Research

Integrative Family and Systems Treatment

Summary of Research

Study One: Efficacy of I-FAST funded by The Ohio Department of Mental Health 2003-2007, Grant# 744832 (Lee et al., 2009)

77 families with children who had DSM diagnoses and received services from the Scioto Paint Mental Health Center and Thompkins Adolescents and Child Services

Multiple reporting sources including parents, child clients 12-year-old or older, and I-FAST case managers

Summary of findings:

• • Significant decrease in child’s level of problem severity from pre-treatment to post treatment as measured by The Ohio Scales

  • Significant increase in child’s level of functioning from pre-treatmment to post-treatment as measured by The Ohio Scales

  • Significant increase in parental competence to address their children’s issues

  • Significant improvement in family functioning in terms of family cohesion and adaptability as measured by FACES II

  • Significant decrease in the number of children in out-of-home placement

  • Consistently high level of family participation in treatment

  • Children maintain positive changes that had made at the time of termination at 6-month follow-up

Reference: Lee, M. Y., Greene, G. J., Hsu, K. S., Solovey, A., Grove, D., Fraser, S., Washburn, P., Teater, B. (2009). Utilizing Family Strengths and Resilience: Integrative Family and Systems Treatment (I-FAST) with Children and Adolescents with Severe Emotional and Behavioral Problems. Family Process, 48(3), 395-416

Study 2: Efficacy of I-FAST at The Buckeye Ranch with minimum clinical support from I-FAST developers and trainers, January 2009 to September 2010 (Lee & Greene, 2010)

136 children and adolescents and their families received I-FAST services: 68% were males and 32.0% were females.

Multiple reporting sources including parents, child clients 12-year-old or older, and I-FAST case managers

Summary of findings:

• • Significant decrease in child’s level of problem severity from pre-treatment to post treatment as measured by The Ohio Scales

  • Significant increase in child’s level of functioning from pre-treatmment to post-treatment as measured by The Ohio Scales

  • Approximately 60% of clients achieved clinically significant and reliable changes or some improvement in their level of problem severity and level of functioning from pre-treatment to termination.

  • Significant increases in the level of adaptability in these families from pre-treatment to termination based on parents’ and youth clients’ reports.

  • Significant increase in parental hopefulness regarding their parenting role from pre-treatment to termination and youth’s hopefulness about their futures.

  • Significant increase in treatment satisfaction among parents and youth clients from pre-treatment to termination

Study 3: Key processes, ingredients and components of successful systems collaboration: Working with severely emotionally or behaviorally disturbed children and their families (Lee et al., 2012)

Through qualitative data, this study explored the process of and the skill components involved in inter-agency collaboration when providing Integrative Family and Systems Treatment (I-FAST) for families with severely emotionally or behaviorally disturbed children who were at risk of out-of-home placement.

Data were collected through a series of eight focus groups with 26 agency collaborators across 11 counties in Ohio.

Data analysis revealed two emergent phenomena: the process of developing collaboration, which consisted of making initial contact, a trial period and developing trust; and the key ingredients of collaboration, which focused on interpersonal and professional qualities.

Reference:

Lee, M. Y., Teater, B., Greene, G. J., Hsu, K.S., Fraser, S., Solovey, A., Grove, D., & Washburn, P. (2012).: Key processes, ingredients and components of successful systems collaboration Working with severely emotionally or behaviorally disturbed children and their families. Administration and Policy in Mental Health and Mental Health Services Research, 39 (5), 394-405.

Study 4: Comparison of efficacy of I-FAST and MST for treating at-risk youth (Lee et al., 2013)

A non-randomized quasi-experimental design to examine the outcomes of 79 youth who have received I-FAST and 47 youth who have received MST from January 2009 to December 2010.

Multiple reporting sources including parents, child clients 12-year-old or older, and I-FAST case managers on two subscales of The Ohio Scales: Problem Severity and Functioning

Using non-inferiority test and a non-inferiority margin 15%, I-FAST is not inferior to MST in reducing Problem Severity and improving Functioning in youth clients based on parents, youth, and I-FAST case managers’ reports.

Reference:

Lee, M. Y., Greene, G. J., Fraser, S., Grove, D, Solovey, A., Edwards, S., & Scott, P. (2013). Common and Specific Factors Approaches to Home-based Treatment: I-FAST and MST. Research on Social Work Practice, 23(4), 407-418.

Study 5: Systems collaboration with schools and I-FAST child outcomes (Lee et al., 2013)

Using data collected from 38 child clients with DSM diagnoses who had received I-FAST service, this study utilized a structural equation model (SEM) to explore how systems collaboration with schools influenced children’s behavioral outcomes, parental competence and family functioning.

The final SEM model accounted for 31% of the variance in Problem Severity in Children, 38% of the variance in Level of Functioning in Children, 30% of the variance in Parental Competence with Children, and 41% of the variance in Family Functioning.

The final model indicated the following: Systems Collaboration with Schools positively influenced Parental Competence with Children, which positively predicted Level of Functioning in Children and negatively predicted Problem Severity in Children.

The limited sample size of the study precludes any definitive conclusions. However, there are initial empirical evidence that systems collaboration with schools positively influenced child and family outcomes.

Reference:

Lee, M. Y., Teater, B., Hsu, K.S., Greene, G. J., Fraser, S., Solovey, A., Grove, D. (2013). Systems collaboration with schools and treatment of SED children or adolescents. Children & Schools, 35(3), 155-168.

Links to published Research Studies