Multidimensional Family Therapy

Mental Health Substance Use Prevention or Treatment In-home Parent Skill-Based Supported

Multidimensional Family Therapy (MDFT) focuses on addressing the needs of adolescents and young adults with substance use, delinquency, mental health, and emotional problems. MDFT is an integrated therapy model that incorporates and supports parents, families, and community partners (e.g., child welfare, schools). MDFT seeks to enhance coping, problem solving, and communication skills; stabilize mental health issues; reduce youth substance use; and improve school achievement among adolescents and young adults.  MDFT aims to improve parenting skills, parents’ functioning, family communication, attachment, and stress-relieving strategies.


MDFT is rated as a supported practice because at least one study carried out in a usual care or practice setting achieved a rating of moderate or high on design and execution and demonstrated a sustained favorable effect of at least 6 months beyond the end of treatment on at least one target outcome.


Date Research Evidence Last Reviewed: Aug 2020


Sources

The program or service description, target population, and program or service delivery and implementation information was informed by the following sources: the program website, the California Evidence-Based Clearinghouse for Child Welfare, the program manual, and the studies reviewed.


This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the Review Process page or download the Handbook.

Target Population

MDFT serves adolescents and young adults (9 to 26 years old) with substance use, delinquency, mental health and emotional problems. At least one parent/guardian or parental figure must also participate in treatment.

Dosage

MDFT intensity varies based on the setting and severity of participants’ needs. The recommended dosage ranges from 1 to 3 weekly sessions over 3 to 6 months. Each session lasts approximately 45 to 90 minutes. Additional check-ins are provided during this time via text and phone. Session length and frequency is designed to decrease over time with the goal of reducing to one session per week for the last four to six weeks of treatment. Sessions are divided roughly proportionally among those held with the adolescent/young adult, parents, and families. Additionally, community sessions are held with schools and representatives of other key partners and systems (e.g., child welfare, juvenile delinquency).

Location/Delivery Setting
Recommended Locations/Delivery Settings

MDFT can be delivered in various settings including clinical offices, in-home, community settings, outpatient, intensive outpatient, inpatient and residential facilities, schools, and in non-clinical residential settings, such as boarding schools or jails.

Location/Delivery Settings Observed in the Research

  • Home
  • Mental Health Center, Treatment Center, Therapist Office

Education, Certifications and Training

MDFT is delivered by therapists with Master’s degrees in social work, counseling, marriage and family therapy, or related clinical fields. MDFT therapists may receive additional support from therapist assistants with Bachelor’s degrees. To deliver services, therapists must complete approximately 5 months of MDFT-specific training. This training includes three 3-day on-site trainings, weekly consultations, online education, video reviews of the therapist’s work, ratings and written tests. At the end of this training, therapists are eligible to receive an MDFT certification. Supervisor training lasts an additional 4 to 6 months. Therapists and supervisors must re-certify annually. MDFT training is delivered virtually over the phone, or in-person.

 

A basic introduction to MDFT is available through 2-day introductory workshops. Additional training is required to achieve MDFT certification. As part of this certification training, therapist teams engage in an onsite introduction (2.5 to 3 days), written assessments, onsite intensive reviews, and weekly consultation calls for 12 to 15 weeks. Additional steps are required for supervisor certification. All clinicians must recertify annually. There is also an MDFT Train-the-Trainer (TTT) model that includes intensive workshops, live and video review of training, and consultation calls.

Program or Service Documentation
Book/Manual/Available documentation used for review

Liddle, H. A. (2007). Multidimensional Family Therapy: Therapist's treatment manual. Center for Treatment Research on Adolescent Drug Abuse, University of Miami.

Available languages

MDFT materials are available in English, French, German, and Spanish.

