Introduction to Functional Family Therapy in Juvenile Probation and parole.

Introduction to Functional Family Therapy in Juvenile Probation and parole.

By Roscoe C. Bright Jr.

This is an overview of the Functional Family Therapy program associated with the Family First Prevention and Services act in Pennsylvania. The goal of this writing is to educate the reader on this program and the benefits of utilizing this program with youths and families involved with the Juvenile Justice system.

In this paper I will be discussing the Family Functional Therapy program set forth by the Family First Prevention Service act legislation. I will outline my understanding of the Family First act legislation, outline what the legislation was seeking to address, discuss risk/ protective factors/ resilience of youth and families, outline Functional Family Therapy in probation and parole, and give suggestions on expansion of the Family First act legislation and Functional Family therapy.

HR. 1892, the Family First Prevention Services act (FFPSA), was signed into law on February 9, 2018, as part of the Bipartisan Budget act. The purpose of this act is to enable states to develop and establish, or expand, and to operate coordinated programs of community-based family support services, family preservation services, family reunification services, and adoption promotion and support services to accomplish the following objectives: (1) To prevent child maltreatment among families at risk through the provision of supportive family services. (2) To assure youth’s safety within the home and preserve intact families in which youth have been maltreated when the family’s problems can be addressed effectively. (3) To address the problems of families whose youth have been placed in foster care so that reunification may occur in a safe and stable manner in accordance with the Adoption and Safe Families Act of 1997. Additionally, the FFPSA supports evidenced based practices and had the practices reviewed by the “title IV-E Prevention Services Clearinghouse” and sets guidelines for reports and documentation relating to the services.

The overarching goal was to keep youth’s safely with their family and avoid the traumatic experience of entering foster care. The idea was that that too many youths were being unnecessarily removed from their home of origin, when the parents could do best if they could access mental health treatment, substance use treatment, and improved parenting skills. The government signed the FFPSA with the goal of supporting prevention services, providing support to kinship caregivers (family and friends), establish requirements for placement in residential programs, and improve services for older youth who have aged out of the child welfare system.

The government sought to avoid the experience of entering foster care by surrounding the family with resources and services prior to the removal of youth. The government aimed to do this by funneling funds for the grant through title VI-E where several portions directly speak to funding services for parents. The Title VI-E are optional and available to parents and families for up to 12 months, however there are not restrictions on the number of times that families utilize these services (Family First Prevention Services Act Summary 2018).

 In summary, the goal of this legislation was to support families by increasing access to helpful services, to move away from utilizing congregate care placements and toward utilizing kinship care, as well as supporting children who have aged out of the system. In Pennsylvania, two parts of the FFPSA have the most impact on child welfare and prevention services which include “the optional Title IV-E Prevention Program (implemented on October 1, 2021) and the required limitation on Title IV-E foster care maintenance payments for placements that are not foster family homes (imposed on October 1, 2021)” (Family First Home n.d.). Pennsylvania believes that prevention services “strengthen family units, increase protective capacities of parents/caregivers, encourage family engagement and empowerment, increase kinship and community support, and provide community resources to avoid initial or future child welfare involvement” (Family First Home n.d.). Pennsylvania exercises their belief in prevention services by offering a list of Evidenced-Based programs in the areas of mental health, substance abuse, and in-home parenting skills. Regarding the foster care maintenance payments for placement in title IV-E, the Pennsylvania Department of Human Services (DHS) aims to utilize family and kinship before considering congregate care where appropriate. Additionally, DHS has implemented a Kinship Navigator program. The kinship navigator role, through Pa KinConnector, is a service that provides information and support to family and kin who take on traditional parenting roles when youth are removed from their home.

Risk factors in out-of-home placement for youth who have encountered the child welfare system differ by family and circumstance. The University of Pittsburgh conducted a training in March of 2017 that outlines a list of factors, including child vulnerability, severity/frequency and/or recentness of abuse and neglect, prior abuse/ neglect, extent of emotional harm, Caregiver age, physical, intellectual or emotional status, parental cooperation, parenting skills/ knowledge, alcohol/substance abuse, access to children, prior abuse/neglect, relationship with children, family violence, conditions of the home, family supports, and stressors (University of Pittsburgh: Pennsylvania Child Welfare Resource Center, 2017). Several of these risk factors are alluded to by the National Foster Care Yough & Alumni Policy Council, in their work group statement, where they sought to remedy these risk factors through preventative service intervention including priority calls for “priority 1: Substance misuse and mental helath crisis are tearing our families apart- treatment with the urgency and resources that they require,  and Priority 2: connect our families to services, even after we have been reunified with our family” (The National Foster Care Youth & Alumni Policy Council, 2019).

