esark, why would you cite a paper that can't be read without an Editor/Society/Insitution Subscription? Post the entire paper if you have a membership. Why do you have a membership to Sage?
I've been reading up on Alexander and his Functional Family Therapy (FFT) approach. I can't find any reference to him being in support of residential treatment. In fact, it's the antithesis of what he recommends- Family Therapy.
My take on what he said is,
IFa kid happens to benefit from a residential placement with highly qualified professionals, s/he will not be successful at home because the parents were not included.
Everything I read about this guy supports intense family therapy, 12-30 sessions with one of his specially trained therapist. I can?t find one instance in which he endorses residential treatment.
Teaches Psych at University of Utah
http://www.psych.utah.edu/classes/Dr. James Alexander, University of Utah, received the American Psychological Association Division 43 Distinguished Contribution to Family Psychology Award on July 29, 2004.
http://www.nida.nih.gov/DirReports/DirR ... ort20.htmlFaculty. Dr. James Alexander (Ph.D., 1967, Michigan State University) is the course instructor and will also lecture on abnormal and clinical psychology.
His intervention model, Functional Family Therapy, has been chosen by the CDC, US Surgeon?s General, National Institute of Justice as one of the few empirically validated interventions for disruptive behavior disorders in adolescents. http://www.psych.utah.edu/classes/2006_ ... llabus.pdfAnd what does the US Surgeon General say about Boot Camps and Residential Treatment?Compared to traditional forms of incarceration, boot camps produced no significant effects on recidivism in three out of four evaluations and trends toward increased recidivism in two. The fourth evaluation showed significant harmful effects on youths, with a significant increase in recidivism.
While some residential programs appear to have positive effects on youths as long as they remain in the institutional setting, research demonstrates consistently that these effects diminish once young people leave.
http://www.surgeongeneral.gov/library/y ... veTertiaryFrom the US Dept of Justice re: FFTFrom 1973 to the present, published data have reflected the positive outcomes of FFT. Data show, for instance, that
when compared with standard juvenile probation services, residential treatment, and alternative therapeutic approaches, FFT is highly successful. Both randomized trials and nonrandomized comparison group studies (Alexander et al., 2000) show that FFT significantly reduces recidivism for a wide range of juvenile offense patterns. In addition, studies have found that FFT dramatically reduces the cost of treatment. A recent Washington State study, for example, shows savings of up to $14,000 per family (Aos, Barnoski, and Lieb, 1998). FFT also significantly reduces potential new offending for siblings of treated adolescents (Klein, Alexander, and Parsons, 1977). Figures 1 (randomized clinical trials) and 2 (comparison studies) summarize the outcome findings of FFT studies conducted during the past 30 years. These studies show that when compared with no treatment, other family therapy interventions, and traditional juvenile court services (e.g., probation), FFT can reduce adolescent rearrests by 20?60 percent.
http://www.ncjrs.gov/pdffiles1/ojjdp/184743.pdfIn December of 2000, Office of Juvenile Justice of Delinquency Prevention issued a Juvenile Justice Bulletin on FFT by the founders of FFT (Sexton & Alexander, 2000). The OJJDP Bulletin cited
recidivism rates for the FFT treated population at just over 20% while the residential treatment cases had a recidivism rate of approximately 90%. These figures are not inconsistent with the New York State experience where estimates of recidivism after placement in a juvenile justice facility approach or exceed 90% while some intensive aftercare models have succeeded in reducing recidivism rates to approximately 20%.
What is FFT? ? Empirically grounded, well-documented and highly successful family intervention program for dysfunctional youth
? Applied to a wide range of at-risk youth aged 11-18 and their families, including youth with problems such as conduct disorder, violent acting-out, and substance abuse
? Intervention ranges from, on average, 8 to 12 one-hour sessions up to 30 sessions of direct service for more difficult situations
? Conducted both in clinic settings as an outpatient therapy and as a home-based model
? A treatment technique that is appealing because of its clear identification of specific phases, which organize intervention in a coherent manner, thereby allowing clinicians to maintain focus in the context of considerable family and individual disruption
? Each phase includes specific goals, assessment foci, specific techniques of intervention, and therapist skills necessary for success.
