Liddle, H. A., Dakof, G. A., Parker, K., Diamond, G. S., Barrett, K., & Tejeda, M. (2001). Multidimensional Family Therapy for adolescent drug abuse: Results of a randomized clinical trial. American Journal of Drug & Alcohol Abuse, 27(4), 651–688. https://doi.org/10.1081/ADA-100107661

Type of Study: Randomized controlled trial
Number of Participants: 182

Population:

• Age — 13–18 years
• Race/Ethnicity — 51% White/Non-Hispanic, 18% African American, 15% Hispanic, 10% Other, and 6% Asian
• Gender — 80% Male and 20% Female
• Status — Participants were youths and their families who were referred from the juvenile justice system and secondarily through schools and health and mental health agencies.

Location/Institution: San Francisco/University of California, San Francisco; San Francisco Bay Area/various community-based clinics; Miami/University of Miami Miller School of Medicine

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the effectiveness of Multidimensional Family Therapy (MDFT) compared to other intervention groups. Participants were randomized into one of three conditions: MDFT, adolescent group therapy (AGT), and multifamily educational intervention (MEI). Measures utilized include adolescent self-report, collateral report (parent report), and urinalysis to assess drug use. Other dimensions measured included family functioning, school performance measured through grade point average (GPA), and problem behaviors measured using the Acting Out Behaviors (AOB) Scale. Results indicate that at termination, 42% of the youths who received MDFT, in comparison to 25% in AGT and 32% in MEI, reported clinically significant reductions in drug use. At the 1-year follow-up, 45% in MDFT, 32% in AGT, and 26% in MEI demonstrated clinically significant changes in that their drug use was below the initial treatment entry criteria. Additionally, those in the MDFT condition showed considerable improvement in school performance. At intake, only 25% of the youths assigned to MDFT had GPAs of 2.0 (C average) or better, while 43% of AGT youths, and 36% of MEI youths had GPAs of 2.00 or better. One year after treatment, 76% of the youths in the MDFT treatment condition had a C average or better, while 60% of AGT, and 40% of MEI youths had a C average or better. There were no differences between the three groups on acting out behaviors. Limitations include a predominantly male and white sample, as well as the use of self-report in assessing drug use.

Length of controlled postintervention follow-up: 6 and 12 months.

Dennis, M. L., Godley, S. H., Diamond, G. S., Tims, F. M., Babor, T., Donaldson, J., Liddle, H., Titus, J., Kaminer, Y., Webb, C., Hamilton, N., & Funk, R. (2004). The Cannabis Youth Treatment (CYT) study: Main findings from two randomized trials. Journal of Substance Abuse Treatment, 27(3), 197–213. https://doi.org/10.1016/j.jsat.2003.09.005

Type of Study: Randomized controlled trial
Number of Participants: 600

Population:

• Age — 13–18 years
• Race/Ethnicity — 61% Caucasian/White, 30% African American/Black, 6% Other/Mixed, and 4% Hispanic/Latino
• Gender — 83% Male
• Status — Participants were adolescents and their families who were recruited from sequential admissions to 4 treatment sites

Location/Institution: University of Connecticut Health Center (UCHC), Operation PAR, Chestnut Health Systems (CHS), and Children’s Hospital of Philadelphia (CHOP).

