Frequently Asked Questions

FCT is an evidence-based trauma treatment model of home-based family therapy focusing on holistic, family derived goals related to family functioning, preservation, permanency, and reunification. FCT aides in identifying practical solutions for those faced with disruption or dissolution of the family due to external and/or internal circumstances such as child welfare, mental health, substance abuse, developmental disabilities, and juvenile justice. A core belief of FCT is that recipients are families with tremendous internal strengths and resources. Goals are collaboratively developed from these resiliency factors. Families engage in experiential activities inclusive of cultural, generational, systemic, and trauma influences. The 4-phase model is rooted in Eco Structural Family Therapy and Emotionally Focused Therapy enhanced with practitioner feedback and family voice. Families uncover inherent values and beliefs while restoring safety, belongingness and connectedness.

1. Enable family stability via preservation of or development of family placement or reunification by fostering necessary shifts in family functioning that underly the causes of family dissolution.

2. Address maladaptive behaviors affecting family functioning by experientially practicing new interactions and learning the underlying function of the behaviors while developing an emotional and functional balance so the family can cope effectively with present and future challenges.

3. Support discovery and effective use of the intrinsic strengths necessary for sustaining change and upholding stability by incorporating generational, cultural and systemic influences of trauma while harnessing the power of giving and instilling hope.

FCT typically requires 6 months of treatment with an average of 50-70 face-to-face sessions. Generally, families receive 2 or more sessions per week for 4 or more hours per week. These sessions may comprise of individual, family, or involve various combinations of family members as appropriate. Sessions times are tailored to meet when the family is most in need. FCT practitioners are available 24/7 for crisis response. Families participate in between-session homework, and during sessions families provide their voice to indicate phase progression through completion of fidelity measures and transitional indicators. All involved parties, professional and personal, invested in the family’s success, are integral in the formulation of shared goals and ongoing goal attainment. Caregivers and children both participate in assessment, including written assessment tools such as the Family Assessment Device (FAD) and Care Process Model-Pediatric Trauma Screener (CPM-PTS), interviews inclusive of interactive drawing, and behavioral observations of the family interacting in their home environment.

FCT has practice-based evidence, research evidence, and traditional knowledge to support its benefits.

FCT was developed by practitioners working with families for practical solutions from real experiences for families faced with the disruption of their family due to external and/or internal stressors, circumstances, or removal of their children from the home due to the youth’s or caregiver’s behaviors or children returning from out of home placement. The majority of children, youth, and families involved in the initial development of this practice identified as numerous ethnic/racial groups, lived in rural, urban, frontier, or mixed geographical area environments, and spoke English or Spanish at home.

Additionally, there have been adaptations of the practice. FCT-Recovery layers the evidence based, in-home treatment model of FCT, with sobriety support and interventions when there is substance misuse by a parent/caregiver. There are translations of FCT materials for children, youth, and families available in Spanish and Vietnamese.

Tracked outcomes include fidelity transitional indicators, phase progression, demographics, and clinical outcome measures. Families complete the FAD and CPM-PTS throughout treatment to assess progress. At closure, family and practitioner voices are captured with their perceived goal progress, placement of children, and reason for case closure.

Children and families who participate in FCT demonstrate family-based permanency associated with children’s safety, permanency goals, and well-being. Children who participated in FCT are more likely to remain in-home during their involvement with social services, as well as be reunited with their family in a shorter timeframe.

Historical data, 2016 to present, shows 89% of all families referred to FCT have a positive placement at closure. 98% of families who completed FCT treatment had positive placement at closure. 94% of FCT families engaged with their practitioner for more than 5 direct contacts. 90% of families agreed that FCT has improved their family life.

Through three decades and more than 40,000 families, empirical research has demonstrated that 9 out of 10 families maintain that the FCT model has not only had a positive impact on their lives, but the program’s sustainable implementation has created an environment where families finally feel safe enough to heal. 

FCT origins derive from practitioners’ efforts to find practical solutions for families faced with forced removal of children from the home or dissolution of the family. In the 1980’s, the first referrals came from juvenile justice for ‘challenging’ youth deemed in need of removal from their home and community. John Sullivan, PhD and his colleagues sought to bring successful practices from residential facilities and apply them to the home and community. A distinguished practice grew out of a mission to create opportunity for change for families emphasizing greatness by uncovering inherent strengths and values while living and modeling dignity, respect and connection. The model evolved and is continually adapted for maximum impact in a family’s home environment which today spans national urban, rural, and frontier communities with inclusion of those influenced by child welfare, mental health, substance abuse, trauma, developmental disabilities, and juvenile justice. Read more here.

FCT is rooted in obtaining input from families, practitioners & community leaders. Cultural, societal and generational influences shared by recipients create solutions for trauma and injustices. Families are invited to engage in surveys, share testimonials, and join FCTF committees. FCTF’s affiliation with NCTSN expands knowledge and access to resources and experts are sought to train FCT staff.

FCT Provider Organizations participate in local and statewide implementation teams comprised of internal FCT personnel and external community members. Skills labs and cohorts hosted by the FCT Foundation elicit feedback and the Foundation has an open-door policy that invites Providers to access any Foundation staff to share insights and suggestions. Foundation committees include Provider representation.

Internal FCT Foundation teams and committees routinely review feedback and suggestions resulting in numerous initiatives such as expanding outreach to rural communities, multi-lingual resources, guides for families and practitioners, training content provided in a variety of learning modalities, focus groups, and collaborative work groups. Family voice is our driving force.