Multidimensional Family Therapy (MDFT) for Young People in Treatment for Non-opioid Drug Use: A Systematic Review

BACKGROUND Youth drug abuse is a severe problem worldwide, and the use of cannabis, amphetamine, ecstasy and cocaine (referred to here as non-opioid drugs) is strongly associated with a range of health and social problems. This review focuses on drug abuse that is severe enough to warrant treatment. The population of interest is young people who are receiving MDFT specifically for non-opioid drug abuse. MDFT is a manual-based family therapy approach that focuses on individual characteristics of the young person, the parents, and other key individuals in the young person's life, as well as on the relational patterns contributing to the drug abuse and other problem behaviors. A variety of therapeutic techniques are used to improve the young person and the family's behaviors, attitudes, and functioning across the variety of domains. MDFT aims to reorient the young person and his/her family towards a more functional developmental trajectory based on key principles that include: 1) Individual biological, social, cognitive, personality, interpersonal, familial, developmental, and social ecological aspects can all contribute to the development, continuation, worsening and chronicity of drug problems; 2) The relationships with parent(s), siblings and other family members are fundamental domains of assessment and change; 3) Change is multifaceted, multi-determined and relates to the youths' cognitive and psychosocial developmental stages; 4) Motivation is not assumed, but is malleable; and motivating the young person and his or her family members about treatment participation and change is a fundamental therapeutic task; 5) Multiple therapeutic alliances are required to create a foundation for change; and 6) Therapist responsibility and attitude is fundamental to success (Liddle, 2010). OBJECTIVES The main objectives of this review are to evaluate the current evidence on the effects of MDFT on drug abuse reduction for young people (aged 11-21 years) in treatment for non-opioid drug abuse, and if possible to examine moderators of drug abuse reduction effects, specifically analysing whether MDFT works better for particular types of participants. SEARCH STRATEGY An extensive search strategy was used to identify qualifying studies. Searches were run in October 2014. A wide range of electronic bibliographic databases were searched along with government and policy databanks, grey literature databases, citations in other reviews and the included primary studies, hand sear