Multidimensional Family Therapy Approaches

Healing Families, Transforming Lives with Multidimensional Family Therapy at Purpose

What are the Four Domains of MDFT?

The four domains of MDFT are the adolescent, the parent or parents, the family, and the community. MDFT addresses concerns like substance abuse by targeting each of these domains.

The Youth Domain

The youth domain focuses on the adolescent’s mental health. This may include helping them reduce substance misuse while improving their emotion regulation, coping, and communication skills. It may also focus on navigating social situations.

The Parent Domain

The parent domain in MDFT focuses on helping parents reduce stress and improve their well-being while learning tailored parenting practices.

The Family Domain

The family domain focuses on improving communication patterns in families and changing unhelpful or dysfunctional family dynamics.

The Community Domain

The community domain in MDFT helps youth and families seek and receive support from social systems outside of the home. For example, MDFT can help you and your child interact with the school system, juvenile justice system, peers, and community resources.

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Addressing Co-Occurring Mental Health Disorders During MDFT

Often, young adult alcohol and drug abuse pairs with one or more additional mental health challenges. For example, trauma, anxiety, mood disorders, conduct disorder, or schizophrenia and related disorders.

When this is the case, integrated approaches that address both addiction and mental health are recommended.

For this reason, MDFT is an excellent choice. MDFT is an integrated treatment (often paired with cognitive behavior therapy and peer group treatment) that focuses on all aspects that might contribute to what a young person in addiction treatment is going through. This includes addressing co-occurring disorders alongside drug and alcohol abuse or dependence.

What is the Effectiveness of Multidimensional Family Therapy for Substance Abuse and Mental Health?

When it comes to treating youth substance abuse and co-occurring psychiatric symptoms, approaches like MDFT are among the most effective. This is likely due to the comprehensive nature of the program and the support provided to all parties involved.

For example, a randomized control trial comparing MDFT to a peer group intervention found that MDFT was superior in reducing substance use, delinquency, internalized distress, and risk in family, peer, and school domains. This was based on twelve-month outcomes.

The Effectiveness of MDFT for Other Youth Behavior Challenges

Youth in substance abuse treatment may face challenges in the juvenile justice system. These could include drug charges or other legal problems. In addition to other benefits of MDFT approaches, evaluation outcomes show that:

• Multidimensional family therapy decreases criminal behavior. At a one-year follow-up, youth involved in the MDFT group (as opposed to treatment as usual) were more likely to abstain from crimes of any type, including violent crimes and property crimes.
• Multidimensional family therapy lowers delinquent behaviors. The difference was statistically significant at an eighteen-month follow-up.

To illustrate the importance of family involvement, it can be helpful to compare MDFT to other approaches.

For example, a randomized clinical trial of family therapy in juvenile drug court suggests that family therapy enhances juvenile drug court outcomes beyond what is achieved in non-family based treatment.

What are the Three Phases of MDFT?

Multidimensional family therapy consists of three phases, also called stages. The phases of MDFT include:

• Stage 1: Focuses on increasing treatment motivation, building therapeutic alliances, and drafting treatment plans.
• Stage 2: Executing the treatment plan. Youth and parents work to build new skills in therapy. Therapists help youth, parents, and families work toward their goals.
• Stage 3: Reinforcing change. This may include a relapse prevention plan and follow-up sessions that provide continued support (e.g., weekly therapy) as needed.

Often, treatment ends with an overview of the progress the client has made.

What are the Typical Goals of MDFT?

MDFT can help young people and families meet a wide range of goals. The specific goals you work toward in MDFT can depend on the unique needs of your child and family.

Goals for youth include:

• Emotion regulation.
• Problem-solving skills.
• Reduce or eliminate substance abuse.
• Promote positive peer relationships.
• Enhance self-worth and confidence.
• Improved performance at school.
• Healthy coping strategies.

Goals for parents include:

• Improving parenting skills.
• Enhance parental teamwork (in two-parent families).
• Help parents care for their personal well-being.

Drug and alcohol abuse can affect anyone. The same is true for other mental health concerns. However, recovery is also very possible.