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to present the main outcome findings from two inter-related randomized trials conducted at four sites to evaluate the effectiveness of five short-term outpatient interventions including Multidimensional Family Therapy (MDFT) for adolescents with cannabis use disorders. Participants were randomized from sequential admissions to four treatment sites. It was not logistically feasible to implement all five conditions in any one site because of the limits of case flow and resources. Therefore, adolescents were randomly assigned within each site to one of three treatment conditions, and the interventions were evaluated in two trials. Trial 1 compared Motivational Enhancement Therapy and Cognitive Behavioral Therapy – 5 Sessions (MET/CBT5) with a 12-session regimen of MET and CBT (MET/CBT12) and another that included family education and therapy components (Family Support Network [FSN]). Trial II compared the Motivational Enhancement Therapy and Cognitive Behavioral Therapy – 5 Sessions (MET/CBT5) with the Adolescent Community Reinforcement Approach (A-CRA) and MDFT. Measures utilized include participant interviews, collateral interviews, self-reports using Global Appraisal of Individual Needs (GAIN), urine tests, and the Drug Abuse Treatment Analysis Program (DATCAP) supplemented with service logs. Results indicate that all five Cannabis Youth Treatment (CYT) interventions demonstrated significant pre-post treatment improvements during the 12 months after random assignment in the two main outcomes: Days of abstinence, as measured by self-reports using Global Appraisal of Individual Needs (GAIN) (a standardized semi-structured interview), and the percent of adolescents in recovery (no use or abuse/dependence problems and living in the community). Overall, the clinical outcomes were very similar across sites and conditions. Limitations include reliance on participant self-report and the lack of a no-treatment control group.

Length of controlled postintervention follow-up: 38–46 weeks.

Liddle, H. A., Rowe, C. L., Ungaro, R. A., Dakof, G. A., & Henderson, C. (2004). Early intervention for adolescent substance abuse: Pretreatment to posttreatment outcomes of a randomized controlled trial comparing Multidimensional Family Therapy and peer group treatment. Journal of Psychoactive Drugs, 36(1), 49–63. https://doi.org/10.1080/02791072.2004.10399723

Type of Study: Randomized controlled trial
Number of Participants: 80

Population:

• Age — 11–15 years
• Race/Ethnicity — 42% Hispanic, 38% African American, 11% Haitian or Jamaican, 4% Other, and 3% Non-Hispanic White
• Gender — 58 Male and 22 Female
• Status — Participants were referred for substance abuse and behavioral problems from juvenile justice, the school system, or other sources such as family.

Location/Institution: Miami FL, Village, Inc. and University of Miami Miller School of Medicine

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate a family-based therapy – Multidimensional Family Therapy (MDFT) and a peer group therapy with urban, low-income adolescents. Participants were randomly assigned to either MDFT or group therapy and reassessed at 6 weeks after intake and at discharge. Measures utilized include the Global Appraisal of Individual Needs (GAIN), the Youth Self-Report (YSR) of the Child Behavior Checklist, the Family Environment Scale (FES), and the Timeline Follow-Back Method (TFLB) as adapted for adolescents, which obtains self-reports of daily substance use. Results indicate that MDFT was significantly more effective than peer group therapy in reducing risk and promoting protective processes in the individual, family, peer, and school domains, as well as in reducing substance use over the course of treatment. Externalizing symptoms decreased more rapidly in the MDFT group than the comparison group, and there was no difference on internalizing symptoms. Limitations include the self-report nature of assessing the youths’ drug use and family problems, as well as the questionable generalizability of the sample, which was low-income, urban, and consisted primarily of males from ethnic minorities.

Length of controlled postintervention follow-up: None.

Liddle, H., Dakof, G., Turner, R., Henderson, C., & Greenbaum, P. (2008). Treating adolescent drug abuse: A randomized trial comparing Multidimensional Family Therapy and cognitive behavior therapy. Addiction, 103(10), 1660–1670. https://doi.org/10.1111/j.1360-0443.2008.02274.x

Type of Study: Randomized controlled trial
Number of Participants: 224

Population:

• Age — 12–17.5 years
• Race/Ethnicity — 72% African American, 18% White (Non-Hispanic), and 10% Hispanic
• Gender — 81% Male and 19% Female
• Status — Participants were referred to the study from a variety of sources, including the juvenile justice system, child welfare service agencies, schools, and other sources.

