Family Centered Treatment®
Family Centered Treatment® (FCT) is a home-based trauma treatment. FCT is designed for families who are at-risk of dissolution or in need of reunification. It is also designed to serve youth who move between the child welfare, behavioral health, and juvenile justice systems. During treatment, FCT practitioners aim to help families identify their core emotional issues, identify functions of behaviors in a family systems context, change the emotional tone and behavioral interaction patterns among family members, and develop secure relationships by strengthening attachment bonds.
Treatment incorporates trauma-informed interventions throughout four phases. (1) During the Joining and Assessment phase, the practitioner aims to establish trust with the family. Together, they identify needed additions, changes, or improvements in family functioning skills and establish therapeutic objectives. (2) During the Restructuring phase, practitioners and families identify and practice new patterns of interacting and daily living in accordance with their goals. (3) During the Valuing Changes phase, FCT practitioners help the family internalize new patterns of interactions to advance the family toward value integration instead of compliance. (4) Finally, during the Generalization phase, the family evaluates their changes, plans for future challenges, and closes out their treatment.
FCT is rated as a supported practice because at least one study carried out in a usual care or practice setting achieved a rating of moderate or high on design and execution and demonstrated a sustained favorable effect of at least 6 months beyond the end of treatment on at least one target outcome.
A re-review of FCT was conducted in April 2022 based on the availability of a new research report for Study 10913. The re-review did not affect the design and execution rating for the study or the program or service rating. The additional research report is listed in the Studies Reviewed section below under Study 10913.
Date Research Evidence Last Reviewed: May 2022
Sources
The program or service description, target population, and program or service delivery and implementation information were informed by the following sources: the program or service manual, the program or service developer’s website, the California Evidence-Based Clearinghouse for Child Welfare, the National Registry of Evidence-based Programs and Practices, and the studies reviewed.
Date Program/Service Description Last Updated: Jun 2022
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 download the Handbook of Standards and Procedures, Version 1.0
Target Population
FCT is designed to support families with youth who are at-risk for out-of-home placements, have trauma exposure, have histories of delinquent behavior, or are working toward reunification. It is also designed to support youth who move between the child welfare, behavioral health, and juvenile justice systems.
Dosage
FCT intensity and duration are determined according to family need. Typically, sessions occur 2 or more times per week for about 6 months. Each session can last for multiple hours. Families also have access to on-call support 24/7. The timeframe for each of the four treatment phases is guided by FCT practitioners based on specific family indicators of progress demonstrating the family has successfully completed a phase of treatment.
Location/Delivery Setting
Recommended Locations/Delivery Settings
FCT can be delivered in the participant’s home or in other treatment and community settings such as the participant’s school, workplace, or the home of a relative.
Location/Delivery Settings Observed in the Research
- Home
- Community Center (e.g., religious or recreational facility)
- School
Education, Certifications and Training
State-specific credentialing drives the minimum qualifications for practitioners and supervisors. Practitioners must be certified in FCT and have at least a bachelor’s degree to deliver FCT. No specific therapy license is required. To become certified, practitioners must complete online modules and field-based competency evaluations that focus on FCT core skills area development and practical utilization in the field. Practitioners must go through re-certification every 2 years and demonstrate fidelity to the model. Supervisors must be certified via an online FCT supervision course that includes field-based competency testing typically lasting 6 months.
Agencies must apply and be licensed before implementing FCT. An agency becomes licensed by submitting an application providing evidence of the management, training, supervision, and data collection infrastructure to support the delivery of FCT. The agency must demonstrate fidelity to the model to maintain licensure.
Program or Service Documentation
Book/Manual/Available documentation used for review
The Wheels of Change—Family Centered Specialists Handbook and Training Manual is implemented in conjunction with the Family Centered Treatment® Design and Implementation Guide.
Painter, W. E., & Smith, M. M. (2004). Wheels of Change—Family centered specialists handbook and training manual. Institute for Family Centered Services.
Wood, T. J. (2018). Family Centered Treatment® design and implementation guide (Rev. ed.). Family Centered Treatment Foundation Inc.
Available languages
FCT materials are available in English and Spanish.
