Family Centered Treatment
Family Centered Treatment (FCT) is a trauma treatment model of home-based therapy. 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 forward through 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.
Date Research Evidence Last Reviewed: Oct 2021
Sources
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 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: Oct 2021
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
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 two 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 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 with 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 (Revised ed.). Family Centered Treatment Foundation Inc.
Available languages
Materials for FCT are available in English and Spanish.
Other supporting materials
How to become an FCT Practitioner
Contact Information for Developers
Website: http://www.familycenteredtreatment.org/
Phone: (703) 757-6243
| 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 |
- |
| Sullivan, 2021 | |||||
| Any Out of Home Placement |
0.39
*
15 |
- | 624 | - | 12 |
| Days in Out of Home Placement |
0.26
*
10 |
- | 624 | - | 12 |
| Child permanency: Least restrictive placement |
-0.02
0 |
1 (6) | 1402 |
Favorable:
0 No Effect: 6 Unfavorable: 0 |
- |
| Sullivan, 2012 | |||||
| Proportion With Secure Detentions |
-0.07
-2 |
- | 894 | - | 12 |
| Frequency of Secure Detentions |
0.00
0 |
- | 894 | - | 12 |
| Duration of Secure Detentions |
0.13
5 |
- | 894 | - | 12 |
| Proportion With Secure Detentions |
-0.10
-3 |
- | 508 | - | 24 |
| Frequency of Secure Detentions |
-0.15
-6 |
- | 508 | - | 24 |
| Duration of Secure Detentions |
-0.04
-1 |
- | 508 | - | 24 |
| Child well-being: Delinquent behavior |
-0.03
-1 |
1 (8) | 1402 |
Favorable:
0 No Effect: 8 Unfavorable: 0 |
- |
| Sullivan, 2012 | |||||
| Frequency of Offenses |
-0.10
-4 |
- | 894 | - | 12 |
| Proportion Offending |
0.03
1 |
- | 894 | - | 12 |
| Frequency of Adjudications |
-0.15
-5 |
- | 894 | - | 12 |
| Proportion Adjudicated |
-0.15
-6 |
- | 894 | - | 12 |
| Frequency of Offenses |
0.03
1 |
- | 508 | - | 24 |
| Proportion Offending |
0.07
2 |
- | 508 | - | 24 |
| Frequency of Adjudications |
0.18
7 |
- | 508 | - | 24 |
| Proportion Adjudicated |
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.
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.
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.
Studies Rated Low
Study 10913Indiana University Evaluation Team (2018). Indiana Department of Child Services Child Welfare Title IV-E waiver demonstration project: Final report 2018. Indiana Department of Child Services
This study received a low rating because none of the target outcomes met measurement standards.Study 10915
Schultz, D., Jaycox, L. H., Hickman, L. J., Chandra, A., Barnes-Proby, D., Acosta, J., Beckman, A., Francois, T., & 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. 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. 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. University of Maryland School of Social Work.
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.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).