Location/Institution: Philadelphia, PA/Temple Teen Care (University Based Community Clinic), Temple University

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare Multidimensional Family Therapy (MDFT) with an individual Cognitive-Behavioral Therapy (CBT) approach. Participants were randomized in block procedure to either MDFT or to CBT. Each block consisted of a random ordering of each treatment twice (four slots per block, two for MDFT and two for CBT for a total of 56 blocks). Measures utilized include the Personal Experience Inventory (PEI) and the Timeline Followback (TLFB) method. Results indicate that both MDFT and CBT were efficacious treatment methods, but MDFT was superior to CBT in decreasing drug abuse problem severity. Additionally, when looking at a measure that assessed functional impairment due to drug use, youth receiving MDFT had better results than those who received CBT. Twelve months following intake, participants who received MDFT decreased their frequency of other drug use by 77%, while CBT recipients increased their frequency of using these substances. MDFT was able to maintain symptomatic reductions at 6- and 12-months posttreatment. Limitations include the questionable generalizability of the data, given that the sample was comprised of mostly African American males, as well as the reliance on self-report, lack of urinalysis in assessing drug use, and that the findings may be subject to Type I error.

Length of controlled postintervention follow-up: 6 and 12 months.

Liddle, H., Rowe, C., Dakof, G., Henderson, C., & Greenbaum, P. (2009). Multidimensional Family Therapy for young adolescent substance abuse: Twelve-month outcomes of a randomized controlled trial. Journal of Consulting & Clinical Psychology, 77(1), 12–25. https://doi.org/10.1037/a0014160

Type of Study: Randomized controlled trial
Number of Participants: 83

Population:

• Age — 11–15 years
• Race/Ethnicity — 42% Hispanic, 38% African American, 11% Haitian or Jamaican, 4% Other, and 3% White (Non-Hispanic)
• Gender — 74% Male and 26% Female
• Status — Participants were referred primarily from juvenile justice and school for outpatient treatment for high risk behaviors including substance use.

Location/Institution: Miami FL, The Village South, Inc. and the University of Miami Miller School of Medicine

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare Multidimensional Family Therapy (MDFT) and a peer group intervention in young teens. Participants were randomly assigned to either peer-group therapy or MDFT. Measures utilized include the Timeline Followback (TFLB) method and the Problem-Oriented Screening Instrument for Teenagers (POSIT). Results indicate that both treatments demonstrated higher than average treatment retention rates (97% for MDFT and 72% for group treatment). From intake to 12 months later, youths in MDFT demonstrated more improvement than those in peer group therapy in substance use, delinquency, internalized distress, affiliation with delinquent peers, and family and school functioning. Participants in the MDFT condition reported fewer days of substance use as well as a tendency to report increased abstinence from drugs and alcohol. Limitations of the study include the sample being predominantly comprised of African American and Hispanic youths, as well as the overall small sample size. Also, the use of self-report in measuring substance abuse may be a limiting factor.

Length of controlled postintervention follow-up: 6–9 months.

Rigter, H., Henderson, C. E., Pelc, I., Tossmann, P., Phan, O., Hendriks, V., Schaub, M., & Rowe, C. L. (2013). Multidimensional Family Therapy lowers the rate of cannabis dependence in adolescents: A randomised controlled trial in Western European outpatient settings. Drug and Alcohol Dependence, 130(1–3), 85–93. https://doi.org/10.1016/j.drugalcdep.2012.10.013

Type of Study: Randomized controlled trial
Number of Participants: 450

Population:

• Age — 13–18 years
• Race/Ethnicity — Not specified though 40% were of first- or second-generation foreign descent
• Gender — 85% Male
• Status — Participants were youth with a cannabis use disorder.

