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Familiebehandling i TSB

- We deal with parents problems if the problems affect the child. If parents problems are separated from childrens, for their own treatment, it can be conflicting. If the child suffer from severe problems, do expect you need 6 month treatment. Dette sier Dr. Henk Rigter, Department of Child Adolecent Psychiatry, University og Leiden, Nederlands. Rigter foreleste om Multipledimentional Family Therapy på Rogaland A-senters kurs for spesialisthelsetjenesten 22.april.
Familieterapi for unge rusavhengige pasienter
Dr. Henk Rigter fremla evidens fra forskningsrapporten: Multidimentional family therapy lowers the rate of cannabis dependance in adolecents: en stor europeisk studie.
Link til presentasjon Henk Rigter
Multiple problems behaviour in adolecents, Treatment program
Multidimensional Family Therapy (MDFT)
Research and state of implementation in Europe, Henk Rigter
The treatment needs to be multifaceted:
•     It is not sufficient for the treatment to focus on just delinquency, or just substance abuse, etc.
•     The programme should target all major problem behaviour
The treatment needs to be both individual and family-based, targeting 4 domains in the life of an adolescent:
•     The adolescent him- or herself
•     The parent(s) or parent figures
•     The family (kid, parents, siblings)
•     Systems outside the family (peers, school, work, leisure time, authorities)
This factors contains risk and healing factors, and must be considered in treatment, or the treatment is doomed to fail.
Adolencets 12- 19+ years of age
Showing single or multiple problems behaviours
In a nutshell:
Out-patient programme 6 month (4-7)
Contains:  Motivation, treatment with goals
How increase motivation? Les mer, Henk Rigter
MDFT is a systems therapy targeting adolescents both individually and as part of their families and wider systems.
developed by H.Liddle U Universiy of Miami)
 14 randomized controlled trials ( RCTs)
Evidence based according to 
Adolencets 12- 19+ years of age
Showing single or multiple problems behaviours
Where is MDFT being offered?
youth addiction care
youth mental health care
youth care
youth forensic care ( skoleskulk?)
this  fragmentation is undesirable 
Therapist work in team( 3- 6 therapists), also individually- bud discuss cases in team, and prevent burn-out.
MDFT therapist and supervisor training takes 2 years
Training academy in Europe; Netherlands
Menuals and other course materials
8 days of plenary training, spaced apart
Telephone consultations
Set of tips and instructions, video – and responsible therapist, not every step is followed.
Outcome of research studies
Reduces substance abuse
Decreace criminality
Approve school attendance
Reduce symptoms of extennalizing disorders
EMCDA evidence based programs;
MDFT is the only evidence based program accepted.
Randomized 450, ca 97 % stayed in treatment- did not drop out!
Increased treatment – retentions, is success of motivational interventions
MDFt did better than individual psycoterapi, after treatment started.
Young people using cannabis and being criminal, the criminal rate dropped seriously
MDFT is more cost effective than individual therapy, on substance abuse and criminality.
Evidenvce based treatment
60 MDFT teams in Europe and 60 MDFT teams in US
40- 50 in Finland, more countries to come.
MDFT is flexible 
We develop modules together with treatmnet centres. Ecamples.
Adolecents inpatients, available
- school-referres adolecents. In preparations
- light mental retardation ( intellectual disability). Available 
If you improve environments at home / parents and friends/ society- the youngster will improve.
Young kids starting using cannabis at 12 years, will continue with cannbis in adolescence, young people who start older, will stop in adolescence.
We identify early problems, with MDFT
What kind of issues do you work with in family:
Family - communications
reflect back on behaviour
home- rules/ house rules, setting home rules
to keep the home rules when rules are broken, react
make parents udnerstad the children, psyco education 
don’t beleave in special methods and theories with stickt rules
adopt the best from different methods
families treatment- tradition family – treatment Menuscin 
22.04.2014/ Marit Vasshus