Protective factors are defined, by the Children’s Bureau Child Welfare Information Gateway (2015) as “conditions or attributes of individuals, families, communities, or the larger society that, when present, promote well-being and reduce the risk for negative outcomes.” The brief continues to describe protective factors as “buffers” to risk factors that “negotiate difficult circumstances.” Essentially protective factors are aspects of the family that can lessen the effects of risk factors that youth are exposed to and should be promoted and enhanced when instituting services to prevent removal of youths. Protective factors can be present for both parents and for the children. In research conducted by Summersett et al. (2019) where the connection between juvenile justice involvement and protective factors found that “youth with a higher number of protective factors and caregiver parenting skills at baseline were less likely to have future involvement with the justice system compared to youth with a lower number of protective factors and caregiver parenting skills.” The findings from this article can be generalized into involvement with other health and human service systems as outlined by Abram et. al (2004) where identified risk factors correlated to systems involvement like the findings in Summersett et. al.

Resiliency is defined as the ability to “bounce back” by the Child Welfare Gateway in a brief regarding building resilience (Child Welfare Information Gateway, 2017).  Resilience was seen in this brief as a skill that can be learned and would be utilized in recovering from “traumatic losses to everyday disappointments.” In another article by Luthar and Cicchetti (2000) they defined resilience as “a dynamic process wherein individuals display positive adaptation despite experiences of significant adversity or trauma.” Both definitions describe that a client has already been exposed to a traumatic event, however the skills and ability to cope following that experience gives the client a better opportunity to buffer the long-term effects of trauma. In the research article by Anctil (2007) it was found that “Perhaps the most promising finding was the limited impact of risk factors including physical, sexual and emotional abuse, neglect and intensity of placement change experience on psychological adaptation.” The research was a significant review of people who were previously in foster care and their ability to manage physical and psychiatric impairments.

As previously mentioned, Pennsylvania Department of Human Services implemented a list of evidenced based practices to achieve the goals set forth in the First Family act legislation. One of the programs that was implemented was Family Functional Therapy (FFT). Family Functional Therapy LLC. describes FFT as “an evidence-based intervention for youth and families. This high-quality, strength-focused family counseling model is designed primarily for at-risk youth who have been referred by the juvenile justice, mental health, school, or child welfare systems” (Functional Family Therapy LLC.). Functional Family Therapy LLC. Further clarifies that FFT is a short-term therapy that can be conducted at home, in clinics, in schools, or in facilities involved with child welfare, mental health, or probation and parole. The following writing will focus on FFT in the function of juvenile probation and parole.

Functional Family therapy for probation and parole focuses on delinquent and/or youth at risk of engaging the juvenile probation system, between ages 11-18 and works to engage the youth, their family, and their support network to address multidimensional and complex problems (CrimeSolutions, National Institute of justice. n.d.). FFT is claimed to have structured flexibility and be culturally sensitive, allowing it to be utilized and more encompassing in how it addresses multiple facets of a youths experiences. When adhered strictly by Sextons model of FFT, Significant reduction of 35% in felony recidivism, 30% in violent crime recidivism, and 21% in misdemeanor recidivism (Sexton. 2010)

Functional Family Therapy for probation and parole can be utilized by many stakeholders, including Probation officers, Probation Counselors, Juvenile Justice Community Staff (CrimeSolutions, National Institute of justice. n.d.). FFT is to be administered for 8-12 one-hour sessions for cases seen as mild risks, but can be increased up to 30 sessions for more difficult situations. Clinical theory, empirically supported principles, and clinical experience are the three integrated elements that contribute into this comprehensive model, and the training for clinicians focuses on each of these areas individually. The FFT model is administered in five phases when working with clients and their families: engagement, motivation, relational assessment, behavior change, and generalization. Additionally, functional family therapy is not utilized as a crisis management service. To address crisis, FFT would adjust their session length, frequency, and number of sessions (Project Bravo: DMAS, 2021).

