MDFT Case Studies

Meet Isaac

Age/Gender: 17, Male
Involved Family: Mother & grandparents
Statement of Problem: Drug use since age 11 related to mental health problems including severe anxiety, depression, and PTSD symptoms stemming from exposure to domestic and community violence. Isaac was both using and selling drugs. Prior to MDFT, Isaac had several unsuccessful treatment episodes with other treatments including a residential program. He was in constant, and often violent, conflict with his mother, had few social ties, and was failing in school. Isaac had strong feelings of resentment toward his father who left him and his mother and started another family.
Strengths: Open-minded and lots of love between Isaac and his mother.

Primary Components of Treatment:

  • Improve communication between Isaac and his mother, including listening, talking in a way that they could understand each other and not get defensive, and problem solving
  • Develop Isaac’s emotional regulation skills to reduce violence and confrontational dialogue, and increase understanding by being able to listen without reactivity.
  • Help Isaac establish personally meaningful long-term goals and build self-awareness of how his continued drug use and criminality interfered with a positive life plan. Build Isaacs’s belief in himself and hope for his future
  • Improve Mom’s self care practices and help her engage in therapy for her own issues
  • Help Isaac’s mother set developmentally appropriate expectations, function as the mother in the relationship even when not feeling her best, and begin to believe in and trust Isaac

The Take-Away: Isaac's case demonstrates how MDFT’s focus on multiple domains—the youth, parent, family, and community—work synergistically to create positive change. Change in all 4 areas are necessary for deep and lasting change. In this case there was significant change within Isaac, in his mother as a person and in her parenting practices, in the relationship between Mother and son, and in how they interacted with their community and accessed critical resources and supports.

Read the full case summary.


Meet Joy

Age/Gender: 18, Female
Involved Family: Mother and stepfather (separated half-way through therapy)
Statement of Problem: Drug and alcohol addiction, depression, school failure. When Joy started in MDFT she had just flunked out of her first year of college and had a long history of substance use and depression.
Strengths: Insightful, intelligent, mature, loving family, willing/motivated to change.

Primary Components of Treatment:

  • Challenge Joy to examine the discrepancies between her dreams and goals and her current behavior, especially addressing how she would like her life to change, how she sees her parents being able to help her in that process, and developing action plans to help Joy stop using drugs and alcohol, manage her emotions, and get her life on a healthy developmental trajectory
  • Help mom and stepfather clarify their expectations for Joy and their parental roles as Joy becomes increasingly independent, mature, and responsible
  • Help parents to work more effectively as a team even when separated
  • Help Joy to develop a strong sense of self, resolve cultural identity issues, and establish a positive peer network as an emerging adult
  • Foster better communication between Joy and parents about matters of everyday life and to heal past and current hurts and resentments
  • Develop a workable plan with both Joy and parents for everyday life

The Take-Away: Joy's therapy is illustrative of the many themes that develop during the transition from adolescence into young adulthood, and describes the MDFT therapist's role in helping youth and parents work through these issues and make the many changes necessary for successful preparation for this new life stage. It is also one of many examples of how we work with parents to be a team despite conflict and separation, and how biracial youth explore identity and cultural issues with families.

Read the full case summary.


Meet James

Age/Gender: 17, Male
Involved Family: Mother
Statement of Problem: School failure and truancy, drug use, general disregard for mom’s rules. James is 17 and still in the ninth grade. Mom is at the end of her rope.
Strengths: Funny, social, well-liked by peers, strong parenting team, loving family.

Primary Components of Treatment:

  • Help mom develop skills to enable her to better regulate her emotions, and influence James in a more effective manner
  • Minimize the risk of neighborhood and negative school influences on James
  • Help James establish life goals and develop tangible steps for reaching them, including tools to help him reduce his drug use
  • Facilitate communication between James and his mother to emphasize feelings of love and concern

The Take-Away: James’ case demonstrates the importance of addressing both parental despair and hopelessness as well as parenting skills, improving the emotional relationship between mother and son, addressing neighborhood risk factors, and helping the youth discover his healthy and positive self.

Read the full case summary.


Meet Ryan

Age/Gender: 17, Male
Involved Family: Mother
Statement of Problem: Ryan’s drug use, mom’s drug use, break-down of their relationship. Ryan’s mother, Marge, is a single parent with a history of cocaine addiction and current alcohol dependence; she feels like a failure as a mother and does not know how to help her son. Ryan is resistant to treatment and acts independently from his mother.
Strengths: Resourceful, hard working and determined, loving family, independent.

Primary Components of Treatment:

  • Help Ryan identify life goals, plans to achieve his goals, and learn to regulate his emotions and express them in a healthier and less destructive manner
  • Help mom address her own substance abuse, establish self-care practices, utilize available supports as a single parent, and adopt new parenting skills
  • Facilitate communication between Ryan and mom to help them reconnect and resolve past feelings of abandonment and neglect, and to enhance their communication and family problem solving skills
  • Empower mom to work more effectively with Ryan’s school and to organize pro-social activities for Ryan

The Take-Away: Ryan’s case demonstrates the importance of addressing pain of the past and improving communication between youth and parents, to empower parents with the skills to cope with their own problems, and to enhance parenting practices. It is an example of how we work as allies of single parents to build supports so that they can become the excellent parents they want to be and not be overwhelmed.

Read the full case summary.


MDFT Case Presentation (Part 1 of 2)
Howard Liddle

MDFT Case Presentation (Part 2 of 2)
Howard Liddle

MDFT Case Description -
Doris Perdomo-Johnson