Current MDFT Studies

Family Partnership for our Girls' Futures

Under the direction of the University of Miami, a broad-based coalition of service providers, community stakeholders, experts in adolescence, have designed a comprehensive, scientifically valid, neighborhood-based and family focused system of care targeting high risk girls ages 11-18 in South Dade County.

A Girl’s Place is a family focused system of care designed to prevent delinquency, arrest, out of home placement, school failure and dropout, pregnancy, and the continuation of the cycle of involvement in the criminal justice and child welfare systems among high risk 11 – 18 year old females living in the Naranja area.  An evidence-based, family focused intervention system, Multidimensional Family Therapy, is the integrative organizing system of Family Partnership for Our Girls’ Futures.

This system-of-care will be comprised of multiple partners including mental health, sexual health and educational service providers. Partners include:

  • Family Counseling Services (FCS) will provide family therapy and HIV/STD education.
  • MUJER will provide family therapy and HIV/STD education.
  • Planned Parenthood: will provide sexual education, pregnancy prevention and sexual health related services.
  • Miami Dade College will provide tutoring, educational advocacy, and other educational and career related services.

In the first year we intend to serve between 100- 150 families, doubling the number served in subsequent year.

Civil Citation Project

The Children's Trust Contract #864-272.

H. Liddle

The Civil Citation Project is a randomized controlled study, "Preventing Adolescents from Entering the Juvenile Justice System," that aims to test an innovative juvenile diversion model that integrates evidence-based family therapy: Multidimensional Family Therapy (MDFT). The study asks a classical services research question  - does the addition of a state-of-the-science intervention into an existing diversion program significantly enhance the program outcomes in key outcome domains – areas supported as intervention targets in the literature as well as areas of functioning that predict developmental outcomes.  Immediate and longer-term effects of the family intervention will be compared to services as usual with 120 adolescents participating in Miami-Dade's Civil Citation Program.



Family-Based Drug Services for Young Disaster Victims

NIDA, Grant # 1 R01 DA021887

C. Rowe & H. Liddle

The devastation that Hurricane Katrina wrought on New Orleans and its surrounding communities stunned the world. Its consequences are expected to be particularly acute for adolescents, who are vulnerable for both trauma and substance abuse under conditions of extreme stress, family disorganization, and life disruption. This proposal, submitted in response to NOT-DA-05-013, “Notice of Mechanism for Time-Sensitive Research Opportunities: PAR-05-150, Expansion to Include Alcohol and Drug Abuse Research Pertaining to Hurricane Katrina,” would be the first examination of co-occurring adolescent substance abuse and trauma following a community-wide disaster. It would explore the potential of a family-based intervention, Multidimensional Family therapy (MDFT; Liddle, 2002a), which has demonstrated strong effects with adolescent substance abusers, to address co morbid trauma and substance abuse among teens impacted by Hurricane Katrina. The investigators will partner with clinical providers in St. Charles Parish, Louisiana, a New Orleans area community that was heavily impacted by the storm, to rigorously test MDFT vs. group CBT in a real-world service setting. This randomized controlled trial has four aims: 1) To explore links between hurricane-related stress and trauma and youths’ substance abuse; 2) To investigate in a community-based randomized controlled trial the effectiveness of a family-based intervention (MDFT) vs. group CBT for teen substance abusers impacted by Hurricane Katrina; 3) To examine teen and parent coping as mediators of treatment effects; and 4) To explore moderators of treatment effects based on post-Katrina stress and trauma symptoms. 150 youth ages 13 to 17 who are clinically referred for outpatient substance abuse treatment and experiencing trauma symptoms related to the hurricane will be randomized to either MDFT or group CBT. Both treatments will incorporate trauma-focused interventions and will be delivered by treatment providers in the same community-based agency. A multiple time point (intake, 2, 4, 6, and 12 months), multiple-domain and method assessment approach will evaluate MDFT’s capacity to: (1) decrease youths’ substance use, trauma, delinquency, and school problems; (2) reduce youths’ diagnoses of PTSD; and (3) reduce parental stress and family conflict. Latent growth curve modeling will be used to test study hypotheses regarding treatment outcomes, youth and parent coping as treatment mediators, and post-Katrina stress and trauma as moderators of treatment effects. The study has significant potential to advance the field by validating a promising family-based intervention for traumatized adolescent substance abusers in the wake of the nation’s most catastrophic disaster to date.


Long-Term Outcomes of Adolescents in Drug Treatment

NIDA, Grant # 1R01 DA15412-01

H. Liddle, G. Dakof, & M. French
This project entails the first controlled long-term study of two state-of-the-science, commonly-practiced treatment modalities for adolescent drug abuse--intensive family-based treatment and residential treatment. This study will follow 140 adolescents and their parents randomized to either outpatient or residential treatment. Youth and their parents/guardians will be assessed at 2, 3, and 4- year follow-up periods on a range of drug use, family and psychosocial functioning, as well as economic evaluation measures. The study has three aims: (a) to compare the long term effectiveness of residential treatment with outpatient, family-based treatment; (b) to examine the relationships among predictors and outcome variables during the four-year post intake period; and (c) to contrast the total and net long-term monetary benefits of the residential treatment and the outpatient family based treatment.     

