Scaling-Up Evidence-Based Programs Using a Public Funding Stream: a Randomized Trial of Functional Family Therapy for...

Area of Science:

• Public Health
• Health Services Research
• Adolescent Psychology

Background:

• The Affordable Care Act expanded Medicaid, covering essential health benefits including prevention services.
• Juvenile justice-involved youth often face challenges with gang involvement and recidivism.
• Evidence-based programs can improve outcomes for at-risk youth populations.

Purpose of the Study:

• To assess the cost-effectiveness of using Medicaid funding for Functional Family Therapy (FFT) with juvenile justice-involved youth.
• To rigorously test an adapted FFT model for urban, gang-affiliated, or at-risk youth.
• To evaluate the impact of FFT on service utilization and recidivism rates.

Main Methods:

• A randomized controlled trial involving 129 predominantly minority and low-income families.
• Families were assigned to either an enhanced FFT intervention or an alternative family therapy.
• Data collected included interviews, court records, service records, and cost analyses.

Main Results:

• Functional Family Therapy (FFT) was implemented with fidelity using Medicaid funding.
• Treatment subjects received more services, yet the cost per youth was lower than for controls.
• FFT resulted in lower recidivism rates during the 18-month follow-up period.

Conclusions:

• Using Medicaid funding for evidence-based practices like FFT is cost-effective.
• FFT demonstrates significant cost savings and recidivism reduction in at-risk youth.
• Expanded use of evidence-based interventions via public funding is warranted.