Other supporting materials

Online Training Video: Multidimensional Family Therapy: A Research-Proven, Innovative Treatment for Adolescent Substance Abuse

DVD: Multidimensional Family Therapy

MDFT Fact Sheets

Contact Information for Developers

Website: www.mdft.org

Phone: (305) 749-9332

Email: gdakof@mdft.org

Results of Search and Review Number of Studies Identified and Reviewed for Multidimensional Family Therapy
Identified in Search 8
Eligible for Review 2
Rated High 2
Rated Moderate 0
Rated Low 0
Reviewed Only for Risk of Harm 0
Outcome Effect Size
and Implied Percentile Effect
N of Studies (Findings) N of Participants Summary of Findings
Child well-being: Behavioral and emotional functioning 0.17
6
2 (15) 465 Favorable: 6
No Effect: 9
Unfavorable: 0
Child well-being: Social functioning 0.44
17
1 (4) 83 Favorable: 3
No Effect: 1
Unfavorable: 0
Child well-being: Substance use 0.52
19
1 (16) 83 Favorable: 8
No Effect: 8
Unfavorable: 0
Child well-being: Delinquent behavior 0.13
5
2 (25) 306 Favorable: 3
No Effect: 21
Unfavorable: 1
Child well-being: Educational achievement and attainment 0.51
19
1 (4) 83 Favorable: 3
No Effect: 1
Unfavorable: 0
Adult well-being: Positive parenting practices 0.00
0
1 (12) 83 Favorable: 3
No Effect: 7
Unfavorable: 2
Adult well-being: Family functioning 0.00
0
2 (9) 440 Favorable: 1
No Effect: 8
Unfavorable: 0

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes for some outcomes were not able to be calculated by the Prevention Services Clearinghouse.

