Uppsatsen är en studie av Funktionell Familjeterapi (FFT). Syftet var att undersöka om en FFT-behandling innebar en förändring för en ungdom och dennes föräldrar avseende deras beskrivning av familjeklimatet och dyaderna inom familjen. Målgruppen utgjordes av 29 familjer som under åren 2011-2013 avslutat en FFT-behandling på Ungdomscentrum, Uppsala kommun. Familjerna hade fyllt i självskattningsformulären Frågor om Familjemedlemmar och Familjeklimat före och efter behandlingen. Resultatet visade ett flertal statistiskt signifikanta skillnader vilket stämde överens med tidigare forskning av modellen, både internationellt och nationellt. Kritik och klander hade minskat mellan familjemedlemmarna och föräldrarna ansåg sig mindre överinvolverade i sina ungdomar efter behandlingen. När det gäller Familjeklimat visade det sig att ungdomarna, mödrarna och fäderna upplevde mer närhet och mindre distans inom familjen efter genomför behandling. Studien bekräftade att FFT-modellen ger en viss effekt för familjer med en tonåring som har ett utagerande beteende. Den starka betoningen på att ändra familjens kommunikationsmönster till en mer stödjande sådan, har avgörande betydelse för om familjen fullföljer behandlingen och för om behandlingsresultatet blir positivt. / The paper is an evaluation of Functional Family Therapy (FFT). The aim was to investigate whether a FFT treatment meant a change for a youth and his parents regarding their description of family climate and dyads within the family. The target group consisted of 29 families that during 2011-2013 completed the FFT treatment at Ungdomscentrum (Youth Centre), in Uppsala community. The families had completed the self-assessment forms Issues of Family members and Family climate before and after the treatment. The results showed several significant differences that were consistent with previous research of the model, both internationally and nationally. Criticism and blame had been reduced between family members and the parents considered themselves less over-involved in their youth after the treatment. Current Family climate, it turned out that the adolescents, mothers and fathers experienced more closeness and less distance within the family in the end of treatment. The evaluation confirmed that the FFT- model provides some effect for families with a teenager with behavior problems. The strong emphasis on changing family patterns of communication to a more supportive one, is crucial for the family to complete their treatment and for the result of the treatment.

Hemuppgiften är ett viktigt moment inom såväl Funktionell familjeterapi (FFT) som Dialektisk beteendeterapi (DBT). Målsättningen med denna uppsats var att utröna om, och i sådana fall på vilket sätt, hemuppgifter ges inom den familjeterapeutiska kontext som utgör ramen för FFT. En hypotes vid arbetets ingång var att de interaktionistiska hemuppgifterna kommit att ersättas av de mer beteendeorienterade som ingår i DBT. De personer som utgjort underlag för undersökningen arbetar alla på en öppenvårdsmottagning inom Barn- och ungdomspsykiatrin (BUP) i Uppsala, med antingen ovan nämnda Funktionella familjeterapi (n=3) eller med Dialektisk beteendeterapi (n=2). Syftet med studien var att, dels via en enkätundersökning dels via en intervju i fokusgruppform, försöka förstå mer av det psykoterapeutiska redskap som utgörs av hemuppgiften. Fokus låg på den relationella hemuppgift som familjeterapeuterna tillhörande nämnda team förväntas konstruera utifrån tillhandahållen FFT-manual. Resultatet visade på en relativt stor bredd när det gällde terapeuternas syn på och tillämpning av hemuppgiften, men det generella mönstret pekade på att terapeuterna i sitt praktiska arbete konstruerade såväl relationella som beteendeorienterade hemuppgifter. Vad som framkom är dock ett behov av och en önskan från familjeterapeuternas sida om en större tydlighet kring hur man går tillväga då man fastställer och ger en familj en relationellt orienterad hemuppgift. Det vi sluter oss till i vår uppsats är att ett sådant förtydligande inte låter sig göras med mindre än att man går till botten med och definierar vad funktionen av relationen innebär samt hur man använder sig av denna vid det som inom Funktionell familjeterapi kallas för relationsbedömningen. / The homework is an important part of both Functional Family Therapy (FFT) and Dialectical Behavior Therapy (DBT). The goal of this essay has been to determine if, and in what way, homework is used in the context of family therapy, that is the frame of FFT. One hypothesis at the beginning of this work was that the interactional home assignments have started to be replaced by the behavior oriented ones that are a part of DBT. The individuals participating in the study are all working in a psychiatric outpatient clinic (BUP) in Uppsala. They are all using either Functional Family Therapy (n=3) or Dialectical Behavior Therapy (n=2) as treatment methods. The purpose of the study has been to try to understand more of the homework as a therapeutic instrument, especially the relational homework that family therapists are expected to work out on the basis of a manual that is provided within FFT. Two methods have been used to examine this: a survey and focus group interview. The results show a relatively large width when it comes to the therapists view on and practice of homework, though the general pattern indicates that they work out both relational as well as behavior oriented assignments in their practical work. However, there is a need and a wish of the family therapists to gain more clarity on how to determine and give a family a relational oriented homework. The conclusion of this essay is that a clarification like that is not possible, unless you go to the bottom with and define what the relational function is and how to use it in what within Functional Family Therapy is called the Relational Assessment Phase.