Brief Family-Based Therapy for Adolescent Drug Abuse

NIH, Grant # 1R01 DA15995-01

H. Liddle, C. Rowe, & G. Dakof
This study is a 3-year treatment development study in which we will develop and evaluate through an iterative process a brief, prescriptive, 6-session, family-based therapy for adolescent drug abusers that is specifically intended to be community-friendly.  This treatment will be a brief therapy adaptation of MDFT.  As part of the proposed project, a therapy manual for this brief version of the treatment (MDFT-B) and associated training materials, suitable for use with community-based drug counselors will be produced.  Therapist adherence and competence measures also will be developed.  This will be followed by a randomized, controlled pilot study of 70 adolescent drug abusers and their families, in which we will test the acceptability and efficacy of MDFT-B versus Community Treatment As Usual (CTAU), and examine predictors of outcome in both.  The study could produce one of the first brief, family-based therapies for adolescent drug abusers and yield findings that would have significant implications for technology transfer efforts.

"Engaging Mom's": An Intervention for Family Drug Court

NIDA, 1 R01 DA016733-01

G. Dakof & A. Frank
In response to the growing need for efective family drug court interventions and empirical investigation of their outcomes, this study is a treatment development project exploring the use of a promising family-based intervention, the Engaging Mom's Program (Dakof et al., in press), within the family drug court context.  This project has four primary aims: (1) develop a manualized, court-based family intervention, the Engaging Mom's Program (EMP), as an alternative to standard family drug court case management services, (2) develop training manuals and materials, (3) develop adherence/competence measures, and (4) experimentally compare, in a randomized pilot study, acceptability and efficacy of the Engaging Mom's Program versus standard family drug court case management services.  the pilot test will be carried out in the real-world setting of family drug court, using existing drug court staff to deliver the court-based interventions.  The study will be one of the first scientific investigations of family drug court and has the potential to make a major contribution to the enhancement of family drug court programs, and can provide the foundation for a full-scale randomized clinical trial.

Training Clinicians in Empirically Based Family Therapy

NIDA, Grant # 1 R01 DA016969-01

H. Liddle, A. Frank, C. Rowe, & B. Issenberg  
This four-year study aims to develop a theory-based, multicomponent community therapist training system (CTTS) that will teach and foster competence among community drug treatment providers in the application of MDFT. The study will pilot test the feasibility, acceptability and impact of the CTTS in changing provider practices and client outcomes. An innovative aspect of the project is the plan to use new technologies (CD-ROM and PDA) to supplement existing training methods in order to facilitate the learning, mastery, and continued use of the manualized treatment following training.  A total of 40 community therapists and 10 program directors from 10 drug abuse treatment sites will receive training in MDFT. Using an interrupted time series design, we will examine changes in therapist practice patterns and client outcomes in relation to training by means of the CTTS. The study consists of four phases: (1) Baseline, in which we will develop the training system and collect baseline data on clinicians' practice patterns and case outcomes; (2) Training, in which we will evaluate the feasibility and acceptability of the CTTS with therapists and program directors; (3) Implementation, in which providers' practices and case outcomes will continue to be tracked to evaluate the impact of training effects after MDFT experts withdraw; and (4) Revision, which will consist of revision of the CTTS based on feedback from previous phases.

Criminal Justice Drug Abuse Treatment Studies (CJ-DATS)

NIDA, Grant # 1 U01 DA016193-01

H. Liddle, G. Dakof, C. Rowe, & C. Henderson  
The Center for Treatment Research on Adolescent Drug Abuse (CTRADA) is one of nine research centers selected for Criminal Justice Drug Abuse Treatment Studies (CJ-DATS), a new NIDA funded national effort investigating novel solutions to habitual drug use among juvenile offenders. The overarching aim of CJ-DATS is to establish a research infrastructure that will develop, test, and transport practical models of an integrated service delivery approach for individuals with drug abuse and addictive disorders who are in juvenile justice facilities or are transitioning back into the community. The ultimate objective is to ameliorate drug abuse and addiction among adolescents involved in the criminal and juvenile justice systems, and to prevent recidivism.

CTRADA's mission under the CJ-DATS grant: (1) to support scientifically rigorous multisite studies focusing on integrating during- and post-incarceration drug abuse treatment systems with juvenile justice systems, (2) to encourage research on understudied or alternative treatment approaches for this population, (3) to encourage research on the organizational processes needed to integrate community-based treatment and juvenile justice requirements, (4) to support research on continuity of care models for transitioning juvenile offenders, including mental health services and services for other problems such as HIV/AIDS, (5) to support research on how treatment effectiveness is achieved, and (6) to foster collaboration of treatment providers, juvenile justice professionals, and researchers to provide opportunities for education and knowledge exchange/dissemination.

Family-Based Juvenile Drug Court Services

NIDA, Grant # 1 R01 DA017478-01

G. Dakof, H. Liddle, C. Rowe, & C. Henderson
This study represents one of the first attempts to scientifically investigate the process and outcomes of juvenile drug court. The study addresses several gaps in the knowledge base on juvenile drug courts by examining the extent to which MDFT can improve existing court services by increasing drug court graduation rates; decreasing drug use, delinquent behavior, and arrests; and improving school and vocational outcomes. The study design is a fully randomized controlled trial that compares the acceptability, efficacy, and benefit-cost of two different juvenile drug court models, MDFT and an individual and peer focused drug treatment intervention, both integrated with existing core juvenile drug court services. In addition, JDC will investigate mechanisms of change by which both drug court models achieve their effects.


Testing an Empirically-Supported Family-Based Therapy

NIDA, Grant # R01 DA016969

H. Liddle        

This supplement provides a unique opportunity to test the transfer of the U.S.-based treatment into practice settings in the Netherlands, and to test the clinical effectiveness of the transported treatment