Implementation Evidence

Flexible enough for implementation anywhere

MDFT has been successfully researched and implemented in a wide variety of settings, including outpatient, in-home, intensive outpatient, day treatment, and residential, and has served adolescents in juvenile justice, drug court, mental health and substance abuse treatment, and child welfare systems.

Clinicians also report that the MDFT model is flexible enough to meet the needs of a variety of clients. One therapist noted, "I think [it was flexible because of] the emphasis on building a foundation with the family... the themes were common enough that most of the families were variations on those themes. I think there was flexibility in the manual to decide how much family sessions versus parent sessions versus individual sessions you could do."1

Increased collaboration with the community

MDFT therapists don't just work with the family. They also collaborate with community partners such as probation officers and teachers.

A study on juvenile offenders leaving detention found MDFT therapists had high levels of collaboration with juvenile justice professionals. It also found these higher levels of collaboration to be associated with greater reductions in substance use.2

Improved treatment outcomes

MDFT has been shown to improve both client outcomes and system-level factors at existing programs. For example, youth substance use fell by 50% after therapists received MDFT training at a community-based treatment program, compared to 25% prior to MDFT. Youth association with delinquent peers also dropped more rapidly after MDFT than before.

In that same study, adolescents also reported that they felt their treatment program was more organized, and treatment expectations more clear, after MDFT was introduced.3

Therapist receptivity to training

MDFT is easy to learn and gives clinicians the tools to be better therapists. A study that examined changes in therapist practices after MDFT training found that it broadened therapist treatment focus, taught them to address more approach-specific content themes, and focus more on adolescents' thoughts and feelings about themselves and others. These improvements were sustained a year later, long after the conclusion of the training program.4

Clinicians also report that the MDFT manual helps organize treatment, and consistently note the user-friendliness of the MDFT approach in evaluations. One therapist noted that the MDFT treatment manual also "sharpened [his] intentionality."1

Cost effectiveness

MDFT has been found to be more cost-effective than many alternative treatments. A large evaluation of representative adolescent programs across the United States found that community-based outpatient treatment averaged at $365 per week, while MDFT cost only $164 per week.5

In another study, an intensive version of MDFT designed as an alternative to residential treatment provided superior outcomes at only a third of the cost of residential. Average weekly costs for MDFT were $384, compared to $1,068 for residential.6

From MDFT Sites


  1. Godley, S.H., White, W.L., Diamond, G., Passetti, L., & Titus, J.C. (2001). Therapist reactions to manual-guided therapies for the treatment of adolescent marijuana users. Clinical Psychology: Science and Practice, 8, 405-417.
  2. Liddle, H. A., Dakof, G. A., Henderson, C. E., & Rowe, C. L. (2011). Implementation outcomes of Multidimensional Family Therapy-Detention to Community: A reintegration program for drug-using juvenile detainees. International Journal of Offender Therapy and Comparative Criminology, 55, 587-604.
  3. Rowe, C. L., Liddle, H. A., Dakof, G. A., & Henderson, C. E. (2009). Development and evolution of an evidence-based practice: Multidimensional Family Therapy as treatment system. In F. Collins & L. Cohen (Eds.), Pharmacology and treatment of substance abuse (pp. 441-464). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.
  4. Liddle, H. A., Rowe, C. L., Gonzalez, A., Henderson, C. E., Dakof, G. A., & Greenbaum, P. E. (2006). Changing provider practices, program environment, and improving outcomes by transporting Multidimensional Family Therapy to an adolescent drug treatment setting. American Journal on Addictions, 15, 102-112.
  5. French, M. T., Roebuck, M. C., Dennis, M., Godley, S., Liddle, H. A., & Tims, F. (2003). Outpatient marijuana treatment for adolescents: Economic evaluation of a multisite field experimentEvaluation Review, 27(4), 421-459.
  6. Zavala, S. K., French, M. T., Henderson, C. E., Alberga, L., Rowe, C., & Liddle, H. A. (2005). Guidelines and challenges for estimating the economic costs and benefits of adolescent substance abuse treatmentsJournal of Substance Abuse Treatment, 29(3), 191-205.