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1. Family Behavior Therapy (FBT)

Azrin, Nathan, Donohue, Brad.

Family Behavior Therapy has demonstrated postive results in both adults and adolescents and is aimed at addressing not only substance use problems but other co-occurring problems as well, such as conduct disorders, child mistreatment, depression, family conflict, and unemployment. FBT combines behavioral contracting with contingency management.

FBT involves the patient along with at least one significant other, such as a cohabitating partner or parent (in the case of adolescents). Therapists seek to engage families in applying the behavioral strategies taught in sessions and in acquiring new skills to improve the home environment. Patients are encouraged to develop behavioral goals for prevention substance use and HIV infection, which are anchored to a contingency management system. Substance abusing parents are prompted to set goals related to effective parenting behaviors. During each session, the behavioral goals are reviewed, with rewards provided by signficant others when goals are accomplished. Patients participant in treatment planning, choosing specific interventions from a menu of evidence-based treatment options.

Treating Adolescent Substance Abuse Using Family Behavior Therapy.

Donohue B, Azrin NH. New York: Wiley, 2001. ISBN: 978-0-470-62192-9. Available for purchase from the Wiley web site.

Intervention Details:

Population studied:Adolescents; Young adults; Adults
Drug studied:Applicable to most drug problems
Therapy format:Family
Therapy type:Cognitive-behavioral; Contingency management
Delivery mode:Manual-driven
Setting:Inpatient; Outpatient
Outcomes:In a series of comparisons involving adolescents with and without conduct disorder, FBT was found to be more effective than supportive counseling. In other studies, FBT has been found to reduce depression, increase parents' "satisifaction" with adolescents, reduce adult alcohol use by nearly 50%, and reduce illicit drug use for both adolescents and adults. (See References section for studies.)

Training/Technical Assistance: Assistance in finding training on the implementation of FBT is available from the University of Nevada, Las Vegas:


Supporting References:

  1. LaPota HB, Donohue B, Warren CS, Allen DN. Integration of a Healthy Living curriculum within Family Behavior Therapy: A clinical case example in a woman with a history of domestic violence, child neglect, drug abuse, and obesity. Journal of Family Violence 2011;26:227-234.
  2. Donohue B, Azrin N, Allen DN, et al. Family Behavior Therapy for substance abuse: A review of its intervention components and applicability. Behavior Modification 2009;33:495-519.
  3. Carroll KM, Onken LS. Behavioral therapies for drug abuse. American Journal of Psychiatry 2005;168(8):1452-1460.
  4. Azrin NH, Donohue B, Teichner GA, et al. 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 2001;11:1-41.
  5. Azrin NH, Donohue B, Besalel VA, et al. Youth drug abuse treatment: A controlled outcome study. Journal of Child and Adolescent Substance Abuse 1994;3:1-16.
  6. Azrin NH, McMahon PT, Donohue B, et al. Behavior therapy for drug abuse: A controlled treatment outcome study. Behaviour Research and Therapy 1994;32:857-866.
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