Randomized controlled trial of Functional Family Therapy for offending and antisocial behavior in UK youth

Sajid Humayun; Lauren Herlitz; Melanie Chesnokov; Moira Doolan; Sabine Landau; Stephen Scott

doi:10.1111/jcpp.12743

Randomized controlled trial of Functional Family Therapy for offending and antisocial behavior in UK youth

J Child Psychol Psychiatry. 2017 Sep;58(9):1023-1032. doi: 10.1111/jcpp.12743. Epub 2017 May 15.

Authors

Sajid Humayun^{1

2}, Lauren Herlitz³, Melanie Chesnokov⁴, Moira Doolan², Sabine Landau⁵, Stephen Scott²

Affiliations

¹ Department of Psychology, Social Work and Counselling, University of Greenwich, London, UK.
² Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
³ Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK.
⁴ Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁵ Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

PMID: 28504358
DOI: 10.1111/jcpp.12743

Abstract

Background: Youth offending and antisocial behavior (ASB) are associated with low quality mental health and relationships and usually lead to poor adult functioning; they are very costly for society. Family interventions are effective in children but there are few reliably effective and inexpensive interventions for adolescents. Functional Family Therapy (FFT) is an evidence-based intervention but seldom tested outside the United States.

Methods: One hundred and eleven adolescents (10-17 years of age, M = 15.0, SD = 1.63) and their families were randomized to FFT + Management As Usual (MAU) (n = 65) or to MAU (n = 46). Assessments were made at baseline 6, and 18 months after randomization and included interviews and questionnaires of parenting behaviors, conduct disorders (CDs) and offending. Parent-child interaction was directly observed and police records obtained.

Trial registration: ISRCTN27650478.

Results: Eighty-nine (80%) were followed-up. In both groups, there were large reductions over time in all measures of offending and antisocial behavior (e.g. primary outcome p < 0.001), but no significant changes over time in parenting behavior or the parent-child relationship. However, there were no differences between intervention and control groups at 6 or 18 months on self-reported delinquency, police records of offending, symptoms or diagnoses of CDs, parental monitoring or supervision, directly observed child negative behavior, or parental positive or negative behavior. Against predictions, the intervention group showed lower levels of directly observed child positive behavior at 18 months compared to controls.

Conclusions: In contrast to most previous trials of FFT, FFT+MAU did not lead to greater reductions in youth ASB and offending compared to MAU alone, and did not lead to improvements in parenting or the parent-child relationship. This may be because the trial was more rigorously conducted than prior studies; equally, the possibility that MAU was effective requires further research.

Keywords: FFT; RCT; UK; antisocial behavior; conduct disorder; offending; parenting; youth.

Publication types

Randomized Controlled Trial

MeSH terms

Adolescent
Adolescent Behavior / psychology*
Adult
Child
Child Behavior / psychology*
Conduct Disorder / therapy*
Criminals / psychology*
Family Therapy / methods*
Female
Humans
Juvenile Delinquency / prevention & control*
Male
Parent-Child Relations*
Parenting / psychology*
Treatment Outcome
United Kingdom