. O., & Symonds, D. B. (1991). Relationship between working alliance and outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology, 38, 139–149.

    Google Scholar 

  • Kandel, D., Kessler, R., & Margulies, R. (1978). Antecedents of adolescent initiation into stages of drug use: A developmental analysis. In D. B. Kandel (Ed.), Longitudinal research on drug use. New York, NY: Wiley.

    Google Scholar 

  • Kazdin, A. E. (1993).Treatment of conduct disorder: Progress and directions in psychotherapy research. Development and Psychopathology, 5, 277–310.

    Google Scholar 

  • Kazdin, A. E. (1995). Conduct disorders in childhood and adolescence (2nd ed.). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Klein, N. C., Alexander, J. F., & Parsons, B. V. (1977). Impact of family systems intervention on recidivism and sibling delinquency: A model of primary prevention and program evaluation. Journal of Consulting and Clinical Psychology, 45(3), 469–474.

    Google Scholar 

  • Koss, M. P., Shiang, J. (1994). Research on brief psychotherapy. In A. E. Bergin & S. L. Garfield (Eds.), Handbook of psychotherapy and behavior change (4th ed.) (pp. 664–700). New York, NY: Wiley.

    Google Scholar 

  • Krinsley, K., & Bry, B. H. (1991). Sequential analyses of adolescent, mother, and father behaviors in distressed and nondistressed families. Child and Family Behavior Therapy, 13(4), 45–62.

    Google Scholar 

  • Krupnick, J., Sotsky, S., Simmens, S., & Moyer, J. (1992, June). The role of the therapeutic alliance in psychotherapy and pharmacotherapy outcome: Findings from the NIMH Treatment of Depression Collaborative Research Program. Paper presented at the annual meeting of the Society for Psychotherapy Research, Berkeley, CA.

  • Kumpfer, K. L. (1989). Family function factors associated with delinquency. In K. L. Kumpfer (Ed.), Literature review of effective parenting projects: Strategies for high risk youth and families. (Research Report No. 2). Washington, DC: Office of Juvenile Justice Delinquency Prevention.

    Google Scholar 

  • Lambert, M. J. (1992). Implications of outcome research for psychotherapy integration. In J. C. Norcross & M. R. Goldstein (Eds.), Handbook of psychotherapy integration. New York, NY: Basic Books.

    Google Scholar 

  • Liddle, H. A., & Dakof, G. A. (1995a). Efficacy of family therapy for drug abuse: Promising but not definitive. Journal of Marital and Family Therapy, 21(4), 511–544.

    Google Scholar 

  • Liddle, H. A., & Dakof, G. A. (1995b). Family-based treatment for adolescent drug use: State of the science. In E. Rahdert & D. Czechowicz (Eds.), Adolescent drug abuse: Clinical assessment and therapeutic interventions (pp. 218–254). NIDA Research Monograph No. 156, NIH Publication No. 95-3908. Rockville, MD: National Institute on Drug Abuse.

    Google Scholar 

  • Liddle, H. A., Dakhof, G. A., Parker, K., Diamond, G. S., Barrett, K., & Tejeda, M. (under editorial review). Multidimensional family therapy for adolescent drug abusers: Results of a randomized clinical trial.

  • McGee, S, & Rinaldi, L. (1997). Implementation of the Community Juvenile Accountability Act: Report and Recommendations of the CJAA Workgroup. Unpublished technical report for the Washington State Association of Juvenile Court Administrators.

  • Melidonis, G. G.,& Bry, B.H. (1995). Effects of therapist exceptions questions on blaming and positive statements in families with adolescent behavior problems. Journal of Family Psychology, 9(4), 451–457.

    Google Scholar 

  • Multon, K. D., Kivlighan, D. M.,& Gold, P. B. (1996). Changes in counselor adherence over the course of therapy. Journal of Counseling Psychology, 43, 356–363.

    Google Scholar 

  • Muran, J. C., Gorman, B. S., Safran, J. D., Twining, L., Samstag, L.W., & Winston, A. (1995). Linking in-session change to overall outcome in short-term cognitive therapy. Journal of Consulting and Clinical Psychology, 63, 651–657.

    Google Scholar 

  • Parsons, B. V., & Alexander, J. F. (1973). Short term family intervention: A therapy outcome study. Journal of Consulting and Clinical Psychology, 41(2), 195–201.

    Google Scholar 

  • Patterson, G. R., & Dishion, T. J. (1985). Contributions of families and peers to delinquency. Criminology, 23, 63–79.

    Google Scholar 

  • Patterson, G. R.,& Forgatch, M. (1985). Therapist behavior as a determinant for client non-compliance: A paradox for the behavior modifier. Journal of Consulting and Clinical Psychology, 53(6), 846–851.

    Google Scholar 

  • Pinsof, W. M., & Catherall, D. R. (1986). The integrative psychotherapy alliance: Family, couple, and individual therapy scales. Journal of Marital and Family Therapy, 12, 137–151.

    Google Scholar 

  • Robbins, M. S., Alexander, J. F., Newell, R. M., & Turner, C. W. (1996). The immediate effect of reframing on client attitude in family therapy. Journal of Family Psychology, 10(1), 28–34.

    Google Scholar 

  • Robbins, M. S., Alexander, J. F., & Turner, C. W. (In press). The impact of therapist reframing on reciprocal pejorative family member interactions in family therapy with delinquent youth.

  • Robbins, M. S., Mitrani, V., Zarate, M., Coatsworth, D.,& Szapocznik, J. (1996, June). Linking process to outcome in structural family therapy with drug using youth: An examination of the process of family therapy in successful and unsuccessful outcome cases. Paper presented at the 27th Annual meeting of the Society for Psychotherapy Research (SPR), Amelia Island, FL.