In the Virginia Manual for the FFT training, the steps are explained as follows: First phase, (engagement) the goal is to enhance the youth’s perception of the FFT professional and to cultivate an environment of credibility and professional responsiveness (Project Bravo: DMAS, 2021). This goal is achieved through high clinician availability, and therapeutic interventions with as many family members as possible. The focus in the first phase is on immediate responsiveness to a family’s needs and maintaining a strengthen based relational focus.

In phase two (motivation), the goal is to decrease family conflict, blame, and hostility while also increasing home and building alliances within the family. The activities in phase 2 include interrupting negative interaction patterns, reframing themes of family interactions, and changing meaning of the family interactions through a “strength based relational focus” (Project Bravo: DMAS, 2021). The focus in phase 2 is on “changing the meaning of family relationships,” through non-judgmental approaches and “conveying acceptance” (Project Bravo: DMAS, 2021).

In phase three (relational assessment) the goal is to identify the family’s pattern of interaction and understand “positive interpersonal benefits for individual family members” (Project Bravo: DMAS, 2021). This is done through “observations, questioning, inferences regarding the function of negative behaviors, switching from an individual problem focus to a relational focus” (Project Bravo: DMAS, 2021). In this phase the clinician is looking to gather information and assess the family dynamics.

In phase four (behavior change), the goal is to reduce problems that lead to referral by improving the functioning of the family and improving the individual’s skill development. This is achieved by engaging in coaching, feedback, and modeling of tasks and skills for the family. The family would be given homework in this phase of tasks and skills to work on. In this phase, the clinician seeks to improve communication and teach new skills in the pursuit of positive interactions.

In phase five (generalization), the goal is to utilize the skills learned through FFT and utilize them in new skills or challenges that the family encounters. This is achieved by the family utilizing services or supports in the community to address concerns in pursuing independence from the FFT clinician. The clinician’s task is a move toward case management, where the goal is to support the family in engaging with community resources to address concerns following the closure of services. At this stage, the family would been seen as reaching autonomy and obtaining skills to address their concerns without the probation and parole system intervention.

As previously stated, the functional family therapy is a program that can be utilized in the child welfare system or child welfare systems. Both the child welfare system and the juvenile justice system intervein in family structures to address issues on a short-term basis, and both have the power to remove children, possibly leading to the disruption of the family system but compelling reliance on these systems to address family and behavioral issues. The FFT program is one that is utilized by these systems to divert the families from requiring ongoing support from this governmental system intervention. Additionally, when considering systems such as schools, the goal would be to support families outside of the time that youth are in schools by connecting them with community supports that can be long-term supports.

Currently Functional Family therapy is being implemented by the child welfare system in Allegheny County, however there is no indication that formal FFT is being utilized by the Fifth judicial court juvenile probation. Juvenile probation’s Community Intervention Supervision Program (CISP) does utilize many of the skills that are outlined in the FFT manual, however FFT is not formally followed. The goal of the CISP program is to work with both the youth and the family in addressing skills for juveniles who are struggling on probation, by increasing regular contact with juvenile probation staff, whose goal is to build skills and work with families to address concerns, with hopes that the family will learn how to address their concerns without juvenile probation intervention being necessary. I believe that the Fifth judicial district would benefit by implementing the formalized structure of FFT into the work that is already being done at the CISP, to strengthen the family to address their issues. In schools, FFT would be beneficial for youth who would be seen as at-risk, and/or families who continue to disclose that they are having trouble managing behaviors. By utilizing the FFT program with these families, the goal would be to support the family and youth outside of the time that the youth is in school. By supporting the family in changing patterns, behaviors, and connection with community resources, schools would increase the likelihood of the youth reducing adverse behaviors (Functional Family Therapy LLC. n.d.).

In reviewing the Family First legislation, I believe that there are some expansions that should be made to benefit the families and pursue prevention further. First, I believe that the act needs to change the phrase “foster care candidates” in regard to identifying youths who’s families would be candidates for funding through the legislation. By utilizing this language, this would identify the family as those who may be subject to a child welfare investigation, by which a mandated reporter would likely identify a need to contact the agency (as they are instructed to do, by law) instead of instituting one of the evidence-based practices. This also speaks to a barrier that is currently present regarding mandated reporter laws, which is in conflict with the idea of prevention set forth in the Family First act.

A second change that should be made to the Family First act is to relax the standards of evidence-based practice programs that are accepted by the clearinghouse. Currently, in PA, there are 11 different evidence-based practices that are being utilized, however several of them are the same program, instituted for different populations or age ranges. There are nine different programs totality and only one program to address substance use (albeit as a co-occurring treatment). An asserted effort to specify funding for substance abuse treatment as a priority.

