Midtreatment Problems Implementing Evidence-based Interventions in Community Settings.

Area of Science:

• Child and Adolescent Psychology
• Family Therapy Research
• Evidence-Based Practices

Background:

• Multisystemic Therapy (MST) and Functional Family Therapy (FFT) are leading evidence-based family treatments for adolescent behavioral issues.
• Understanding midtreatment implementation challenges is crucial for optimizing these widely used interventions.

Purpose of the Study:

• To investigate common and model-specific implementation problems encountered during midtreatment for MST and FFT.
• To identify factors predicting these problems and their impact on treatment outcomes.

Main Methods:

• A mixed-method study involving semistructured telephone interviews with experienced MST and FFT therapists and supervisors across the U.S.
• Retrospective identification and qualitative coding of midtreatment process problems into five major themes and 12 categories.

Main Results:

• Therapists and supervisors reported numerous similar midtreatment problems in both MST and FFT, including family engagement and strategy implementation difficulties.
• Model-specific differences emerged, with FFT showing more family relational issues and MST having more follow-through problems.
• Predictors of problems and variations in outcomes based on problem type, model, and therapist-family race/ethnicity were analyzed.

Conclusions:

• Both MST and FFT face shared implementation hurdles, necessitating a focus on common factors.
• Addressing model-specific challenges is essential for tailoring support and improving treatment efficacy in adolescent family therapy.
• Recognizing both universal and unique implementation issues is key to successful treatment process in family-based interventions.