Integrative
Family and Systems Treatment (I-FAST) with Children
and Adolescents with Severe Emotional and Behavioral Problems
Funders and stakeholders of mental health
services to children and adolescents have increasingly required providers to
use treatments deemed to be "evidence-based." There are several
evidence-based family treatment (EBFT) approaches found to be effective with
the same types of presenting problems and populations. All of these EBFTs have specified treatment
protocols that providers must follow to be faithful to the model. However, these
EBFTS are expensive for agencies to establish and maintain. Many agencies that
initially adopted one of these EBFTs later de-adopted it because they could not financially
sustain it.
Meta-analyses of treatment outcome studies have found that various theoretical
approaches to therapy are effective but no one approach is more effective than
any other. What accounts for client improvement is not the specific treatment
approach but rather the factors they all have in common.
As
a treatment model, I-FAST offers a cost-effective, sustainable, efficacious
approach for mental health agencies that can address sustainability issues. This is critical during a period of diminishing financial resources for mental health services.
Overview
- Integrated Family and Systems Treatment (I-FAST) is an evidence-supported
family treatment model.
- The efficacy of I-FAST has been researched in three different studies involving ten different sites in both rural and urban areas. Data from two additional sites is being
gathered. Five research papers have been published in prominent peer-reviewed journals on these studies.
- The purpose of I-FAST is to provide integrated family oriented treatment
to children and adolescents who exhibit a wide range of problems and
diagnoses.
- I-FAST follows The American Academy of Child and Adolescent Psychiatry
Practice Parameter for the Assessment of the Family.
- As a treatment model, I-FAST is organized around the common treatment factors
that are present in all of the evidence based family treatment models.
- I-FAST is an episode of care model.
Treatment focuses on specific symptoms and problems that parents
identify as their main concerns.
Treatment is administered in treatment episodes, which end when goals
are met and can be resumed if problems reoccur. Services are delivered efficiently and
cost effectively.
Family Level Focus
- I-FAST emphasizes parent* empowerment, collaboration with parents, and
respecting parent choices
- I-FAST seeks to identify interactional patterns in the child's family and
social environment that are contributing to and maintaining problems and
identify strengths and existing deviations from those patterns that have the
potential to solve problems.
- The main purpose of intervention in I-FAST is to interrupt interactional
patterns that contribute to maintaining problems and amplify interactions that
can solve problems. This approach
can be applied to a wide range of problems and diagnoses.
- Parents are helped to devise new parenting strategies that are effective
at eliminating problem behaviors, improve their child's overall functioning and
improve the parent/child relationship.
- When effective, the child improves due to their own parent' improved
parenting and due to improved overall family functioning.
*Parents refer to biological parents, and other caregivers including adoptive parents, foster parents, etc.
Agency Level Focus
- I-FAST is an agency
empowerment model. I-FAST
training is structured in a way that key agency staff will eventually develop
expertise to sustain fidelity to I-FAST without ongoing involvement of outside
I-FAST consultants. Cost of training staff are contained and
ongoing post-training need for consultation kept at a minimum.
- Administrative and ongoing clinical support
to the I-FAST treatment staff is an integral part of the model.
- The ultimate goal is to match I-FAST with the agency culture for susttainability purpose.
- I-FAST treatment
can be delivered in the home or in an office setting. Intensity level of involvement is adjusted to
meet the need of each case.
Systems Level Focus
- I-FAST is a system-level intervention that emphasizes
ongoing collaborations between professionals from different systems as well
as their collaboration with the family to achieve positive client outcomes.
What is Unique about I-FAST?
I-FAST is developed within the community mental
health system with the purpose of making it agency-friendly, realistically
fitting the demands of community mental health, utilizing agency and clients’
strengths and resources, and effective in bringing positive outcomes in families that have chlldren and adolescents with severe emotional and behavioral problems. As a both/and moderated common factors approach, I-FAST
holds promise of using a broader and more flexible evidence-informed
approach in social services delivery.
Check out our book Integrative Families and Systems Treatment (I-FAST): A strengths-based commom factors approach by The Oxford University Press at http://ukcatalogue.oup.com/product/9780199368969.do
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