Helping adolescents just say no to drugs: a multidimensional family therapeutic approach.

After participating in this educational activity, the psychiatrist should be better able to 1. Evaluate patients using the theory of Multidimensional Family Therapy (MDFT). 2. Treat adolescents with substance abuse problems using the three stages of MDFT. 3. Identify the limitations of MDFT. Multidimensional Family Therapy (MDFT) is reviewed, both in theory and as an evidence-based approach to treating adolescent substance abuse and related risk factors. The primary objectives of MDFT are to improve functioning in the four domains that centrally influence the course of adolescent development-the adolescent himself or herself, the parents, family interactions, and extrafamilial relationships. In MDFT, functioning in each domain is conceptualized as a risk or protective factor for problematic adolescent behavior and overall development; adolescent substance abuse is thus understood as a deviation from healthy, adaptive development and as indicative of impaired family systemic functioning. Improved functioning in the four domains is expected to place adolescents on healthier developmental trajectories, which decreases risk for substance abuse. Previous reviews of treatment approaches for adolescent substance abuse have surveyed multiple models. Previous articles specifically on MDFT have addressed a defined range of issues-whether theory, technique, or research. This review comprehensively synthesizes MDFT in theory, research, and practice, and suggests directions for future research.