Lastly, I would look to add prevention services as a differential response that child welfare agencies were obligated to adopt at the call screening level and juvenile probation and parole were obligated to consider at the intake level. For child welfare, it should be adopted that if a family calls the agency seeking assistance with obtaining resources or that the concern would be deemed a low-level risk, non-violent risk, prevention services were to be offered. This would encompass non-violent parent- child conflict, runaway concerns, truancy issues, substance use issues with youth above the age of 13, and mental health concerns without concerns of suicidal or homicidal ideation. In juvenile probation, misdemeanor charges including compulsory attendance, petty theft, and non-violent crimes involving family or kin, and non-violent first-time offender charges, should be considered for prevention services. It should be noted that in the fifth judicial district, juvenile probation does offer some prevention services including Victim-Offender dialogue, that could be a procedure that the Family First act could implement to prevent youths from penetrating the system completely.  

In conclusion, this paper discussed the Family Functional Therapy program set forth by the Family First act legislation. I outlined my understanding of the Family First act legislation, outline what the legislation was seeking to address, discussed risk/ protective factors/ resilience of youth and families, outlined Functional Family Therapy in probation and parole, and gave suggestions on expansion of the Family First act legislation and Functional Family therapy.

References

Abram, K. M., Teplin, L. A., Charles, D. R., Longworth, S. L., McClelland, G. M., & Dulcan, M. K. (2004). Posttraumatic stress disorder and trauma in youth in juvenile detention. Archives of general psychiatry, 61(4), 403-410.

 Anctil. (2007). An evaluation of recovery factors for foster care alumni with physical or psychiatric impairments: predictors of psychological outcomes. Children and Youth Services Review., 29(8), 1021–1034.

Building resilience in children and Teens - Child Welfare. Child Welfare Information Gateway. (2017, January 13). Retrieved March 18, 2023, from https://www.childwelfare.gov/pubPDFs/resilience_ts.pdf

Brief family first prevention services act. National Conference of State Legislatures. (n.d.). Retrieved February 9, 2023, from https://www.ncsl.org/human-services/family-first-prevention-services-act

Family First Home. Department of Human Services. (n.d.). Retrieved March 18, 2023, from https://www.dhs.pa.gov/KeepKidsSafe/FamilyFirst/Pages/default.aspx

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Functional Family Therapy LLC. (n.d.). Functional Family Therapy: Evidence Based Therapy for Youth and Families. FFTLLC. Retrieved March 18, 2023, from https://www.fftllc.com/

A Historic Opportunity to Reform the Child Welfare System: Youth & Alumni Priorities on Preventing Unnecessary Removal of Children from their Families. The National Foster Care Youth & Alumni Policy Council. (2019, October). Retrieved March 18, 2023, from https://www.nationalpolicycouncil.org/sites/default/files/docs/blogs/Prevention_2019%20Council%20Workgroup%20Statement_Final%209.28.19.pdf

Luthar and Cicchetti, 2000S.S. Luthar, D. Cicchetti. The construct of resilience: Implications for interventions and social policies. Development and Psychopathology, 12 (2000), pp. 857-885

Project Bravo: DMAS. (2021, October). Multisystemic Therapy and Functional Family Therapy Provider Manual Training. Provider Manuals Library | MES. Retrieved March 19, 2023, from https://vamedicaid.dmas.virginia.gov/manuals/provider-manuals-library

Sexton T, Turner CW. The effectiveness of functional family therapy for youth with behavioral problems in a community practice setting. J Fam Psychol. 2010 Jun;24(3):339-48. doi: 10.1037/a0019406. PMID: 20545407; PMCID: PMC4172308.

Summersett, F. C., Jordan, N., Griffin, G., Kisiel, C., Goldenthal, H., & Martinovich, Z. (2019). An examination of youth protective factors and caregiver parenting skills at entry into the child welfare system and their association with Justice System Involvement. Children and Youth Services Review, 99, 23–35. https://doi.org/10.1016/j.childyouth.2019.01.001

University of Pittsburgh: Pennsylvania Child Welfare Resource Center. (2017, March). Curriculum materials. Curriculum Materials. Retrieved March 18, 2023, from https://www.pacwrc.pitt.edu/Curriculum/