Family Behavior Therapy - Adult with Child Welfare Supplement

Substance Use Prevention or Treatment Does Not Currently Meet Criteria

Family Behavior Therapy – Adult with Child Welfare Supplement (Adult FBT-CWS) is a therapeutic treatment intended to accomplish goal performance within the family context. It is designed to treat adults with substance abuse and dependence and who are involved with the child welfare system. In Adult FBT-CWS, clients and their significant others complete assessment measures that allow therapists to understand the family and create an intervention plan. Following these assessments, clients are offered 20 sessions (typically lasting 75 minutes) over a six month period. When appropriate, clients’ significant others may also participate in these sessions. Similar to the standard Adult FBT program, Adult FBT-CWS typically includes an orientation to introduce FBT, a contingency management system (i.e., creating contracts with goals that may be contingently rewarded by adult relatives/significant others), and treatment planning to determine the desired interventions. Based on identified needs, different interventions may be implemented. These interventions could include support for meeting basic needs, managing triggers associated with substance use, supporting skill development for coping, self-control, and communication skills, or support with employment. Additionally, FBT-CWS includes tailored support for topics such as setting goals/rewards, financial management, child management, emergency management, and home safety. Adult FBT-CWS sessions are usually delivered in homes. Therapists and supervisors must be state-licensed mental health professionals. Adult FBT-CWS therapists must participate in 3 sets of multi-day training sessions on Adult FBT, an additional training module on delivering the child welfare supplement, and on-going telephone training.

Adult FBT-CWS does not currently meet criteria to receive a rating because no studies of the program achieved a rating of moderate or high on design and execution.

Date Research Evidence Last Reviewed: Mar 2020


The program or service description, target population, and program or service delivery and implementation information was informed by the following sources: the program or service developer’s website, the program or service manual, and the studies reviewed.


Program/Service Description Updated: Week of August 24, 2020

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

Adult FBT-CWS targets adults who experience substance abuse and/or dependence and are involved with the child welfare system. These adults may have associated problems related to depression, family dysfunction, trauma, child maltreatment, noncompliance, employment, and risky sexual behavior.


Adult FBT-CWS is typically offered for six months. Clients usually receive 20 sessions that average 75 minutes in length.

Location/Delivery Setting
Recommended Locations/Delivery Settings

Adult FBT-CWS sessions are usually delivered in homes.

Education, Certifications and Training

Therapists and supervisors must be state-licensed mental health professionals. Therapist training in Adult FBT-CWS involves initial participation in a 3 day training in Adult FBT and then participating in an additional half-day session to become trained in Adult FBT-CWS. Therapists also participate in two three-day booster trainings that occur 4 and 8 months after the initial workshop. The Adult FBT workshops include four modules: (1) Substance Abuse/Problem Behavior Interventions, (2) Family Relationship Building Interventions, (3) Job-Getting and Financial Management, and (4) Child Management Skills Training. In the half-day child welfare supplement trainings, therapists learn how to support and train their clients in topics including emergency management, behavior reinforcement, and home safety. Agencies may participate in up to 33 on-going telephone training meetings. Supervisors must complete the full Adult FBT training and a half-day supervisor training. To become a certified FBT trainer for an agency, supervisors must additionally implement the second and third FBT Trainer Workshops with certified National Trainers as a secondary trainer with 80% or greater protocol adherence.

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

Treating Adult Substance Abuse Using Family Behavior Therapy: A Step-By-Step Approach is implemented in conjunction with the Adult-Focused Family Behavior Therapy Child Welfare Supplement PowerPoint that is specific to the child welfare supplement.

Donohue, B., & Allen, N. D. (2011). Treating adult substance abuse using family behavior therapy: A step-by-step approach. John Wiley & Sons.

Donohue, B. (2017). Adult-focused Family Behavior Therapy child welfare supplement [PowerPoint slides]. Family Behavior Therapy.

Available languages

Materials for Adult FBT-CWS are available in English and Spanish.

Other supporting materials

Overview of Intervention Components

Overview of Child Welfare Supplement for Adult FBT

Intervention Protocols

Training Information

For More Information


Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.

Results of Search and Review Number of Studies Identified and Reviewed for Family Behavior Therapy - Adult with Child Welfare Supplement
Identified in Search 4
Eligible for Review 1
Rated High 0
Rated Moderate 0
Rated Low 1
Reviewed Only for Risk of Harm 0
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 Low

Study 10568

Donohue, B., Azrin, N. H., Bradshaw, K., Van Hasselt, V. B., Cross, C. L., Urgelles, J., . . . Allen, D. N. (2014). A controlled evaluation of Family Behavior Therapy in concurrent child neglect and drug abuse. Journal Of Consulting And Clinical Psychology, 82(4), 706-720. doi:10.1037/a0036920

This study received a low rating because the standards for addressing missing data were not met.

Studies Not Eligible for Review

Study 10565

Azrin, N. H., McMahon, P., Donohue, B., Besalel, V., Lapinski, K., Kogan, E., & Galloway, E. (1994). Behavior therapy of drug abuse: A controlled outcome study. Behaviour Research and Therapy, 32, 857-866.

Azrin, N., Acierno, R., Kogan, E. S., Donohue, B., Besalel, V., & McMahon, P. T. (1996). Follow-up results of Supportive versus Behavioral Therapy for illicit drug use. Behaviour Research and Therapy, 34, 41-46.

This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).

Study 10566

Ahluwalia, H., Anand, T., & Suman, L. N. (2018). Marital and family therapy. Indian Journal Of Psychiatry, 60(Suppl 4), S501-S505. doi:10.4103/psychiatry.IndianJPsychiatry_19_18

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

Study 10782

Donohue, B. D., Plant, C., Loughran, T. A., & Torres, A. (2018). Family assisted contingency management within the context of evidence-supported treatment for child neglect and drug abuse, Journal of Child and Family Studies, 26, 2224-2236.

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