presented by: kimberly mccaskey-lee, lcsw amy punsky, ma, ncc & kelly pavelko, ba child to...
TRANSCRIPT
Presented by: Kimberly McCaskey-Lee, LCSW Amy Punsky, MA, NCC & Kelly Pavelko, BA
Child to Family Connections
What is FBT?
Evidenced-based, cost-effective intervention approach that utilizes innovative behavioral therapies used to treat substance abuse and associated problems within the family context
Created by Bradley Donohue, Ph.D.Associate professor UNLVDirector of the Achievement Center
Empirical BackgroundStudy 1Azrin, N.H., McMahon, P.T., Donohue, B., Besalel, V.A.,
Lapinski, K.J., Kogan, E.S., et al. (1994). Behavior therapy for drug abuse: A controlled treatment outcome study. Behaviour Research and Therapy, 32, 857-866.
Study 2Azrin, N.H., Acierno, R., Kogan, E.S., Donohue, B.,
Besalel, V.A., & McMahon, P.T. (1996). Follow-up results of supportive versus behavioral therapy for illicit drug use, Behaviour Research and Therapy, 34, 41-46.
Empirical Background Study 3Azrin, N. H., Donohue, B., Besalel, V. A., Kogan, E. S., &
Acierno, R. (1994). Youth drug abuse treatment: A controlled outcome study. Journal of Child & Adolescent Substance Abuse, 3, 1-15.
Study 4Azrin, N. H., Donohue, B., Teichner, G. A., Crum, T.
Howell, J., & DeCato, L. A. (2001). A controlled evaluation and description of individual-cognitive problem solving and family-behavior therapies in dually diagnosed conduct-disordered and substance-dependent youth. Journal of Child & Adolescent Substance Abuse, 11, 1-41.
How does FBT work?Uses a team approachPlans are individualizedServices are provided during weekly
family sessionsEncourages increased family involvementUtilizes interventions focusing on
communication within the family as well as targeting substance abuse issues and troublesome behaviors
Target populationYouth between 12 -18At risk for problems associated with
illicit drug and/or alcohol useAt risk of out-of-home placement or who
have been placed previouslyYouth and at least one adult support
person willing to participateYouth NOT involved with domestic
violence or sexual abuse
What does FBT look like?Typically consists of 16-20 home-based
sessions, running for a 6 month period.Incorporates an enlistment and retention
strategy to improve attendance.Family guided treatment plan with their own
selection of skills.Selected therapies are implemented
successively and cumulatively.Meaning each therapy is reviewed and built
upon during all subsequent sessions to increase development of skills.
What does FBT look like?All interventions are based on prompting lists
used by therapists during sessions.Protocols begin with a rationale, followed by
modeling the skill, then therapist role-play of the skill, into role-playing with the client.
Client rates the helpfulness of each intervention on a Likert scale from 1 -7 (1 being extremely unhelpful to 7 being extremely helpful) with no obligation to give a high score.
Therapist rates client on compliance (attendance, participation, etc) on same Likert scale.
Initial Meetings and Assessments
Quick introduction to program and team
Elicit initial commitment
Complete consents and assessments
Assessments UsedYouth Life Satisfaction
Scale
Youth Satisfaction with Parent Scale
Parent Satisfaction with Youth Scale
FBT Questionnaire
Youth Self Report
Child Behavior Checklist
Parenting Stress Index
FBT InterventionsProgram OrientationTreatment PlanningAnnoyance ReviewStimulus ControlI’ve Got a Great FamilyLevel SystemSelf ControlPositive RequestJob ClubLast Session Review
Program Orientation and Treatment Planning
Orientation sets the tone for what treatment sessions will look like, obtaining commitments from adolescent & caregivers, communication guidelines, etc.
Review of attendance policy/cancellation expectations
Discussion of referral source and completed assessments
Commitment to stay drug freeCommunication guidelines
Program Orientation and Treatment Planning
Treatment Planning includes:Explaining interventions
Adolescent ranks priority
Caregivers rank priorityAverage of rankings = order of
interventions
Therapeutic StylePositively focused agendas
Emphasis on positive feedback and encouragement
Praising desired/ignoring undesired
Role playing
Consequence ReviewIncreasing or maintaining motivation to avoid
drug use and troublesome behavior
Stimulus ControlLearning to avoid
people, places, and situations that increase the risk of using drugs and getting into trouble, and instead spending greater amounts of time with people, places, and situations that do not involve drug use or troublesome behavior
I’ve Got a Great FamilyIncreasing communication between family
members about what they love and appreciate about each other, rather than focusing on what is not liked
Level System
Getting rewards from caregivers when goals (behaviors) are accomplished
Self ControlLearning to control impulses, urges, and
thoughts that increase drug use and trouble
Positive Request
Learning how to best make requests so people are more likely to do what you want, as well as how to best settle disagreements
Job ClubLearning techniques
to help get satisfying jobs at higher wages
How to obtain an interview
Mock interviewsHow to present self
for an interview
Donohue, B., Allen, D. (2011). Treating adult substance abuse
using family behavior therapy: A step by step approach.
Hoboken, NJ: John Wiley & sons Inc.
Kimberly McCaskey-Lee, LCSWAmy Punsky, MA, NCC
Kelly Pavelko, BAChild to Family Connections