MDFT – Multidimensional Family Therapy

Summary

Phenomena

Behavioural and substance abuse problems

Introduction

Behavioural and substance abuse problems during adolescence are a significant burden on the young person, their loved ones and society at large. Multidimensional family therapy (MDFT) is a family- and system-oriented working method for social and healthcare workers who support young people experiencing wide-ranging and diverse challenges. The goal of MDFT is to reduce the adolescent’s behavioural and substance abuse problems and to support interaction between the adolescent and their parents.

Research question

Is the MDFT method effective on the wide-ranging and diverse behavioural and substance abuse problems of young people aged 12–18in a Finnish context?

Data and methods

This study used the Population, Concept, Context (PCC) strategy to search for literature, which is a typical strategy in exploratory literature reviews. The search targeted the following question: What research has been carried out on the multidimensional family therapy method?  The keywords used were: P = children and adolescents aged 12–18, C = Multidimensional Family Therapy (MDFT), C = Child welfare, outpatient care in specialised health care, other. The primary areas of interest in the search were the effectiveness studies carried out on the method, although studies with different frameworks were also included. A systematic search was carried out for the following six databases: MEDLINE, APA PsycInfo, CINAHL, ERIC, Web of Science and Scopus.

Results

Based on themethod guide, the MDFT method has a sufficient description and theoretical basis. Based on the literature search, one systematic review, three meta-analyses and nine original studies were selected. The studies were conducted in the United States and Central Europe. No Finnish or Nordic implementation studies were found. The effectiveness of the method has not been compared to non-treatment (people in queue), but in randomised effectiveness studies, MDFT has been compared to active interventions, such as enhanced standard services, cognitive behavioural therapy, individual and group therapy, long-term institutional care and motivational enhancement therapy. In these comparisons, the effects on 12–18-year-old adolescents ranged from small to large in response variables (d = 0.24–1.23, NNT [Number-Needed-to-Treat ] = 1.62–7.46 ). Regarding response variables related to substance abuse and behavioural disorders, MDFT is equal to other comparative methods, or in some respects, more effective. The quality of the studies included in the meta-analyses was moderate at most, and the quality of the studies evaluated for the review ranged from poor to good. There is sufficient support for implementing the MDFT method.

Method assessment

MDFT’s method assessment is 5/5, which means that there is strong effectiveness research on the method in a US and European context, but no data is available for the Nordic countries and Finland. There is evidence to support that MDFT is effective compared to active methods when treating adolescents aged 12–18 who have substance abuse or behavioural problems. The method assessment is based on the criteria of the Kasvun tuki (Early Interventions) assessment system.