1. The MDFT Model And Some Notes on Germany Andreas Gantner

2. Multidimensional Family Therapy MDFT is a family based outpatient treatment, developed for adolescents with substance use and behavioural problems Tested in the USA since 1985 Developers are at the Center for Treatment Research on Adolescent Drug Abuse (CTRADA), University of Miami. Director: Howard Liddle

3. Multidimensional Family Therapy – Roots, theory and focus MDFT Adolescent development Developmental psychopathology Risk and protective factors Ecology dimension Family Therapy (Minuchin/Haley) Other therapeutic models: Rogers/CBT

4. General Approach in MDFT Substance use related problems of adolescents are mostly multidimensional, i.e., part of more general trouble Multidimensional problems require multiple targets of change, with a varying set of interventions, in a variety of contexts and settings.

5. Intervention Targets of MDFT MDFT is focusing on four ‘life domains’, or target areas. Some interventions are intrapersonal, others are interpersonal Adolescents Attitudes and Behaviour Parents Attitudes and Parenting practices Family Functioning, Relationships Ecological/Social context Extrafamiliar influences

6. Stages of Treatment The “four corners” of MDFT are worked on in three stages : Stage 1: Build the foundation: Alliance and Motivation Stage 2: Requests For Change Stage 3: Seal Changes and Exit The therapist works the “four corners” through all stages of treatment.

7. MDFT Principles/Requirements (1) Therapy Sessions and Settings Combination of individual sessions (adolescent, parent), family sessions and sessions with relevant persons outside the family. Sessions are conducted at the institute as well as at home or other places. No session time limits. Phone calls are important part of the interventions. Frequency and Duration of MDFT treatment 1 to 4 sessions/contacts weekly in varying settings, 4 to 6 months

8. MDFT Principles/Requirements (2) MDFT Forms Case Conceptualization Form, Therapist Session Planning Sheet, Treatment Contact Log MDFT Supervision Weekly team supervision, individual supervision, live supervision, videotape reviews

9. Some Principles of MDFT Every Assessment Is An Intervention & Every Intervention Is An Assessment Development and Maintenance of Multiple Therapeutic Alliances (Youth, Parent, Other persons) Motivation Not Assumed to be Present In Adolescents or Parent(s)

10. Some Principles of MDFT Identify and enlarge upon Strengths & Competencies Planning and Flexibility Are Necessary Complementary Components: Read client feedback and shift focus, when necessary, to respond to clients needs and concerns

11. Some Principles of MDFT Therapist behaviour is fundamental to success: Comfortable working in “close proximity” “Do what it takes” attitude Focus on outcomes to be achieved

12. German TAU is called „JUP“ Youth Psychotherapy for Cannabis Clients Based on specific child and youth psychotherapy According to the law (KJHG,SGBVIII) Psychotherapy is part of rehabilitation/help for education (Target group specific approach since 2000 in Therapieladen e.V. Restraints on JUP in INCANT Setting: Individual therapy with additional counselling of parents Frequency: 1 session weekly with youth, about 1 session monthly with parents. Duration: 8 to max. 9 months Supervision/Intervision : weekly 2 hours

13. General approach of JUP Integrative Psychotherapy approach Client-centred Psychotherapy Cognitive Behavioural Therapy (CBT) Motivational Interviewing (MI) drug- and addiction-specific oriented, including co- morbidity based on developmental psychology integrated in the pedagogic/educational context

14. Record so far in Germany Recruitment 26 Clients included (12 MDFT/14 JUP) Age Range 14 - 18 years, Ø 16,5 years Gender 21 male, 5 female Living situation 15 living in family, 11 living outside family (youth care) Clinical Severe co-morbidity Very low treatment motivation (adolescent and parents)

15. Thank you for your attention www.incant.de www.incant.eu