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<p>This article presents a comprehensive modular pathway for delivering systemic family therapy (SFT) for adolescent behavior problems (ABP). Although SFT is an evidence-based approach for adolescent conduct and substance use disorders, manualized SFT models have not been widely adopted in usual care due to the training and implementation resources required. The article begins by discussing challenges to implementing SFT in routine care and presents the core elements strategy. It then describes the rationale and procedures for developing the SFT for ABP pathway, which provides guidance for clinicians about the sequencing of core practices. The ABP pathway was developed using an iterative approach through the collaboration of family therapy and youth mental health experts with experience in modular therapy development and implementation. The final ABP pathway contains six modules comprised of 25 core practices, each of which are described in detail. The pathway begins with the Family Systems Outreach practice, followed by the Engage the Family module, which contains one submodule focused on engaging parents (Caregiver Collaboration, Love and Commitment, Caregiver Ecosystem) and another on engaging youth (Join with Adolescents, Family Goal Collaboration, Adolescent Ecosystem). Clinicians facilitate the use of the Set the Foundation module (Location of Self, Relational Reframe) in advance of proceeding to two signature SFT modules used in dynamic combination, Change Attributions (Refocus and Reframe, Goal Setting: Family Skills) and Change Interactions (Prepare, Prompt, Coach, Process). The article next describes the Improve Family Skills module that includes Family Problem Solving along with one submodule focused on parenting skills (Caregiver Monitoring, Behavior Management) and another on family communication skills (“I” Statements, Reflective Listening, Reciprocity Awareness, Positive Request, Mutual Validation). Clinicians and families wrap treatment using the Punctuate Gains module (Amplification, Coda). The article concludes with a discussion of implications for implementation, practice, and future research.</p>

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Core Practices in Systemic Family Therapy for Adolescent Behavior Problems: A Comprehensive Modular Pathway

  • 期刊论文

  • 发表日期：

    2025年4月2日

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  • Molly Bobek,
  • Aaron Hogue,
  • Nicole Porter,
  • Alex MacLean,
  • Teri Bourdeau,
  • Taya Cromley,
  • Charmaine Higa-MacMillan,
  • Taylor Thompson,
  • Janelle Wagner,
  • Eric Daleiden

摘要

This article presents a comprehensive modular pathway for delivering systemic family therapy (SFT) for adolescent behavior problems (ABP). Although SFT is an evidence-based approach for adolescent conduct and substance use disorders, manualized SFT models have not been widely adopted in usual care due to the training and implementation resources required. The article begins by discussing challenges to implementing SFT in routine care and presents the core elements strategy. It then describes the rationale and procedures for developing the SFT for ABP pathway, which provides guidance for clinicians about the sequencing of core practices. The ABP pathway was developed using an iterative approach through the collaboration of family therapy and youth mental health experts with experience in modular therapy development and implementation. The final ABP pathway contains six modules comprised of 25 core practices, each of which are described in detail. The pathway begins with the Family Systems Outreach practice, followed by the Engage the Family module, which contains one submodule focused on engaging parents (Caregiver Collaboration, Love and Commitment, Caregiver Ecosystem) and another on engaging youth (Join with Adolescents, Family Goal Collaboration, Adolescent Ecosystem). Clinicians facilitate the use of the Set the Foundation module (Location of Self, Relational Reframe) in advance of proceeding to two signature SFT modules used in dynamic combination, Change Attributions (Refocus and Reframe, Goal Setting: Family Skills) and Change Interactions (Prepare, Prompt, Coach, Process). The article next describes the Improve Family Skills module that includes Family Problem Solving along with one submodule focused on parenting skills (Caregiver Monitoring, Behavior Management) and another on family communication skills (“I” Statements, Reflective Listening, Reciprocity Awareness, Positive Request, Mutual Validation). Clinicians and families wrap treatment using the Punctuate Gains module (Amplification, Coda). The article concludes with a discussion of implications for implementation, practice, and future research.