Family Behavior Therapy

Family Behavior Therapy (FBT) has been effectively applied to treat substance use issues and co-occurring problems amongst both adolescents and adults. Child mistreatment, depression, unemployment, poor attendance at school or work, conduct disorders, and family conflict are some of the co-occurring issues that FBT targets. It is a form of outpatient treatment that is most often implemented as a step towards long-term recovery following detoxification. As the name suggests, FBT engages families to work together to use the strategies outlined in therapy in creating a more supportive and healthy home environment.

Program Characteristics

Family Behavior Therapy is based on something called the Community Reinforcement Approach. Patients must attend therapy sessions with a significant other, such as a parent if the participant is under the age of eighteen or a spouse or live-in partner. Treatment occurs over a period of six months and includes a total of fifteen 90- or 60-minute sessions. FBT utilizes several types of interventions, including:

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  1. Behavioral contracting procedures, which allow the establishment of an environment that enables the reinforcement of positive behaviors and actions associated with sobriety.
  2. Skill-based interventions that help patients to spend less time associating with individuals and situations conducive to drug use or other problematic behaviors.
  3. Helping patients to develop the skills required to cope with and lessen urges to use the drugs or engage in other impulsive or compulsive behaviors.
  4. The development of communication skills that can help patients to establish supportive social relationships with individuals who do not use substances and to avoid substance abusers.
  5. Skills training associated with career and/or educational development.


During sessions, therapists encourage patients to identify goals that will help them to avoid substance use and related behaviors. Therapists help patients to develop a contingency management system that uses rewards to promote good behavior. Patients who are also parents are encouraged to set goals related to becoming better parents. Each session involves a review of the behavioral goals; if they were adhered to between the sessions, the significant other provides rewards. As the program continues, participants are given more autonomy over their own treatment and are able to choose from a number of proven treatment options according to what they believe will work best for them.

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FBT is unique in that it incorporates family members in helping one individual overcome behavioral and substance abuse problems, hinging on the role of social systems in both maintaining and overcoming substance abuse. The inclusion of family members in treatment has been proven to help address multiple problems concurrently and improve motivation for change. Effectiveness has been shown in both adult and adolescent contexts. Since FBT utilizes a variety of clinical methods and forms of treatment and skill development, it can serve as a comprehensive and practical method of overcoming substance abuse. Due to the number of components included in FBT, researchers have had difficulty identifying which components are most effective and whether some might be dropped in order to maximize efficacy.