Outcome Effect Size
and Implied Percentile Effect
N of Studies (Findings) N of Participants Summary of Findings Months after treatment
when outcome measured
Child well-being: Behavioral and emotional functioning 0.17
6
2 (15) 465 Favorable: 6
No Effect: 9
Unfavorable: 0
-
Liddle, 2004
Youth Self Report: Externalizing Problems (6 week interim) 0.44
16
- 83 - 0
Youth Self Report: Externalizing Problems (end of treatment) 0.64 *
23
- 83 - 0
Youth Self Report: Internalizing Problems (6 week interim) 0.41
15
- 83 - 0
Youth Self Report: Internalizing Problems (end of treatment) 0.43
16
- 83 - 0
Liddle, 2009
Global Appraisal of Individual Needs: Internalized Distress 0.89 *
31
- 83 - 2
Global Appraisal of Individual Needs: Internalized Distress 0.53 *
20
- 83 - 8
Conduct Grades (Academic Period 1) 0.51 *
19
- 83 - 0
Conduct Grades (Academic Period 2) 0.22
8
- 83 - 0
Conduct Grades (Academic Period 3) 0.65 *
24
- 83 - 3
Conduct Grades (Academic Period 4) 0.57 *
21
- 83 - 5
Schaub, 2014
Youth Self Report: Internalizing Problems 0.08
3
- 346 - 0
Youth Self Report: Internalizing Problems 0.08
3
- 382 - 6
Child Behavior Checklist: Internalizing Problems 0.04
1
- 341 - 0
Child Behavior Checklist: Internalizing Problems 0.04
1
- 363 - 6
Child Behavior Checklist: Externalizing Problems 0.20
7
- 341 - 0
Child well-being: Social functioning 0.44
17
1 (4) 83 Favorable: 3
No Effect: 1
Unfavorable: 0
-
Liddle, 2009
National Youth Survey: Peer Delinquency Scale (6-week post-baseline) -0.10
-4
- 83 - 0
National Youth Survey: Peer Delinquency Scale (end of treatment) 0.79 *
28
- 83 - 0
National Youth Survey: Peer Delinquency Scale (6-month post-baseline) 0.62 *
23
- 83 - 2
National Youth Survey: Peer Delinquency Scale (12-month post-baseline) 0.48 *
18
- 83 - 8
Child well-being: Substance use 0.52
19
1 (16) 83 Favorable: 8
No Effect: 8
Unfavorable: 0
-
Liddle, 2009
Problem Oriented Screening Instrument for Teenagers: Substance Use Problems (6-week post-baseline) 0.51 *
19
- 83 - 0
Problem Oriented Screening Instrument for Teenagers: Substance Use Problems (end of treatment) 0.47 *
18
- 83 - 0
Problem Oriented Screening Instrument for Teenagers: Substance Use Problems (6-month post-baseline) 0.66 *
24
- 83 - 2
Problem Oriented Screening Instrument for Teenagers: Substance Use Problems (12-month post-baseline) 0.59 *
22
- 83 - 8
Problem Oriented Screening Instrument for Teenagers: % w/ SU Problems (6-week post-baseline) 0.93 *
32
- 83 - 0
Problem Oriented Screening Instrument for Teenagers: % w/ SU Problems (end of treatment) 0.45
17
- 83 - 0
Problem Oriented Screening Instrument for Teenagers: % w/ SU Problems (6-month post-baseline) 0.87 *
30
- 83 - 2
Problem Oriented Screening Instrument for Teenagers: % w/ SU Problems (12-month post-baseline) Null
not calculated
- 83 - 8
Timeline Follow-Back Method: 30 Day Substance Use Frequency (6-week post-baseline) 0.25
9
- 83 - 0
Timeline Follow-Back Method: 30 Day Substance Use Frequency (end of treatment) 0.48 *
18
- 83 - 0
Timeline Follow-Back Method: 30 Day Substance Use Frequency (6-month post-baseline) 0.40
15
- 83 - 2
Timeline Follow-Back Method: 30 Day Substance Use Frequency (12-month post-baseline) 0.66 *
24
- 83 - 8
Timeline Follow-Back Method: Percent with Any Use in 30 Days (6-week post-baseline) 0.28
11
- 83 - 0
Timeline Follow-Back Method: Percent with Any Use in 30 Days (end of treatment) 0.61
22
- 83 - 0
Timeline Follow-Back Method: Percent with Any Use in 30 Days (6-month post-baseline) 0.55
20
- 83 - 2
Timeline Follow-Back Method: Percent with Any Use in 30 Days (12-month post-baseline) 0.55
20
- 83 - 8
Child well-being: Delinquent behavior 0.13
5
2 (25) 306 Favorable: 3
No Effect: 21
Unfavorable: 1
-
Liddle, 2009
National Youth Survey: Self-Report Delinquency Scale (% w/ Any Delinquency; 6-week post-baseline) 0.82 *
29
- 81 - 0
National Youth Survey: Self-Report Delinquency Scale (% w/ Any Delinquency; end of treatment) 0.54
20
- 81 - 0
National Youth Survey: Self-Report Delinquency Scale (% w/ Any Delinquency; 6-month post-baseline) -0.01
0
- 83 - 2
National Youth Survey: Self-Report Delinquency Scale (% w/ Any Delinquency; 12-month post-baseline) 0.23
