Voluntary uptake and continuation of treatment among court-involved youth: Lessons learned from the implementation of Functional Family Therapy in a community setting

Functional Family Therapy (FFT) is generally recognized as an effective intervention for court-involved youth. Relatively few studies, however, have focused on the delivery of FFT among youth offenders, especially among older minority youth located at the “deep end” of the juvenile justice system. This research adds to this sparse literature by focusing on the voluntary uptake and continuation of FFT among such youth (N = 60) in Lucas County, Ohio. Most of these youth were Black males nearing adult age who were referred to FFT while in residential placement or on probation. Getting these youth to start and advance in therapy proved a considerable challenge, with only 28% of referred youth making it to the final phase of FFT. Multiple group meetings and an interview with court and treatment practitioners brought to light various factors viewed by these personnel as inhibiting uptake and retention. These factors serve as potential lessons that other jurisdictions can learn from and have implications for future research on FFT that are discussed. These lessons learned include (1) setting an expected rate of uptake and retention that reflects the risk profile of referred youth; (2) considering whether to deliver FFT alone or in combination with other services; (3) devising ways to incentivize uptake and retention; (4) formalizing FFT eligibility or referral criteria; and (5) weighing whether to exclude certain youth or families from FFT due to factors such as guardian turnover.