Location/Institution: Various sites in Western Europe

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to test the effectiveness of Multidimensional Family Therapy (MDFT) in adolescent youth recently diagnosed with Cannabis Use Disorder in several Western European countries as part of a trans-national study. Participants were randomly assigned to MDFT or to Individual Psychotherapy (IP). Measures utilized include the Adolescent Diagnostic Interview-Light (ADI-Light for cannabis). Results indicate that positive outcomes were found in both the MDFT and IP conditions. MDFT outperformed IP on the measures of treatment retention and prevalence of cannabis dependence, MDFT reduced the number of cannabis consumption days more than IP in a subgroup of adolescents reporting more frequent cannabis use at baseline, and MDFT exceeded IP in decreasing the prevalence of cannabis dependence. Limitations include the lack of long-term follow-up and lack of generalizability to other ethnic groups.

Length of controlled postintervention follow-up: Unclear (3, 6, 9 and 12 months after baseline results reported, but length of treatment is not clear).

Schaub, M. P., Henderson, C. E., Pelc, I., Tossman, P., Phan, O., Hendriks, V., Rowe, C., & Rigter, H. (2014). Multidimensional Family Therapy decreases the rate of externalising behavioural disorder symptoms in cannabis abusing adolescents: outcomes of the INCANT trial. BMC Psychiatry, 14, Article 26. https://doi.org/10.1186/1471-244X-14-26

Type of Study: Randomized controlled trial
Number of Participants: 450

Population:

• Age — 13–18 years
• Race/Ethnicity — Not specified
• Gender — Not specified
• Status — Participants were youth involved in the INCANT project with a cannabis use disorder.

Location/Institution: Berlin, Brussels, Geneva, The Hauge, and Paris

Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as Rigter et al. (2013). The purpose of the study was to compare Multidimensional Family Therapy (MDFT) with individual therapy (IP). Participants were randomized to either MDFT or to IP control. Measures utilized include the Timeline Followback (TLFB), the Youth Self Report (YSR), the Child Behavior Checklist (CBCL), and the Family Environment Scale (FES). Results indicate that MDFT and IP groups improved on all outcome measures. Models including treatment, site, and referral source showed that MDFT outperformed IP in reducing externalizing symptoms. Both MDFT and IP reduced the rate of externalizing and internalizing symptoms and improved family functioning among adolescents with a cannabis use disorder, while MDFT outperformed IP in decreasing the rate of externalizing symptoms. Limitations include the reliance on self-reported measures and concerns about the generalizability to other substance disorders.

Length of controlled postintervention follow-up: Approximately 6 months.

Dakof, G. A., Henderson, C. E., Rowe, C. L., Boustani, M., Greenbaum, P. E., Wang, W., Linares, C., & Liddle, H. A. (2015). A randomized clinical trial of family therapy in juvenile drug court. Journal of Family Psychology, 29(2), 232–241. https://doi.org/10.1037/fam0000053

Type of Study: Randomized controlled trial
Number of Participants: 112

Population:

• Age — 13–18 years
• Race/Ethnicity — 59% Hispanic and 35% African American
• Gender — 88% Male
• Status — Participants were youth involved in juvenile district court.

Location/Institution: State of Florida 11th Judicial Circuit Juvenile Court in Miami-Dade County

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to examine the effectiveness of two theoretically different treatments delivered in juvenile drug court, Multidimensional Family Therapy (MDFT) and adolescent group therapy (AGT) on offending and substance use. Participants were randomly assigned to either MDFT or AGT groups. Measures utilized include the Diagnostic Interview Schedule for Children, Second Edition (DISC-2) and the National Youth Survey (NYS), Self-Report Delinquency Scale (SRD). Results indicate that youth in both treatments showed significant reductions in delinquency, externalizing symptoms, rearrests, and substance use. At 24-month follow-up, MDFT showed greater maintenance of treatment gains than AGT for externalizing symptoms, commission of serious crimes, and felony arrests. There was no significant difference between the treatments with respect to substance use or misdemeanor arrests. Limitations include that there was no comparison with youth in a non-drug court setting, concerns about generalizability to other jurisdictions given variability between drug courts, and the small sample size.