Other supporting materials
How to become an FCT Practitioner
For More Information
Website: http://www.familycenteredtreatment.org/
Phone: (980) 269-4390
Email: info@familycenteredtreatment.org
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 Centered Treatment® |
|---|---|
| Identified in Search | 6 |
| Eligible for Review | 4 |
| Rated High | 0 |
| Rated Moderate | 1 |
| Rated Low | 3 |
| Reviewed Only for Risk of Harm | 0 |
| Outcome | Effect Size
 and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
|---|---|---|---|---|
| Child permanency: Out-of-home placement |
0.33
12 |
1 (2) | 624 |
Favorable:
2 No Effect: 0 Unfavorable: 0 |
| Child permanency: Least restrictive placement |
-0.02
0 |
1 (6) | 1402 |
Favorable:
0 No Effect: 6 Unfavorable: 0 |
| Child well-being: Delinquent behavior |
-0.03
-1 |
1 (8) | 1402 |
Favorable:
0 No Effect: 8 Unfavorable: 0 |
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group.
| Outcome | Effect Size
and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
Months after treatment when outcome measured
|
|---|---|---|---|---|---|
| Child permanency: Out-of-home placement |
0.33
12 |
1 (2) | 624 |
Favorable:
2 No Effect: 0 Unfavorable: 0 |
- |
| Study 10917 - Family Centered Treatment® vs. Group Home Services (August 2021 Report) (Sullivan, 2021) | |||||
| Out-of-Home Placement (Any) |
0.39
*
15 |
- | 624 | - | 12 |
| Out-of-Home Placement (Number of Days) |
0.26
*
10 |
- | 624 | - | 12 |
| Child permanency: Least restrictive placement |
-0.02
0 |
1 (6) | 1402 |
Favorable:
0 No Effect: 6 Unfavorable: 0 |
- |
| Study 10917 - Family Centered Treatment® vs. Residential Services (Year 1) (Sullivan, 2012) | |||||
| Secure Detentions (Proportion) |
-0.07
-2 |
- | 894 | - | 12 |
| Secure Detentions (Frequency) |
0.00
0 |
- | 894 | - | 12 |
| Secure Detentions (Duration) |
0.13
5 |
- | 894 | - | 12 |
| Study 10917 - Family Centered Treatment® vs. Residential Services (Year 2) (Sullivan, 2012) | |||||
| Secure Detentions (Proportion) |
-0.10
-3 |
- | 508 | - | 24 |
| Secure Detentions (Frequency) |
-0.15
-6 |
- | 508 | - | 24 |
| Secure Detentions (Duration) |
-0.04
-1 |
- | 508 | - | 24 |
| Child well-being: Delinquent behavior |
-0.03
-1 |
1 (8) | 1402 |
Favorable:
0 No Effect: 8 Unfavorable: 0 |
- |
| Study 10917 - Family Centered Treatment® vs. Residential Services (Year 1) (Sullivan, 2012) | |||||
| Alleged Offenses (Frequency) |
-0.10
-4 |
- | 894 | - | 12 |
| Alleged Offenses (Proportion) |
0.03
1 |
- | 894 | - | 12 |
| Adjudications (Frequency) |
-0.15
-5 |
- | 894 | - | 12 |
| Adjudications (Proportion) |
-0.15
-6 |
- | 894 | - | 12 |
| Study 10917 - Family Centered Treatment® vs. Residential Services (Year 2) (Sullivan, 2012) | |||||
| Alleged Offenses (Frequency) |
0.03
1 |
- | 508 | - | 24 |
| Alleged Offenses (Proportion) |
0.07
2 |
- | 508 | - | 24 |
| Adjudications (Frequency) |
0.18
7 |
- | 508 | - | 24 |
| Adjudications (Proportion) |
0.07
2 |
- | 508 | - | 24 |
*p <.05
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications.
Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.
Full citations for the studies shown in the table are available in the "Studies Reviewed" section.
The participant characteristics display is an initial version. We encourage those interested in providing feedback to send suggestions to preventionservices@abtglobal.com.
The table below displays locations, the year, and participant demographics for studies that received moderate or high ratings on design and execution and that reported the information. Participant characteristics for studies with more than one intervention versus comparison group pair that received moderate or high ratings are shown separately in the table. Please note, the information presented here uses terminology directly from the study documents, when available. Studies that received moderate or high ratings on design and execution that did not include relevant participant demographic information would not be represented in this table.
For more information on how Clearinghouse reviewers record the information in the table, please see our Resource Guide on Study Participant Characteristics and Settings.
| Characteristics of the Participants in the Studies with Moderate or High Ratings | ||||||
|---|---|---|---|---|---|---|
|
Study Location
|
Study Year
|
Age or Grade-level
|
Race, Ethnicity, Nationality
|
Gender
|
Populations of Interest*
|
Household Socioeconomic Status
|
| Study 10917 - Family Centered Treatment® vs. Group Home Services (August 2021 Report) | ||||||
| Characteristics of the Children and Youth | ||||||
| Maryland, USA | 2003 | Average age: 15.4 years |
62% African American 32% White 9% Hispanic 0.5% Asian |
74% Male |
100% Adjudicated youth; 89% Out-of-home placement in prior year |
-- |
| Study 10917 - Family Centered Treatment® vs. Residential Services (Year 1) | ||||||
| Characteristics of the Children and Youth | ||||||
| Maryland, USA | 2003 | Average age: 15 years |
59% African American 32% Caucasian 8% Hispanic |
74% Male 26% Female |
100% Adjudicated youth | -- |
| Study 10917 - Family Centered Treatment® vs. Residential Services (Year 2) | ||||||
| Characteristics of the Children and Youth | ||||||
| Maryland, USA | 2003 | Average age: 15 years |
59% African American 32% Caucasian 8% Hispanic |
74% Male 26% Female |
-- | -- |
“--” indicates information not reported in the study.