9
- 83 - 8
National Youth Survey: Self-Report Delinquency Scale (6-week post-baseline) 0.36
14
- 83 - 0
National Youth Survey: Self-Report Delinquency Scale (end of treatment) 0.46 *
17
- 83 - 0
National Youth Survey: Self-Report Delinquency Scale (6-month post-baseline) 0.20
7
- 83 - 2
National Youth Survey: Self-Report Delinquency Scale (12-month post-baseline) 0.25
9
- 83 - 8
van der Pol, 2018a
Self Report Delinquency Scale: Number of Criminal Offenses in the Past 90 Days -0.05
-2
- 104 - 0
Self Report Delinquency Scale: Number of Criminal Offenses in the Past 90 Days 0.22
8
- 114 - 6
Self Report Delinquency Scale: Number of Property Crimes in the Past 90 Days -0.17
-6
- 77 - 0
Self Report Delinquency Scale: Number of Property Crimes in the Past 90 Days 0.26
10
- 113 - 6
Self Report Delinquency Scale: Number of Violent Crimes in the Past 90 Days 0.19
7
- 73 - 0
Self Report Delinquency Scale: Number of Violent Crimes in the Past 90 Days 0.63 *
23
- 107 - 6
van der Pol, 2018b
Total Number of Police-Arrest Offenses in Past Year -0.15
-5
- 109 - 6
Total Number of Police-Arrest Offenses in Past Year 0.10
4
- 109 - 18
Total Number of Police-Arrest Offenses in Past Year -0.25
-9
- 109 - 30
Total Number of Police-Arrest Violent Offenses in Past Year -0.43 *
-16
- 109 - 6
Total Number of Police-Arrest Violent Offenses in Past Year 0.23
9
- 109 - 18
Total Number of Police-Arrest Violent Offenses in Past Year 0.23
9
- 109 - 30
Total Number of Police-Arrest Property Offenses in Past Year 0.20
7
- 109 - 6
Total Number of Police-Arrest Property Offenses in Past Year 0.13
5
- 109 - 18
Total Number of Police-Arrest Property Offenses in Past Year 0.05
2
- 109 - 30
Time to First Registered Offense Null
not calculated
- 109 - 30
Severity of Police-Arrest Offenses Null
not calculated
- 109 - 30
Child well-being: Educational achievement and attainment 0.51
19
1 (4) 83 Favorable: 3
No Effect: 1
Unfavorable: 0
-
Liddle, 2009
Academic Grades (Academic Period 1) 0.51 *
19
- 83 - 0
Academic Grades (Academic Period 2) 0.22
8
- 83 - 0
Academic Grades (Academic Period 3) 0.70 *
25
- 83 - 3
Academic Grades (Academic Period 4) 0.61 *
22
- 83 - 5
Adult well-being: Positive parenting practices 0.00
0
1 (12) 83 Favorable: 3
No Effect: 7
Unfavorable: 2
-
Henderson, 2009
Adolescent Daily Interview: Parental Monitoring (6-week post-baseline) 0.53 *
20
- 83 - 0
Adolescent Daily Interview: Parental Monitoring (end of treatment) 0.73 *
26
- 83 - 0
Adolescent Daily Interview: Parent-Child Relationship Quality (6-week post-baseline) 0.50 *
19
- 83 - 0
Adolescent Daily Interview: Parent-Child Relationship Quality (end of treatment) 0.43
16
- 83 - 0
Liddle, 2009
Adolescent Daily Interview: Positive Family Interactions (6-week post-baseline) -0.34
-13
- 83 - 0
Adolescent Daily Interview: Positive Family Interactions (end of treatment) -0.47 *
-17
- 83 - 0
Adolescent Daily Interview: Positive Family Interactions (6-month post-baseline) -0.13
-5
- 83 - 2
Adolescent Daily Interview: Positive Family Interactions (12-month post-baseline) 0.09
3
- 83 - 8
Adolescent Daily Interview: Negative Family Interactions (6-week post-baseline) 0.02
0
- 83 - 0
Adolescent Daily Interview: Negative Family Interactions (end of treatment) -0.49 *
-18
- 83 - 0
Adolescent Daily Interview: Negative Family Interactions (6-month post-baseline) -0.43
-16
- 83 - 2
Adolescent Daily Interview: Negative Family Interactions (12-month post-baseline) -0.43
-16
- 83 - 8
Adult well-being: Family functioning 0.00
0
2 (9) 440 Favorable: 1
No Effect: 8
Unfavorable: 0
-
Liddle, 2004
Family Environment Scale: Cohesion (6 week interim) 0.39
15
- 83 - 0
Family Environment Scale: Cohesion (end of treatment) 0.61 *
22
- 83 - 0
Family Environment Scale: Conflict (6 week interim) -0.22
-8
- 83 - 0
Family Environment Scale: Conflict (end of treatment) 0.12
4
- 83 - 0
Schaub, 2014
Family Environment Scale: Conflict -0.10
-3
- 345 - 0
Family Environment Scale: Conflict -0.05
-1
- 308 - 3
Family Environment Scale: Conflict -0.10
-4
- 357 - 6
Family Environment Scale: Cohesion -0.02
0
- 345 - 0
Family Environment Scale: Cohesion 0.02
0
- 357 - 6