Length of controlled postintervention follow-up: 6, 12, 18, and 24 months.

Liddle , H. A., Dakof, G. A., Rowe, C. L., Henderson, C., Greenbaum, P., Wang, W., & Alberga, L. (2018). Multidimensional Family Therapy as a community-based alternative to residential treatment for adolescents with substance use and co-occurring mental health disorders. Journal of Substance Abuse Treatment, 90, 47–56. https://doi.org/10.1016/j.jsat.2018.04.011

Type of Study: Randomized controlled trial
Number of Participants: 113

Population:

• Age — 13–18 years (Mean=15.4 years)
• Race/Ethnicity — 68% Hispanic, 18% African American, and 13% White, Non-Hispanic
• Gender — 75% Male and 25% Female
• Status — Participants were youth referred to a residential treatment center diagnosed with a substance use disorder and at least one comorbid psychiatric disorder.

Location/Institution: Florida

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to compare Multidimensional Family Therapy (MDFT) with residential treatment (RT) for adolescents with co-occurring substance use and mental health disorders on substance use, delinquency, and mental health symptoms. Participants were randomly assigned to either MDFT in the home/community or RT. Measures utilized include the Personal Experience Inventory (PEI), the Timeline Follow-Back Method (TLFB), the National Youth Survey (NYS) Self Report Delinquency Scale (SRD), and the Youth Self-Report (YSR). Results indicate that during the early phase of treatment (baseline to 2 months), youth in both treatments showed significant reductions in substance use and that youth receiving MDFT reported significantly greater reductions in internalizing symptoms than youth receiving RT. In phase 2, from 2 to 18 months after baseline, youth in MDFT maintained their early treatment decreases in substance use problems, frequency of use, and delinquent behaviors more effectively than youth in RT. During this period, there were no significant treatment differences in maintenance of gains for externalizing and internalizing symptoms. Limitations include limited generalizability to other treatment programs and samples due to the sample being primarily male and Hispanic, youth who met eligibility criteria for the study may not have been as severe as all youth referred for residential treatment nationwide as well as to other treatment programs, and the small sample size.

Length of controlled postintervention follow-up: Average 11.5 months.

Nielsen, P., Christensen, M., Henderson, C., Liddle, H. A., Croquette-Krokar, M., Favez, N., & Rigter, H. (2021). Multidimensional Family Therapy reduces problematic gaming in adolescents: A randomised controlled trial. Journal of Behavioral Addictions, 10(2), 234–243. https://doi.org/10.1556/2006.2021.00022

Type of Study: Randomized controlled trial
Number of Participants: 42

Population:

• Age — Mean=14.9 years
• Race/Ethnicity — Not specified
• Gender — 98% Male
• Status — Participants were 12–19-year-old adolescents meeting at least 5 of the 9 DSM-5 IGD criteria and with at least one parent willing to participate in the study.

Location/Institution: Centre Phenix-Mail, Geneva

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to evaluate Multidimensional Family Therapy (MDFT) and family therapy as usual (FTAU) on their impact on the prevalence of Internet Gaming Disorder (IGD) and IGD symptoms. Participants were randomized to either MDFT or FTAU. Measures utilized include Petry’s DSM-5 based IGD scale, the Timeline Followback (TLFB) method, and the Abbreviated Self Completion Teen-Addiction Severity Index. Results indicate that both family therapies decreased the prevalence of IGD across the one-year period, both therapies lowered the number of IGD criteria met, with MDFT outperforming FTAU, and there was no effect on the amount of time spent on gaming. At baseline, parents judged their child’s gaming problems to be important whereas the adolescents thought these problems were minimal. This discrepancy in judgment diminished across the study period as parents became milder in rating problem severity. Finally, MDFT better retained families in treatment than FTAU. Limitations include the small sample size and the lack of examination of treatment integrity.

Length of controlled postintervention follow-up: 6 and 12 months