Multidimensional Family Therapy (MDFT)

Multidimensional Family Therapy (MDFT) is an outpatient family-based drug abuse treatment program for teenage substance abusers. MDFT is being implemented in state-wide dissemination initiatives and investigators are examining the process of adapting and transporting the model into an existing day treatment drug program for adolescents. MDFT has been applied in several geographically distinct settings with a range of populations, targeting ethnically diverse adolescents at risk for abuse and/or abusing substances and their families. The majority of families treated have been from disadvantaged inner-city communities. As a developmentally- and ecologically-oriented treatment, MDFT takes into account the interlocking environmental and individual systems in which clinically referred teenagers reside. Targeted outcomes in MDFT include reducing the impact of negative factors as well as promoting protective processes in as many areas of the teen's life as possible. Objectives for the adolescent include transformation of a drug-using lifestyle into a developmentally normative lifestyle and improved functioning in several developmental domains, including positive peer relations, healthy identity formation, bonding to school and other pro-social institutions, and autonomy within the parent-adolescent relationship. For the parent(s), intermediate objectives include: increasing parental commitment and preventing parental abdication; improved relationship and communication between parent and adolescent; and increased knowledge about parenting practices (e.g., limit-setting, monitoring, appropriate autonomy granting).

The goal of MDFT is to reduce adolescent drug abuse and increase self-efficacy in the teen population.

Systematic reviews comparing the effective of adolescent drug use interventions across studies found that MDFT reduces substance use, delinquency, behavior problems, and symptoms of anxiety and depression. The program has also been found to improve educational performance.

Several treatment efficacy studies have been conducted on MDFT. In one study, the general pattern of results indicated improvement among youth in all three treatment programs, with MDFT participants showing the largest and most stable gains on all outcomes. Another study conducted compared MDFT to individual cognitive-behavioral therapy (CBT) for adolescent drug abuse. While investigators found no evidence to suggest that either treatment was superior to the other in influencing the amelioration of symptoms at termination, adolescents receiving MDFT continued to improve after termination while CBT youth did not. A third study found that both MDFT and peer group interventions resulted in reductions in the number of youth reporting substance use problems during the 1-year follow-up. In a controlled trial testing MDFT, the model fared well in terms of comparative efficacy as well as cost analyses. Results are also available of a randomized trial comparing the clinical effectiveness and relative monetary benefits of MDFT vs. residential treatment for dually diagnosed adolescent substance abusers. Cost analyses revealed an almost 3:1 differential in the costs of the two treatments favoring MDFT ($384 per week vs. $1,138), suggesting that these more promising results can be obtained in MDFT at a fraction of the cost of residential treatment.