Presented by: Kimberly McCaskey-Lee, LCSW Amy Punsky, MA, NCC & Kelly Pavelko, BA

Child to Family Connections

What is FBT?

Evidenced-based, cost-effective intervention approach that utilizes innovative behavioral therapies used to treat substance abuse and associated problems within the family context

Created by Bradley Donohue, Ph.D.Associate professor UNLVDirector of the Achievement Center

Empirical BackgroundStudy 1Azrin, N.H., McMahon, P.T., Donohue, B., Besalel, V.A.,

Lapinski, K.J., Kogan, E.S., et al. (1994). Behavior therapy for drug abuse: A controlled treatment outcome study. Behaviour Research and Therapy, 32, 857-866.

        Study 2Azrin, N.H., Acierno, R., Kogan, E.S., Donohue, B.,

Besalel, V.A., & McMahon, P.T. (1996). Follow-up results of supportive versus behavioral therapy for illicit drug use, Behaviour Research and Therapy, 34, 41-46.

Empirical Background Study 3Azrin, N. H., Donohue, B., Besalel, V. A., Kogan, E. S., &

Acierno, R. (1994). Youth drug abuse treatment: A controlled outcome study. Journal of Child & Adolescent Substance Abuse, 3, 1-15.

Study 4Azrin, N. H., Donohue, B., Teichner, G. A., Crum, T.

Howell, J., & DeCato, L. A. (2001). A controlled evaluation and description of individual-cognitive problem solving and family-behavior therapies in dually diagnosed conduct-disordered and substance-dependent youth. Journal of Child & Adolescent Substance Abuse, 11, 1-41.

How does FBT work?Uses a team approachPlans are individualizedServices are provided during weekly

family sessionsEncourages increased family involvementUtilizes interventions focusing on

communication within the family as well as targeting substance abuse issues and troublesome behaviors

Target populationYouth between 12 -18At risk for problems associated with

illicit drug and/or alcohol useAt risk of out-of-home placement or who

have been placed previouslyYouth and at least one adult support

person willing to participateYouth NOT involved with domestic

violence or sexual abuse

What does FBT look like?Typically consists of 16-20 home-based

sessions, running for a 6 month period.Incorporates an enlistment and retention

strategy to improve attendance.Family guided treatment plan with their own

selection of skills.Selected therapies are implemented

successively and cumulatively.Meaning each therapy is reviewed and built

upon during all subsequent sessions to increase development of skills.

What does FBT look like?All interventions are based on prompting lists

used by therapists during sessions.Protocols begin with a rationale, followed by

modeling the skill, then therapist role-play of the skill, into role-playing with the client.

Client rates the helpfulness of each intervention on a Likert scale from 1 -7 (1 being extremely unhelpful to 7 being extremely helpful) with no obligation to give a high score.

Therapist rates client on compliance (attendance, participation, etc) on same Likert scale.

Initial Meetings and Assessments

Quick introduction to program and team

Elicit initial commitment

Complete consents and assessments

Assessments UsedYouth Life Satisfaction

Scale

Youth Satisfaction with Parent Scale

Parent Satisfaction with Youth Scale

FBT Questionnaire

Youth Self Report

Child Behavior Checklist

Parenting Stress Index

FBT InterventionsProgram OrientationTreatment PlanningAnnoyance ReviewStimulus ControlI’ve Got a Great FamilyLevel SystemSelf ControlPositive RequestJob ClubLast Session Review

Program Orientation and Treatment Planning

Orientation sets the tone for what treatment sessions will look like, obtaining commitments from adolescent & caregivers, communication guidelines, etc.

Review of attendance policy/cancellation expectations

Discussion of referral source and completed assessments

Commitment to stay drug freeCommunication guidelines

Program Orientation and Treatment Planning

Treatment Planning includes:Explaining interventions

Adolescent ranks priority

Caregivers rank priorityAverage of rankings = order of

interventions

Therapeutic StylePositively focused agendas

Emphasis on positive feedback and encouragement

Praising desired/ignoring undesired

Role playing

Consequence ReviewIncreasing or maintaining motivation to avoid

drug use and troublesome behavior

Stimulus ControlLearning to avoid

people, places, and situations that increase the risk of using drugs and getting into trouble, and instead spending greater amounts of time with people, places, and situations that do not involve drug use or troublesome behavior

I’ve Got a Great FamilyIncreasing communication between family

members about what they love and appreciate about each other, rather than focusing on what is not liked

Level System

Getting rewards from caregivers when goals (behaviors) are accomplished

Self ControlLearning to control impulses, urges, and

thoughts that increase drug use and trouble

Positive Request

Learning how to best make requests so people are more likely to do what you want, as well as how to best settle disagreements

Job ClubLearning techniques

to help get satisfying jobs at higher wages

How to obtain an interview

Mock interviewsHow to present self

for an interview

Donohue, B., Allen, D. (2011). Treating adult substance abuse

using family behavior therapy: A step by step approach.

Hoboken, NJ: John Wiley & sons Inc.

Kimberly McCaskey-Lee, LCSWAmy Punsky, MA, NCC

Kelly Pavelko, BAChild to Family Connections

cfcfbt1@windstream.net814.336.3007