In this time of disruption and economic stress brought on by COVID-19, keeping families safe, healthy, and intact is more important than ever. Family therapy aims to improve a family’s communication and relationships. At Commonwealth Medicine, we specialize in designing, implementing, and evaluating health care and child and family programs for public sector partners. We emphasize promoting the family therapies that focus on helping troubled youth succeed, because we know that investing early in life leads to improved outcomes in the future.
In evidence-based family therapies targeting troubled youth, a clinician and family work together to gain an understanding of a youth’s conduct or delinquency issues and how those issues are impacted by the family unit. Using communication, problem-solving, and conflict-management skills learned in treatment, family members work together to help the youth reach their goals and build stronger familial connections. A bonus of family therapy is that it touches more than one individual. Each family member learns skills they can use to help maintain their own healthy relationships and behaviors.
For a practice to be considered evidence-based it must undergo rigorous study; typically, that means multiple randomized controlled trials that compare the practice to treatment as usual vs. no treatment. Examples of family therapy evidence-based practices (EBPs) are Functional Family Therapy (FFT),1 Multisystemic Therapy (MST),2 and Brief Strategic Family Therapy (BSFT).3 FFT, MST, and BSFT have shown that they reduce recidivism and delinquency and improve family functioning.
In 2011 the New York City Administration for Children’s Services (ACS) – the city’s child welfare, juvenile justice, and subsidized early care and education service provider4 – began to offer a wide variety of evidence-based and evidence-informed practices for the youth in their care.5 ACS saw positive results in families participating in EBPs immediately. Results included a decline in investigations for high-risk families even six months after completing the program, more clients achieving their treatment goals, and more families being served by ACS’s programs compared to their clients who were not in EBPs.6 Nine years later, ACS continues to contract with community-based organizations providing EBPs.
EBPs are being adopted in large scale as states seek opportunities to invest in practices with predictable and positive outcomes. We see this as New York switches its Medicaid program to a value-based payment system that incorporates evidence-based practices, like FFT, into the Medicaid reimbursement models.
While states and cities benefit from EBPs by reducing caseloads and program costs, in the end, it’s individuals and families who benefit the most as behavioral issues are addressed, juvenile justice-involved youth see their cases discharged, and familial relationships are strengthened. Evidence-based family therapies provide avenues for troubled adolescents to receive the help they need and give families tools to live safely and happily together.
At Commonwealth Medicine, we have a deep understanding of health care and social service delivery systems. When promoting evidence-based family therapies, we begin by getting to know the organization providing the therapies, including its partners, programs, and its challenges, be they financial, policy or operational. We then collaborate on a strategy to expand the reach of evidence-based family therapies within communities.
To explore new ways to promote evidence-based family therapies, contact Audrey Smolkin, MPP, director, Child and Family Policy, or Catherine Geary, MPH, senior policy analyst, Health Law and Policy.
1 https://www.blueprintsprograms.org/programs/28999999/functional-family-therapy-fft/
2 https://www.blueprintsprograms.org/programs/32999999/multisystemic-therapy-mst/
3 https://www.cebc4cw.org/program/brief-strategic-family-therapy/
4 https://www1.nyc.gov/site/acs/about/about.page
5 ACS offered 11 practices in total, including FFT, MST, and BSFT.