*p <.05

Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications. Effect sizes for some outcomes were not able to be calculated by the Prevention Services Clearinghouse.

Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.

Full citations for the studies shown in the table are available in the "Studies Reviewed" section.

Sometimes study results are reported in more than one document, or a single document reports results from multiple studies. Studies are identified below by their Prevention Services Clearinghouse study identification numbers.

Studies Rated High

Study 10644

Liddle, H. A., Rowe, C. L., Dakof, G. A., Ungaro, R. A., & Henderson, C. E. (2004). Early intervention for adolescent substance abuse: Pretreatment to posttreatment outcomes of a randomized clinical trial comparing Multidimensional Family Therapy and peer group treatment. Journal of Psychoactive Drugs, 36(1), 49-63. https://doi.org/10.1080/02791072.2004.10399723

Liddle, H. A., Rowe, C. L., Dakof, G. A., Henderson, C. E., & Greenbaum, P. E. (2009). Multidimensional Family Therapy for young adolescent substance abuse: Twelve-month outcomes of a randomized controlled trial. Journal of Consulting and Clinical Psychology, 77(1), 12-25. https://doi.org/10.1037/a0014160

Henderson, C. E., Rowe, C. L., Dakof, G. A., Hawes, S. W., & Liddle, H. A. (2009). Parenting practices as mediators of treatment effects in an early-intervention trial of Multidimensional Family Therapy. The American Journal of Drug and Alcohol Abuse, 35(4), 220-226. https://doi.org/10.1080/00952990903005890

Study 10649

Rigter, H., Pelc, I., Tossmann, P., Phan, O., Grichting, E., Hendriks, V., & Rowe, C. (2010). INCANT: A transnational randomized trial of Multidimensional Family Therapy versus treatment as usual for adolescents with cannabis use disorder. BMC Psychiatry, 10. https://doi.org/10.1186/1471-244X-10-28

Rigter, H., Henderson, C. E., Pelc, I., Tossmann, P., Phan, O., Hendriks, V., Schaub, M., & Rowe, C. L. (2013). Multidimensional Family Therapy lowers the rate of cannabis dependence in adolescents: A randomised controlled trial in Western European outpatient settings. Drug and Alcohol Dependence, 130(1-3), 85-93. https://doi.org/10.1016/j.drugalcdep.2012.10.013

Schaub, M. P., Henderson, C. E., Pelc, I., Tossmann, P., Phan, O., Hendriks, V., Rowe, C., & Rigter, H. (2014). Multidimensional Family Therapy decreases the rate of externalising behavioural disorder symptoms in cannabis abusing adolescents: Outcomes of the INCANT trial. BMC Psychiatry, 14. https://doi.org/10.1186/1471-244X-14-26

Phan, O., Henderson, C. E., Angelidis, T., Weil, P., van Toorn, M., Rigter, R., Soria, C., & Rigter, H. (2011). European youth care sites serve different populations of adolescents with cannabis use disorder Baseline and referral data from the INCANT trial. BMC Psychiatry, 11. https://doi.org/10.1186/1471-244X-11-110

van der Pol, T. M., Henderson, C. E., Hendriks, V., Schaub, M. P., & Rigter, H. (2018). Multidimensional Family Therapy reduces self-reported criminality among adolescents with a cannabis use disorder. International Journal of Offender Therapy and Comparative Criminology, 62(6), 1573-1588. https://doi.org/10.1177/0306624X16687536

van der Pol, T. M., Hendriks, V., Rigter, H., Cohn, M. D., Doreleijers, T. A. H., van Domburgh, L., & Vermeiren, R. R. J. M. (2018). Multidimensional Family Therapy in adolescents with a cannabis use disorder: Long-term effects on delinquency in a randomized controlled trial. Child And Adolescent Psychiatry And Mental Health, 12, 44. https://doi.org/10.1186/s13034-018-0248-x

