Functional Family Therapy (FFT)-Aggression Replacement Training® (ART®)
The FFT/ART® is an innovative integration of the best of two programs that bring family based and competency development integrated with individualize treatment planning that is prescriptive based on needs. Both approaches are evidence based to help with the complex problems of youth with serious behavioral problems. Aggression Replacement Training® is a structured learning approach to teach social skills to both youth and families. Functional Family Therapy, an evidence based treatment program, to systematically move those ideas into everyday family life helping empower them to overcome current and future problems in an alliance based way. Together the systematic integration of these two models brings a comprehensive, practical, and realistic way to help families successfully to problem solve and communicate in an effective manner that allows for growth and development. Treatment is guided by a family case manager who guides youth and families through the program developing family based treatment plans.
FFT-ART® Clinical Model
Phase 1: Developing a plan: Collaborative Family Based Treatment Planning
FFT core of engagement & motivation serves as entry into the intervention. In the early phase FFT sanctuary family case manager use the core skills of FFT to build reduce the harmful blame and negativity that stands in the way of families working together to successfully solve problems. The outcome of this phase is a collaborative family based treatment plan that is family focused and incorporates skill building.
Phase 2: Structured Learning – Competency Development
Skilltsreaming, Anger Control, Empathy and Problem Solving Training are psycho educational approaches that helps the family acquire a family based understanding of communication styles and problem solving coping skills. Sessions use discussion and metacognition activities to promote an emotionally safe, therapeutic setting that promotes safety, support and alliance. The format provides a safe learning
climate to help families learn social skills and problem solving capabilities. The family is conceptualized as the group system and role plays incorporate situations that are germane to interpersonal relationships and stress that occurs with family members.
Phase 3: Implementing Change
Functional Family Therapy helps each individual family address the challenges of everyday life and integrate the principles of ART(®) through a pragmatic, alliance based, family approach. FFT case managers use the established and evidence based phase approach to help families frame problems as family based, identify specific and individualized skills to integrate, and generalization and maintenance of those change over time. The specific nature of FFT allows families to move through change in an efficient manner. FFT helps the family focus on the specific details of the treatment plan.
Cognitive Change Strategies (Metacognition Processes)
The core of ART(®) is the ability to develop new problem solving styles and coping skills through cognitive change. The underlying strategy is new metacognition, which is one’s ability to use prior and new knowledge to plan a strategy for approaching a learning task, take necessary steps to problem solve, reflect on and evaluate results, and modify one’s approach as needed. It helps learners choose the right cognitive tool for the task and plays a critical role in successful learning. These strategies are utilized in Skillstreaming and Anger Control Training. Problem Solving assist with identifying thinking errors or cognitive distortions that are barriers to effectively solving problems. Empathy and Social Competence Training provides skills to understand others points of view.
Therapists would pick 3-4 lessons from the Program Overview below and base which competencies are necessary on the needs of the family.
The care manager identifies skills that the family can benefit from based on the initial treatment plan and input from the family. The care manager is the facilitator and a family member, acts as the main actor (based on need) and the remaining family members are either co-actors or provide feedback to the skill steps. Focus is given to cognitive change based on the main actors’ prosocial responses to skill steps.
The facilitator coaches as necessary to assure fidelity with metacognition steps.
The following skills from Skillstreaming (McGinnis, E., Sprafkin P., Gershaw J., Klein, P. (2011) Research Press, Champaign, Il.) are recommended for use with families. The care manager can choose which 4 the family will benefit from:
Group I: Beginning Social Skills
- Saying Thank You
Group II: Advanced Social Skills
- Asking for Help
- Following Instructions
Group III: Skills for Dealing with Feelings
- Expressing Your Feelings
- Understanding the Feelings of Others
- Dealing with Someone Else’s Anger
- Expressing Affection
Group IV: Skill Alternatives to Aggression
- Using Self-Control
- Responding to Teasing
Group V: Skills for Dealing with Stress
- Dealing with Embarrassment
- Responding to Failure
- Dealing with Group Pressure
- Making a Decision
Anger Control Training
Session 5 – Teach the Anger Control Chain
Session 6 – Guided practice Anger Control scenario
Session 7 – Overview of Problem-Solving (Session 1 from Problem-Solving)
Session 8 – Problem-Solving Worksheet (Session 8 problem-solving practice from Problem-Solving)
Empathy and Social Competence Training
Session 9 – What is empathy? (Lesson 2 from Empathy Curriculum)
Session 10 – Trust accounts (Lesson 18 from Empathy Curriculum)