The model was originally developed by Professor Ian Falloon and colleagues in the early 1980’s. It is a practical, skills based intervention that usually takes 10 to 14 sessions to deliver. It typically involves sharing information with the service user and their family about the service user’s mental health issues, experience and treatment. The family also complete work on recognising early signs of relapse and develop a clear staying well plan. BFT promotes positive communication, problem solving skills and stress management within the family. The needs of all family members are addressed, and each family member is encouraged to identify and work towards clear personal goals.
Who can BFT help?
Research has shown that BFT is effective in reducing relapse rates and promoting recovery; especially for those living with serious mental health problems. Because of this, the main focus of delivery has been around working with families where a member experiences psychosis or bipolar disorder. However, family interventions may be helpful for families experiencing a range of mental health problems, including anxiety, depression, eating disorders, the dementias and learning disabilities. BFT can help families to work together and reduce stress for everyone involved.
In the United Kingdom, the National Institute for Health and Care Excellence (NICE) Schizophrenia guidelines, originally published in 2002, recommended family interventions should be offered to 100% of individuals with schizophrenia who have experienced a recent relapse. The revised and updated review of the guidelines (published in 2014) confirms this and further recommends that families are offered intervention and are engaged during the acute phase of illness, or as a method of promoting recovery.
The NICE Guidelines for Bipolar Disorder (2014 – updated December 2023) similarly recommend that family intervention is offered to people with bipolar disorder who are living, or in close contact, with their family. Family and carer involvement is also referenced in the NICE clinical guidelines for depression , depression in long term conditions and eating disorders. For example the May 2017 NICE guideline ‘Eating Disorders: recognition and treatment’ includes the following guidance:
‘Consider anorexia-nervosa-focused family therapy for children and young people (FT-AN), delivered as single-family therapy or a combination of single- and multi-family therapy’.
The overall aims of BFT are increased understanding, stress reduction, and improved communication and problem-solving skills within the family. Although the research evidence base is strongest for those families experiencing psychosis or bipolar disorder, the approach can be used effectively to help meet the needs of other families in contact with mental health services. In addition, there is growing support for using the approach with families experiencing stress in relation to long-term physical conditions.
Overview of the BFT Process
BFT is an individualised approach based on the assessment of each family and tailored to their specific needs. Equally the pace and timescale of the support offered varies from family to family. In this collaborative approach, the therapist and family determine together what the agenda will be. Family work is generally offered in the family home. However it can also be offered at a health care centre or even online.
Family work using the Behavioural Family Therapy model will typically include:
- Meeting with the family to discuss the benefits of the approach
- An agreement with the family that they are willing to try the approach
- One to one discussions with individual family members
- Exploration of the family’s communication and problem solving skills
- Review of the assessment information on the family’s resources, problems and goals
- Meeting with the family to discuss/plan how to proceed and the establishment of family meetings
- Information-sharing about the mental health issue and reaching a shared understanding
- Early warning signs and relapse prevention work – development of ‘staying well’ plans
- Helping the family to develop effective communication skills
- Supporting the development of the family’s problem solving skills
- Booster sessions
- Review and on-going support or closure
Additional Resources
For reading material regarding the evidence base for Behavioural Family Therapy please see our Resources section.
Information on the training offered by the Meriden Family Programme can be viewed in our Training Courses section.