The FCT Model
Development of Family Centered Treatment
Since its beginnings, Family Centered Treatment has been based on Best Practice standards that guide the development and delivery of service:
- Home based intervention is among the most accessible, responsive, timely and intense forms of treatment.
- Interventions are delivered in the client's home and community.
- The client is the family unit, not the individual.
- Services include working with the community system to access local support resources.
- The program is committed to family preservation and reunification unless it's not in the child's best interest.
- The hours are flexible to meet the family’s needs and 24-hour crisis intervention is provided.
- Services are multifaceted: counseling, skills training, interventions, resource coordination and more.
- Intensity and duration of services are customized for each client.
- Staff members carry small caseloads to permit more interaction with each family.
- The home-based clinician and the family share a uniquely close, intense and personal relationship.
- The program is committed to empowering families to set and achieve their own goals.
- The services use a wide range of research-based interventions.
- Participatory assessments permit the family to be in charge of the process.
- Families in crisis receive services within 48 hours of referral.*
*Service response time from referral can be less depending on program specifications.
While Family Centered Treatment integrates elements of several evidence based theoretical models, two in particular form its foundation: Eco-Structural Family Therapy and Emotionally Focused Therapy. Both rely upon changing the emotional tone and interaction patterns among family members.
The Eco-Structural Family Therapy model is based upon Salvador Minuchin’s work (1981) and has been expanded by Aponte (1994), Szapocznik (2000), and Lindblad-Goldberg (1997) to incorporate the environment or larger social context of the family (Bronfenbrenner, 1977). The model most researched derived from the Eco-Structural agenda is the Brief Strategic Family Therapy (BSFT) (Szapocznik, 2000).
The other major theory that influenced the development of Family Centered Treatment is Emotionally Focused Therapy (EFT) (Johnson, 2000). EFT is defined as a systemic model, relying heavily on Structural Family Therapy and particularly the practice of enactments.
FCT has developed its process into a focus for the family to restructure critical areas of functioning and to utilize emotion to build attachments. Both attachment and eco-structural theory stress the importance of emotional experience and expression. Getting to the functions of behaviors rather than simply treating the symptoms is at the crux of FCT and an important reason why the model is effective with clients/families with histories of trauma and with diagnosis.
Additional influences for Family Centered Treatment have been derived from the peers helping peers models that focus upon effective connection and engagement based upon conveying a sense of worthiness, dignity, and respect. These core values drive practical behaviors required of staff and are necessary to form an effective therapeutic alliance (Brendtro, Brokenleg, & Bocken 1990, 2002).
HOW FCT IS DIFFERENT
Distinctive to Family Centered Treatment (FCT) is the fact that it was largely developed by practitioners for inclusion in the behavioral and mental health array of services. Family and clinicians’ feedback, along with research findings, allow for innovation and up-to-date practices that adjust to meet families’ needs in the current world. For over 25 years, FCT has been advanced by these insights to bring a collective knowledge of “what works and what doesn’t work” to deliver family driven positive outcomes. Simply put, this means that most models were designed in a controlled setting, and then field tested. Family Centered Treatment was designed from experience then refined into a researched evidence based model. A truly remarkable accomplishment!
While there are many unique aspects to the FCT model, the Valuing Changes phase of treatment is perhaps the most significant. Most home-based models are ready to close services once the client demonstrates the changes in behaviors that prompted the referral. Conversely, FCT sees this as a crucial turning point and involves broadening treatment beyond conformity and compliance. This phase, while challenging for families and therapists alike, is idiosyncratic for FCT because it examines the following question: does the family “value” the changes they are making?
FCT recognizes that this Valuing Change phase is critical if the changes made during treatment are to be sustained after treatment has ended. Also integral to this phase is a process identified as the “power of giving” in which FCT works to position families to give to others as a method for discovery of their inherent worth and dignity.
There are so many more ways that FCT stands out as a unique model, including but not limited to it systemic trauma treatment focus, the structured implementation process and its constant focus on seeing the family as a whole as the client. Please contact us today to learn more about how we uniquely approach working with families!
The Four Phases
The core practice components required by practitioners of Family Centered Treatment have evolved dramatically since the inception of the model in 1988. This has occurred because the key components of the model have been developed or integrated as front line practitioners’ experiences precipitated changes or additions.
Read more about the Four Phases of the FCT methodology on our Four Phases page.