  • Rutter, M. (1980). Changing youth in a changing society. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Rutter, M., & Guiller, H. (1983). Juvenile delinquency: Trends and perspectives. New York, NY: Penguin.

    Google Scholar 

  • Santisteban, D. A., Szapocznik, J., Perez-Vidal, A., Kurtines, W. M., Coatsworth, J. D., LaPerriere, A., & Lyons-Howie, E. (1996). The efficacy of brief strategic/structural family therapy in modifying behavior problems and an exploration of the role that family functioning plays in behavior change. Manuscript in preparation. Miami, FL: University of Miami.

    Google Scholar 

  • Schmidt, S., Liddle, H. A., & Dakof, G. (1996). Changes in parenting practices and adolescent drug abuse during multidimensional family therapy. Journal of Family Psychology, 10(1), 12–27.

    Google Scholar 

  • Schulman, S. (1998). Urban Ann Arbor, Michigan: COPE/O'BRIEN Center: Delinquency prevention in a high-crime urban area. Alexander, J. F., Pugh, C., & Parsons, B. (1998). Functional Family Therapy. In D. Elliott (Series Ed.) Book Three: Blueprints for Violence Prevention, Golden, CO: Venture Publishing & Denver, CO.: C & M Press.

    Google Scholar 

  • Seligman, M. (1995). The effectiveness of psychotherapy. American Psychologist, 50, 965–974.

    Google Scholar 

  • Sexton, T. S. (1998). Program replication using a collaborative partnership (employer-agencyuniversity). Alexander, J. F., Pugh, C., & Parsons, B. (1998). Functional Family Therapy. In D. Elliott (Series Ed.) Book Three: Blueprints for Violence Prevention, Golden, CO: Venture Publishing & Denver, CO.: C & M Press.

    Google Scholar 

  • Sexton, T. L. & Alexander, J. F. (1999). Family-based interventions an Empirically Supported Intervention Program. Paper presented as part of J. W. Lichtenberg & B. Wampold Principles for Empirically Supported Intervention Programs-Examples and Issues. American Psychological Association, Boston: MA.

    Google Scholar 

  • Sexton, T., Alexander, J. F.,& Harrison, R. (1998). Functional Family Therapy: Overview&State-wide Initial Training. Washington State Department of Social and Health Services, Juvenile Rehabilitation Administration, Washington State Community Juvenile Accountability Act Conference, Seattle, WA (August).

  • Sexton, T. L.,& Ostrom, N. (1998). Functional Family Therapy Clinical Services System. Unpublished Manuscript, University of Nevada, Las Vegas.

    Google Scholar 

  • Shadish, W. R., Montgomery, L. M., Wilson, P., M. R., Bright, I., & Okwumabua, T. (1993). Effects of family and marital spychotherapies: A meta-analysis. Journal of Consulting and Clinical Psychology, 61, 992–1002.

    Google Scholar 

  • Shields, C. G., Sprenkle, D. G., & Constantine, J. A. (1991). Anatomy of an initial interview: The importance of joining and structuring skills. The American Journal of Family Therapy, 19(1), 3–18.

    Google Scholar 

  • Stanton, M. D., & Shadish, W. R. (1997). Outcome, attrition, and family-couples treatment for drug abuse: A meta-analysis and review of the controlled, comparative studies. Psychological Bulletin, 122(2), 170–191.

    Google Scholar 

  • Strupp, H. H., & Hadley, S. W. (1979). Specific versus nonspecific factors in psychotherapy: A controlled study of outcome. Archives of General Psychiatry, 36, 1125–1136.

    Google Scholar 

  • Szapocznik, J., & Kurtines, W. M. (1989). Breakthroughs in family therapy with drug abusing and problem youth. New York, NY: Springer Publishing Co.

    Google Scholar 

  • Szapocznik, J., Rio, A. T., Murray, E., Cohen, R., Scopetta, M. A., Rivas-Vasquez, A., Hervis, O. E., & Posada, V. (1989). Structural family versus psychodynamic child therapy for problematic Hispanic boys. Journal of Consulting and Clinical Psychology, 57(5), 571–578.

    Google Scholar 

  • Waldron, H. B. (1998). Program replication for adolescent substance abusers. Alexander, J. F., Pugh, C., & Parsons, B. (1998). Functional Family Therapy. InD. Elliott (Series Ed.) Book Three: Blueprints for Violence Prevention, Golden, CO: Venture Publishing & Denver, CO.: C & M Press.

    Google Scholar 

  • Waehler, C. A. (1998). The EVT movement in professional psychology: A short history. Paper presented at the 106th Annual Convention of the American Psychological Association. San Francisco, CA.

  • Werner, E. E., & Smith, R. S. (1992). Overcoming the odds: High risk children from birth to adulthood. Ithaca, NY: Cornell University Press.

    Google Scholar 

  • Widom, C. S. (1989). Does violence beget violence? A critical examination of the literature. Psychological Bulletin, 106, 3–28.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, University of Utah, 390 S. 1530 E., Room 502, Salt Lake City, Utah, 84112

    James F. Alexander

  2. University of Miami, USA

    Michael S. Robbins

  3. University of Nevada Las Vegas, USA

    Thomas L. Sexton

Authors
  1. James F. Alexander
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michael S. Robbins
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Thomas L. Sexton
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Alexander, J.F., Robbins, M.S. & Sexton, T.L. Family-Based Interventions with Older, At-Risk Youth: From Promise to Proof to Practice. The Journal of Primary Prevention 21, 185–205 (2000). https://doi.org/10.1023/A:1007031219209

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1007031219209

Search

Navigation