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