Multi-Dimensional Family Therapy (MDFT)

Intervention Basics 

Multi-Dimensional Family Therapy (MDFT) is solution-focused and incorporates a team approach into the treatment of adolescents. MDFT focuses on four areas to provide immediate and practical outcomes: the individual adolescent, the adolescent’s family members as individuals, the family unit, and how the family unit interacts with the social environment.

MDFT targets four areas of social interaction: 
  • The youth's interpersonal functioning with parents and peers
  • The parents' parenting practices and level of adult functioning independent of their parenting role
  • Parent-adolescent interactions in therapy sessions
  • Communication between family members and key social systems (e.g., school, child welfare, mental health, juvenile justice).
Expectation of Sessions:
3-6 months of treatment with varying sessions of 1-2 hours in length. 

Stage 1: Building a Foundation for Change (3 weeks) – Use distress to motivate/focus, create expectations, visit school/neighborhood

Stage 2: Facilitating Individual and Family Change (5 weeks) – Mobilize, make small steps toward progress, think in stages, use mistakes as opportunities

Stage 3: Solidify Changes and Launch (4 weeks) – Appraise current status honestly, except imperfect outcomes, emphasize all changes made, assess future needs and next steps.

Recommended Populations

  • 13-17 (Adolescent)
  • Girls & Boys
  • Asian; Black or African American; Hispanic or Latino; and White
  • Outpatient; Correctional; and Home
  • Urban; Suburban; and Rural and/or frontier

Special Considerations for Juvenile Drug Courts

MDFT is a family therapy approach, so it is extremely important to, not only engage and retain the youth, but to engage and retain the family as a whole unit (whatever that family may look like). Family therapy differs from an individual approach with youth, in that the normal progression during treatment is for the families to get worse before they get better. In addition, families and youth will likely improve at a much slower rate.  

JDCs will need to redefine success if the court is utilizing MDFT. In the Cannabis Youth Series, the research suggested that the initial effects of MDFT did not show the same positive outcomes (at 3 and 6 months) that MET/CBT 12 had. But, when researchers were able to go out a year or more, a correlation between participating in MDFT AND improvement in youth and family functioning. The effects were shown to have a potential residual effect for three years out post-treatment.  This literally means that JDCs will have to keep the slow progress of the youth and families in mind, and develop policies and procedures that match that same progression. 

Engagement Strategies

MDFT uses an ecological model and is not pushing for perfection but change that can be recognized. The court should align itself as much as possible with the treatment providers, as well as family members, in devising incentives and sanctions that make sense within the context of both treatment and the juvenile drug court. The JDC team should work towards empowering the family with workable, agreed upon incentives (i.e., lifting curfew) and sanctions (i.e., taking away electronic devices) and help families understand that they have the power of the court behind them. 

Implementation and Training

Contact Gayle A. Dakof, Ph.D., (305) 243-3656, gdakof@med.miami.edu to research costs and training opportunities.

 

  For more detailed information regarding research and replications associated with MDFT, visit: