Multidimensional family therapy (MDFT) is an evidence-based treatment designed primarily for teens and young adults with substance use disorder. It involves individual therapy, parenting classes, and family therapy.
MDFT addresses substance use alongside mental health, behavioral, school, and legal challenges, because it recognizes that these issues are often interconnected.
Research shows that MDFT is highly effective, often more so than traditional methods like individual therapy alone.
If you have a child with substance use disorder, it can be hard to know how to help. Multidimensional family therapy might make sense for you and your child. This evidence-based treatment not only helps teens and young adults overcome their substance disorder but also helps families come together to support them.
One of the biggest benefits of MDFT is that young people tend to stick with it — far more than they do with other treatment approaches. One review [1] found that 90% of teens and their families completed treatment with MDFT compared with less than 50% for traditional individual therapy. In the U.S., nearly 100% [1] of youth and families who start MDFT complete treatment.
Here’s what to know about multidimensional family therapy:
It’s designed for teens and young adults
MDFT was developed to help teens and young adults. Most of the research has been conducted on young people between the ages of 11 and 18. Family therapy involves the young person’s parents, siblings, and any other family or community members who play a role in their life. It may be possible to adapt it for adults, but almost all of the research has studied it in teens. So we don’t know yet how helpful it could be for adults.
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It focuses on substance use and related concerns
MDFT simultaneously addresses both substance use disorder as well as related conditions and behaviors, including:
Mental health conditions like depression or anxiety
Aggressive behaviors or conduct disorder
School issues, like skipping class or dropping grades
Legal issues and criminal behaviors
Trauma-related symptoms
High-risk sexual behaviors
This is part of the reason MDFT often works so well for teens and their families. Substance use rarely happens in a vacuum. Teens who are having trouble with substances usually experience symptoms across other areas of their lives.
It works across four domains
MDFT works by intervening in four interconnected domains [2] in the teen’s life:
Individual: The therapist works with the teen alone to help them improve self-awareness and set short- and long-term goals. Individual therapy teaches the teen skills to reduce substance use and other problematic behaviors.
Parents: Parenting interventions help parents work more effectively together as a unit. They teach the parents effective parenting practices and how to rebuild emotional bonds with their child. They may also focus on helping parents take care of themselves.
Family: This is more expansive than just working with the parents or caregivers. Siblings, grandparents, and any other important family members can be involved. These interventions strengthen the bond within the family unit as a whole and increase the feeling of love and connection.
Community: This is where MDFT is the most unique. Therapists work with the other systems in the teen’s life, like their school teachers and administrators, other medical providers like psychiatrists, and their probation officer. This ensures that everyone is working toward the same goals and reinforcing the same expectations.
It blends family therapy and individual therapy
Although it has “family therapy” in the name, MDFT involves more than just family therapy sessions. Family therapy plays a significant role because the treatment is primarily used for youth. So it’s essential that the important adults in the teen’s life are involved in their treatment.
But the teen participates in individual therapy as well. Individual therapy helps the teen learn new skills like self-regulation and problem-solving. It gives the teen a safe space to talk about their mental health and trauma, and improve their self-worth. The individual sessions are just as important in MDFT.
It strengthens the family’s attachment
Although this therapy’s main goal is to reduce substance use (and improve other behaviors) in the teen’s life, the family as a whole benefits as well.
Families who participate in MDFT may have less conflict and better communication skills [3]. They have a stronger sense of attachment to each other and tend to use more effective communication skills.
Research shows it works
At least 10 randomized controlled trials [4] show that MDFT is effective for helping teens with substance use. It’s estimated that MDFT reduces substance use by up to 66% [5]. Studies also show that MDFT can help reduce other behaviors, like gaming addiction, spending time with peers who break the law or rules, less probation time, reduced charges and juvenile arrests. One factor that helps support this is the collaboration between MDFT workers and the juvenile justice system. The department of juvenile justice takes into account that the youth is active and engaged in a program with strong outcomes and is willing to work to reduce sentencing.
It’s been shown to be more effective than many other treatment methods [5], including cognitive behavioral therapy, for teens with substance use disorder.
Research has also shown that MDFT can be an effective alternative to residential treatment [6]. Families can help their children while keeping them at home.
Many families think family therapy means blaming or focusing only on feelings the whole time. In MDFT, families are often surprised to find it’s practical and focused on solving problems and working together. This helps families feel supported and hopeful that change is possible.
Ashley Ayala, LMFT
Clinical reviewer
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If your teen is dealing with substance use, effective support is available. Multidimensional family therapy is an evidence-based, comprehensive approach that treats substance use while also addressing mental health, family relationships, and the broader systems in a teen’s life. It works by involving not only the teen themselves but all of the important people and systems in their life.
At Rula, we’re here to help you feel better. Rula makes it easy to find a licensed therapist or psychiatric provider who takes your insurance. That way, you don’t have to choose between great care and a price you can afford.
Rula patients pay about $15 per session with insurance, and 93% say they feel better after getting care through Rula. We have 21,000+ providers, and appointments are available as soon as tomorrow. We’re here to help you take the next step — wherever you are in your mental health journey.
References
- Implementation fidelity of Multidimensional Family Therapy in an international trial https://pubmed.ncbi.nlm.nih.gov/23085040/
- Treatment Techniques and Outcomes in Multidimensional Family Therapy for Adolescent Behavior Problems https://pmc.ncbi.nlm.nih.gov/articles/PMC2843091/
- MDFT Family Functioning https://static1.squarespace.com/static/60469dc5522a05284a1176f8/t/68649806948672132fa0d16e/1752154558170/MDFT%C2%AE_Family+Functioning.pdf
- MDFT Scientific Publications https://static1.squarespace.com/static/60469dc5522a05284a1176f8/t/67e17029099713419ece01fa/1742827561581/MDFT%C2%AE_Scientific+Publications_032025.pdf
- Multidimensional Family Therapy: Addressing Co-Occurring Substance Abuse and Other Problems among Adolescents with Comprehensive Family-Based Treatment https://pmc.ncbi.nlm.nih.gov/articles/PMC2916747/
- Multidimensional Family Therapy as a community-based alternative to residential treatment for adolescents with substance use and co-occurring mental health disorders https://pubmed.ncbi.nlm.nih.gov/29866383/
Saya Des Marais
Saya graduated with her Master in Social Work (MSW) with a concentration in mental health from the University of Southern California in 2010. She formerly worked as a therapist and motivational interviewing trainer in community clinics, public schools, mental health startups, and more.
Her writing has been featured in FORTUNE, GoodRX, PsychCentral, and dozens of mental health apps and therapy websites. Through both her clinical work and her personal OCD diagnosis, she’s learned the importance of making empathetic and accurate mental health content available online.
She lives in Portland, Oregon but you can find her almost just as often in Mexico or in her birthplace, Tokyo.
Ashley Ayala, LMFT
Ashley is a Licensed Marriage and Family Therapist who specializes in generational healing and family dynamics. Ashley has worked in schools, clinics, and in private practice. She believes that people’s relationships, including our relationship with ourselves, greatly shape our experiences in life.
Ashley is committed to empowering others to show up authentically and deepen their self understanding. This passion stems from taking a critical lens on her own life story and doing inner healing. One of her favorite quotes is “Be yourself and the right people will love the real you.”
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