* The information about disabilities is based on initial coding. For more information on how the Clearinghouse recorded disability information for the initial release, please see our Resource Guide on Study Participant Characteristics and Settings. The Clearinghouse is currently seeking consultation from experts, including those with lived experience, and input from the public to enhance and improve the display.
Note: Citations for the documents associated with each 5-digit study number shown in the table can be found in the “Studies Reviewed” section below. Study settings and participant demographics are recorded for all studies that received moderate or high ratings on design and execution and that reported the information. Studies that did not report any information about setting or participant demographics are not displayed. For more information on how participant characteristics are recorded, please see our Resource Guide on Study Participant Characteristics and Settings.
Studies Rated Moderate
Study 10917Sullivan, M. B., Bennear, L. S., Honess, B. S., Painter, W. E., & Wood, T. J. (2012). Family Centered Treatment - An alternative to residential placements for adjudicated youth: Outcomes and cost effectiveness. . OJJDP Journal of Juvenile Justice, 2(1), 25-40. https://www.ncjrs.gov/pdffiles/240461.pdf
Sullivan, M. B., & Bennear, L. S. (2021). A quasi-experimental evaluation of Family Centered Treatment® in the Maryland Department of Juvenile Services community based non-residential program: Child permanency. Family Centered Treatment Foundation.
This study was conducted in a usual care or practice setting (Handbook Section 6.2.2)Studies Rated Low
Study 10915Schultz, D., Jaycox, L. H., Hickman, L. J., Chandra, A., Barnes-Proby, D., Acosta, J., … Honess-Morreale, L. (2010). National evaluation of Safe Start promising approaches: Assessing program implementation. RAND Corporation.
Jaycox, L. H., Hickman, L. J., Schultz, D., Barnes-Proby, D., Setodji, C. M., Kofner, A., Harris, R., Acosta, J., & Francois T. (2011). National evaluation of Safe Start promising approaches: Assessing program outcomes. Results Appendix B: Broward County, Florida. RAND Corporation.
Jaycox, L. H., Hickman, L. J., Schultz, D., Barnes-Proby, D., Setodji, C. M., Kofner, A., Harris, R., Acosta, J., & Francois T. (2011). National evaluation of Safe Start promising approaches: Assessing program outcomes. RAND Corporation.
This study received a low rating because baseline equivalence of the intervention and comparison groups was necessary and not demonstrated.Study 10912
Bright, C. L., Betsinger, S., Farrell, J., Winters, A., Dutrow, D., Lee, B. R., & Afkinich, J. (2015). Summary of Youth Outcomes Following Family Centered Treatment in Maryland. Baltimore, MD: University of Maryland School of Social Work.
Bright, C. L., Betsinger, S., Farrell, J., Winters, A., Dutrow, D., Lee, B. R., & Afkinich, J. (2015). Youth outcomes following Family Centered Treatment® in Maryland. Baltimore, MD: University of Maryland School of Social Work. April, 2017
Bright, C. L., Farrell, J., Winters, A. M., Betsinger, S., & Lee, B. R. (2018). Family Centered Treatment, juvenile justice, and the grand challenge of smart decarceration. Research on Social Work Practice, 28(5), 638-645. https://doi.org/10.1177/1049731517730127
This study received a low rating because it did not meet the statistical model standards.Study 10913
Indiana University Evaluation Team, Indiana Department of Child Services (2018). Indiana Department of Child Services Child Welfare Title IV-E Waiver Demonstration Project. Final Report 2018.
Pierce, B. J., Muzzey, F. K., Bloomquist, K. R., & Imburgia, T. M. (2022). Effectiveness of Family Centered Treatment on reunification and days in care: Propensity score matched sample from Indiana child welfare data. Children and Youth Services, 136, Article 106395. https://doi.org/10.1016/j.childyouth.2022.106395
This study received a low rating because none of the target outcomes met measurement standards.Studies Not Eligible for Review
Study 10914
Magura, S., & Laudet, A. B. (1996). Parental substance abuse and child maltreatment: Review and implications for intervention. Children and Youth Services Review, 18(3), 193-220. https://doi.org/10.1016/0190-7409%2896%2900001-1
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 10916
Sparks, S. N., Tisch, R., & Gardner, M. (2013). Family-centered interventions for substance abuse in Hispanic communities. Journal of Ethnicity in Substance Abuse, 12(1), 68-81. https://doi.org/10.1080/15332640.2013.759785
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).