Lascaux, M., Ionescu, S., & Phan, O. (2016). Effectiveness of formalised therapy for adolescents with cannabis dependence: A randomised trial. Drugs: Education, Prevention & Policy, 23(5), 404-409. https://doi.org/10.3109/09687637.2016.1153603

Rowe, C., Rigter, H., Henderson, C., Gantner, A., Mos, K., Nielsen, P., & Phan, O. (2013). Implementation fidelity of Multidimensional Family Therapy in an international trial. Journal of Substance Abuse Treatment, 44, 391-399. https://doi.org/10.1016/j.jsat.2012.08.225





Studies Not Eligible for Review

Study 10636

Dakof, G. A., Henderson, C. E., Rowe, C. L., Boustani, M., Greenbaum, P. E., Wang, W., Hawes, S., Linares, C., & Liddle, H. A. (2015). A randomized clinical trial of family therapy in juvenile drug court. Journal of Family Psychology, 29(2), 232-241. https://doi.org/10.1037/fam0000053

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 10637

Dennis, M., Godley, S. H., Diamond, G., Tims, F. M., Babor, T., Donaldson, J., Liddle, H., Titus, J. C., Kaminer, Y., Webb, C., Hamilton, N., & Funk, R. (2004). The Cannabis Youth Treatment (CYT) Study: Main findings from two randomized trials. Journal of Substance Abuse Treatment, 27(3), 197-213. https://doi.org/10.1016/j.jsat.2003.09.005

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 10641

Goorden, M., van der Schee, E., Hendriks, V. M., & Hakkaart-van Roijen, L. (2016). Cost-effectiveness of multidimensional family therapy compared to cognitive behavioral therapy for adolescents with a cannabis use disorder: Data from a randomized controlled trial. Drug and Alcohol Dependence, 162, 154-161. https://doi.org/10.1016/j.drugalcdep.2016.03.004

Hendriks, V., van der Schee, E., & Blanken, P. (2011). Treatment of adolescents with a cannabis use disorder: Main findings of a randomized controlled trial comparing Multidimensional Family Therapy and cognitive behavioral therapy in The Netherlands. Drug and Alcohol Dependence, 119(1-2), 64-71. https://doi.org/10.1016/j.drugalcdep.2011.05.021

Hendriks, V., van der Schee, E., & Blanken, P. (2012). Matching adolescents with a cannabis use disorder to Multidimensional Family Therapy or cognitive behavioral therapy: Treatment effect moderators in a randomized controlled trial. Drug and Alcohol Dependence, 125(1-2), 119-126. https://doi.org/10.1016/j.drugalcdep.2012.03.023

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 10643

Liddle, H. A., Dakof, G. A., Parker, K., Diamond, G. S., Barrett, K., & Tejeda, M. (2001). Multidimensional Family Therapy for adolescent drug abuse: Results of a randomized clinical trial. The American Journal of Drug and Alcohol Abuse, 27(4), 651-688. https://doi.org/10.1081/ADA-100107661

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 10645

Henderson, C. E., Dakof, G. A., Greenbaum, P. E., & Liddle, H. A. (2010). Effectiveness of Multidimensional Family Therapy with higher severity substance-abusing adolescents: Report from two randomized controlled trials. Journal of Consulting and Clinical Psychology, 78(6), 885-897. https://doi.org/10.1037/a0020620

Liddle, H. A., Dakof, G. A., Turner, R. M., Henderson, C. E., & Greenbaum, P. E. (2008). Treating adolescent drug abuse: A randomized trial comparing Multidimensional Family Therapy and cognitive behavior therapy. Addiction, 103(10), 1660-1670. https://doi.org/10.1111/j.1360-0443.2008.02274.x

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).

Study 10647

Liddle, H. A., Dakof, G. A., Rowe, C. L., Henderson, C., Greenbaum, P., Wang, W., & Alberga, L. (2018). Multidimensional Family Therapy as a community-based alternative to residential treatment for adolescents with substance use and co-occurring mental health disorders. Journal of Substance Abuse Treatment, 90, 47-56. https://doi.org/10.1016/j.jsat.2018.04.011

This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4).