Family Behavior Therapy (FBT) for Young People in Treatment for Illicit Non-opioid Drug Use: a Systematic Review

BACKGROUND Youth drug use is a severe problem worldwide, and the use of cannabis, amphetamine ecstasy and cocaine, referred to as non-opioid drugs, are strongly associated with a range of health and social problems. This review focuses on Family Behavior Therapy (FBT) as a treatment for young people who misuse non-opioid drugs. FBT is a manual-based family therapy approach. The program is behavior and skill-oriented. It is concerned with identifying psychological and situational stimuli and triggers presumed to be directly related to the youth's drug use, and skills training to improve self-control. FBT is designed to accommodate diverse populations of youth with a variety of behavioral, cultural and individual preferences. FBT incorporates behavioral theory (reduction of undesired behavior by manipulating external reinforcement), structural family theory (in which the structure of the family influence the youth's behavior) and strategic family theory (where treatment methods are problem-focused and pragmatic). OBJECTIVES The main objective of this review is to evaluate the current evidence on the effects of FBT on reduction of drug use frequency for young people in outpatient treatment for non-opioid drug use and, if possible, to examine moderators of drug use reduction effects, specifically analyzing whether FBT works better for particular types of participants. SEARCH STRATEGY A relatively narrow search strategy to identify qualifying studies was performed. A wide range of electronic bibliographic databases were searched along with government and policy databanks, grey literature databases, citations in other reviews and in the included primary studies, hand searches of relevant journals, and Internet searches using Google. We also corresponded with researchers in the FBT field. Neither language nor date restrictions were applied to the searches. SELECTION CRITERIA Studies eligible for inclusion in the review are required to meet several eligibility criteria. Studies must: * have involved a manual-based FBT treatment for young people aged 11-21 years enrolled in outpatient treatment for non-opioid drug use; * have used experimental, quasi-experimental or non-randomized controlled designs; * have reported at least one eligible outcome variable measuring abstinence, reduction of drug use, family functioning, education or vocational involvement, retention, risk behavior or any other adverse effects; * not have focused exclusively on treating mental disorde