Brief Strategic Family Therapy: Implementing evidence-based models in community settings

Abstract

Objective: To review a 40-year collaborative partnership between clinical researchers and clinicians, in developing, investigating and implementing Brief Strategic Family Therapy (BSFT). Method: First, to review theory, practice and studies related to this evidenced-based therapy intervention targeting adolescent drug abuse and delinquency. Second, to present the BSFT Implementation Model created for the BSFT intervention—a model that parallels many of the recommendations from the implementation science literature. Results: Specific challenges encountered during the BSFT implementation process are reviewed, along with ways of conceptualizing and addressing these challenges from a systemic perspective. Conclusion: The BSFT implementation uses the same systemic principles and intervention techniques as those that underlie the BSFT clinical model. Building on our on-the-ground experiences, recommendations are proposed for advancing the field of implementation science.

Ziel: Eine 40-jährige zusammenarbeitende Partnerschaft zwischen klinischen Forschern und Klinkern beim Entwickeln, Untersuchen und Durchführen von Brief Strategic Family Therapy (BSFT) zu überprüfen. Methode: Zuerst werden Theorie und Praxis und Studien überprüft, die mit dieser evidenzbasierten Therapieintervention, die auf adoleszenten Drogenmissbrauch und Kriminalität abzielen, assoziiert sind. Danach wird das BSFT Umsetzungsmodell präsentiert, welches für die BSFT Intervention erstellt wurde - ein Modell, das viele der Empfehlungen der wissenschaftlichen Literatur zur Umsetzung parallelschaltet. Ergebnisse: Bestimmte Herausforderungen, auf die man während des BSFT Umsetzungsprozesses stößt, werden überprüft, zusammen mit Wegen diese Herausforderungen aus einer systematischen Perspektive zu konzeptualisieren und zu adressieren. Schlussfolgerungen: Die BSFT Implementierung verwendet die gleichen systematischen Prinzipien und Interventionstechniken, wie jene, die dem BSFT klinischem Modell unterliegen. Aufbauend auf unseren vor Ort gesammelten Erfahrungen werden Empfehlungen für die Förderung des Bereichs der Umsetzung der Wissenschaft gestellt.

Obiettivo: Esaminare 40 anni di collaborazione tra i ricercatori e clinici, nello sviluppo, studio e realizzazione della Terapia Familiare Strategica Breve (BSFT). Metodo: In primo luogo, rivedere la teoria, la pratica e gli studi relativi a questo intervento terapeutico evidence-based rivolto all'abuso di droga e delinquenza adolescenziale. Secondo, presentare il Modello di Realizzazione della BSFT creato per l’intervento BSFT - un modello che mette in parallelo molte delle raccomandazioni provenienti dalla letteratura sulla realizzazione scientifica. Risultati: Sono esaminate le sfide specifiche incontrate durante il processo di realizzazione della BSFT, insieme ai modi di concettualizzare e di affrontare queste sfide da una prospettiva sistemica. Conclusione: La realizzazione della BSFT utilizza gli stessi principi sistemici e le tecniche di intervento come quelli alla base del modello clinico BSFT. A partire dalla nostra esperienza sul campo, vengono proposte raccomandazioni al fine di far avanzare il campo dell’attuazione scientifica.

Objetivo: Rever uma pareria colaborativa de 40 anos entre investigadores-clínicos e clínicos, no desenvolviment, investigação e implementação da Terapia Familiar Estratégica Breve (Brief Strategic Family Therapy, BSFT). Método: Primeiro, rever a teoria, prática e estudos próximos a esta intervenção terapêutica baseada na evidência direcionada ao abuso de drogas na adolescência e àdelinquência. Segundo, apresentar o Modelo de Implementação da BSFT criado para a intervenção BSFT – um modelo paralelo a muitas das recomendaçõ es da literatura científica. Resultados: Desafios específicos encontrados durante o processo de implementação da BSFT são examinados, juntamente com formas de concetualizar e resolver estes desafios de uma perspetiva sistémica. Conclusão: A implementação da BSFT utiliza os mesmos princípios sistémicos e técnicas de intervenção do modelo clínico subjacente àBSFT. Construídas a partir das nossas experiências no terreno, recomendaçõ es são propostas para o avanço no campo da ciência de implementação.

目的：檢視一對臨床研究者與實務工作者四十年來在發展、調查與實踐短期策略家族治療模式（BSFT）的合作伙伴關係。方法：首先，先重新探究這個以實證研究為基礎的治療介入策略用在青少年藥癮與犯罪的理論、實務與研究。其後，根據先前的文獻發展出BSFT處遇模式，此模式參考許多科學實證研究所提出的建議而發展出來。結果：整理出在發展與執行的歷程中遇到的具體挑戰，同時也以系統觀來概念化及說明這些挑戰。結論：BSFT使用了與臨床模式相同的原則與處遇技巧，並且根據研究者的實際經驗提出建議以進一步發展此領域之科學性。

Keywords:

• implementation
• family therapy
• intervention research

Additional information

Funding

Funding: Preparation of this article was supported by Clinical Translational Science Institute Grant 1UL1TR000460 from the National Center for Clinical and Translational Science and the National Institute on Minority Health and Health Disparities, and U10 DA013720 and RC2 DA028864 from the National Institute on Drug Abuse to José Szapocznik, by Grant DA026595 from the National Institute on Drug Abuse to Seth J. Schwartz, and by Grant AA021888 from the National Institute on Alcohol Abuse and Alcoholism to Jonathan G. Tubman and Seth J. Schwartz, and Grant P30 DA027828 from the National Institute on Drug Abuse to C. Hendricks Brown. The information presented in this article is the sole responsibility of the authors and does not necessarily reflect the views of the funding agencies involved.