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Syftet med denna studie är att undersöka hur familjebehandlare upplever det att arbeta med FFT-metoden samt de faktorerna som gör den funktionell. Eftersom FFT är anpassad till den amerikanska kulturen som skiljer sig ganska mycket från den svenska, båda i kultur och socialsystem är det viktigt att inte bara utvärdera utifrån modellen men också hur implementering och anpassning av modellen har gått. För att kunna besvara syftet och frågeställningar har fem kvalitativa intervjuer genomförts av semistrukturerad karaktär. Urvalet av respondenter gjordes utifrån snöbollsmetoden där de intervjuade arbetar inom socialtjänstens öppenvård. Resultaten visade att det finns många saker som ska tas hänsyn till vid anpassning till andra kulturer, bland annat utbildningar, målgrupper och ekonomi. FFT är en behandlingsmetod och en påbyggnadsutbildning där gränsen mellan det som är klientens behandling och det som är FFT-terapeuternas utbildning är diffus. Studien kan bidra med tankar om hur man skulle kunna göra vidare studier rörande utbildning och implementering av evidensbaserade modeller.

Intensive in-home services is a family-centered, strength-based intervention program offering comprehensive treatment that includes family therapy, mental health treatment and parenting skills for caregivers, development of positive social systems, and assistance with accessing community resources for long-term support (Youth Villages, 2013b). Framed on family system theory, Intensive-In Home Services (IIHS) was developed from Cognitive Behavioral Therapy, Functional Family Therapy, Social Development, and Crisis Intervention models as a means to modify behaviors that place youth at risk for out-of-home placement. The socio-historical development of these models is examined in the literature review. Intensive in-home services is a family-centered, strength-based intervention program offering comprehensive treatment that includes family therapy, mental health treatment and parenting skills for caregivers, development of positive social systems, and assistance with accessing community resources for long-term support (Youth Villages, 2013b). Framed on family system theory, Intensive-In Home Services (IIHS) was developed from Cognitive Behavioral Therapy, Functional Family Therapy, Social Development, and Crisis Intervention models as a means to modify behaviors that place youth at risk for out-of-home placement. The socio-historical development of these models is examined in the literature review. The purpose of this study was to evaluate predictors that may influence outcome measures of a youth’s inclination to remain in the home after having received IIHS treatment. The significant predictors were determined to be age, race, and total length of service received. The study sampled 3,131 youth ages birth through 17 who received IIHS services in Tennessee over a 10-year period and were discharged from July 2001 to July 2010. The study was limited to youth designated under Comprehensive Child and Family Treatment (CCFT), which is classified as part of TennCare coverage. The primary goal of CCFT is to empower families to monitor and manage mental health needs and high-risk youth behaviors in order to provide permanency and longterm stability in the natural home environment (UnitedHealthcare, 2012).

A large body of research has been devoted to understanding evidence-based interventions (EBI) and their effectiveness in the juvenile justice system. This systematic review examines three commonly used interventions used to reduce recidivism among adolescents involved in the juvenile justice system: Cognitive-Behavioral Therapy (CBT), Functional Family Therapy (FFT), and Multisystemic Therapy (MST). The systematic review analyzes findings from prior studies evaluating the impact of CBT, FFT, and MST on recidivism among adjudicated youth. The sample includes 23 peer-reviewed studies that utilized samples of adjudicated youth in the United States and were published after 2010. Findings revealed CBT as the most effective intervention, as evidenced by the efficacy demonstrated across all its studies in reducing recidivism rates. Key findings noted that none of the studies included in the analysis demonstrated higher rates of recidivism within the treatment groups compared to control groups. Secondly, a notable trend emerged across the reviewed studies, revealing a statistically significant reduction in recidivism rates among the treated individuals regardless of the EBI.

In March 2011, Multnomah County's Juvenile Services Division (JSD) in Portland, Oregon implemented a new program model called Functional Family Probation Services, a case management model based on the principles of Functional Family Therapy. Under this model JSD Juvenile Court Counselors deliver Functional Family Probation Services to medium and high-risk youth on probation; both to the youth and their family in their home. This qualitative case study examined the extent to which the Juvenile Court Counselors and Community Justice Managers implemented Functional Family Probation Service's components and recorded their opinions regarding Functional Family Probation Services as a case management model. The study included observations of consultation meetings and interviews of 17 Juvenile Court Counselors, Community Justice Managers, and Senior Managers. The primary results of the study revealed that the Functional Family Probation Services intervention is well received by the county's youth and families and that Functional Family Probation Services increases family functioning. Additionally, both observations and self-reports from the Juvenile Court Counselors and Community Justice Managers indicate that Functional Family Probation Services requires individual and organizational changes critical for its successful implementation and sustainability.