Who benefits from FFT? Youth ages 10-18, and their families, whose problems range from acting out to conduct disorder to alcohol/substance abuse. Often these families tend to have limited resources, histories of failure, a range of diagnoses and exposure to multiple systems. FFT can be provided in a variety of contexts, including schools, child welfare, probation, parole/aftercare, mental health, and as an alternative to incarceration or out-of-home placement.
http://www.fftinc.com/whatis.phphttp://www.hspeople.com/includes/hspeop ... 050701.cfmIn a recent article regarding FFT in King County Washington, parents noted that FFT worked for their children because of
"the emphasis on working with the youth as part of the family (Loughran, 2002). The therapist focused on real, every day solutions to dealing with missed curfews, truancy and drug use. Families learned not to blame the youth or the parents but to talk about differences and talk about attainable goals as a group. A therapist usually meets with families in their homes, at their convenience, and provides continued support after the formal sessions have concluded". It is important that young people are seen as part of the family in this therapy model. In addition, FFT should be accessible to all and according to need. FFT should promote communication between the parents and the young person. The focus of this model needs to be on the total family, not just the young person's issues. Additionally, FFT should consider working with interventions that have made a positive difference in the family.http://www.omh.state.ny.us/omhweb/ebp/children_fft.htmIn general, treatment programs must integrate cognitive, affective and social interventions. They must also be community-based with a strong case advocacy component. Programs should also provide opportunities for the child?s involvement and should demonstrate respect for the youth.8 In view of the fact that "most violent behavior is learned behavior",5 there is a great potential for successful intervention. The Center for the Study and Prevention of Violence has reviewed over 450 delinquency, drug and violence prevention programs and has identified ten programs that meet a high standard (see references for the list).12 The duration of treatment was typically two to five years.
The average cost for a stay in the Department of Corrections is $40,000.00 per year,9 while residential treatment programs cost between $20,000 and $40,000 per youth per year, and mentoring and visitation programs cost $1,000 and $7,000 per year respectively. Four of the ten model programs saved more money than they cost in a three-year period. "Our most effective prevention programs achieve a thirty to forty percent reduction in onset or offending rates compared to control groups or average rates."12 12. Elliott, Delbert S. Prevention Programs that Work for Youth: Violence Prevention. Center for the Study and Prevention of Violence, 1998. (The Nurse Home Visitation Program-Dr. David Olds, The Bullying Prevention Program-Dr. Dan Olweus, Promoting Alternative Thinking Strategies (PATHS)-Dr. Mark Greenburg, Big Brothers Big sisters Mentoring Program-Ms. Dagmar McGill, Life Skills Training-Dr. Gil Botvin, Midwestern Prevention Project-Dr. Mary Ann Pentz, Quantum Opportunities-Mr. Ben Lattimore, Multisystemic Therapy (MST)-Dr. Scott Henggeler, Functional Family Therapy (FFT)-Dr. James Alexander, Multidimensional Treatment Foster Care-Dr. Patricia Chamberlain
http://www.emory.edu/AAPL/newsletter/N232juv-viol.htmDr. James Alexander of the Department of Psychology at the University of Utah developed a research-based intervention called Functional Family Therapy for use with delinquent youth (Alexander and Parsons, 1982). Alexander's family therapy research worked closely with the courts and randomly assigned first-time court offenders to his approach and contrasted it with several other approaches.
His family therapy interventions with families of delinquent youth involved changing how the families interacted with one another (e.g., using communication training, including problem solving, listening, and taking turns speaking). When Alexander and Parsons did 3-year followups with court data, they found that the recidivism rates of the family therapy youth were half those of youth who received the routine array of available services (Alexander and Parsons, 1982). In addition, after the intervention, the siblings of the delinquents in the study's treatment group were also followed; they were half as likely as siblings of control group youth to get involved in the court system as delinquents. Some findings of Alexander's study are integrated into FAST family communication activities.
http://www.ncjrs.gov/html/ojjdp/9911_2/fam6.htmlDetails on FAST, based on FFThttp://www.ncjrs.gov/pdffiles1/ojjdp/173423.pdfSexton and Alexander?s work with functional family therapy
(so called because it focuses its interventions on family relationships that influence and are influenced by, and thus are functions of, positive and negative behaviors) for youth offenders found that family therapy nearly halved the rate of re-offending?19.8 percent in the treatment group compared to 36 percent in a control group. The cost of the family therapy ranged from $700 to $1,000 per family for the 2-year study period. The average cost of detention for that period was at least $6,000 per youth; the cost of a residential treatment program was at least $13,500. In this instance, the cost benefits of family therapy were clear and compelling.
An adolescent who is primarily smoking marijuana, for instance, is a good candidate for family systems work. On the other hand, if a youth is mixing cocaine, amphetamines, alcohol, and other drugs, the client is likely to need more extensive services detoxification, residential treatment, or intensive outpatient therapy which can be used in addition to family therapy (Liddle and Hogue 2001).
http://www.guideline.gov/summary/summar ... 6&nbr=3872