Program History

MDFT arose from a desire to transform the treatment services landscape in the adolescent substance abuse and delinquency specialties. A core objective has been to make widely available a personally engaging, science-based, clinically effective, and practical approach.

MDFT was developed by Howard Liddle, Ed.D, Professor of Public Health Sciences, Psychology, and Counseling Psychology at the University of Miami Miller School of Medicine. A counseling psychologist and family therapist, Dr. Liddle brought together interests in treatment research, intervention development, and therapist training.

Liddle was inspired by and trained by Salvador Minuchin, Jay Haley and others at the Philadelphia Child Guidance Clinic in the mid-1970s. A decade later, he worked with Braulio Montalvo to refine clinical supervision methods that would become a core part of MDFT. While working and teaching in community-based clinics over these foundational years, Liddle was struck by the multiple risks and difficulties and complex clinical needs of clinically referred adolescents. He saw that treating these teens and helping their families requires therapists to go beyond either family therapy or individual therapy alone.

MDFT became a new kind of family therapy - a comprehensive, systemic, and developmentally oriented approach. Liddle’s determination to help adolescents and families find a healthy life path, coupled with concerns about the absence of available and science-supported adolescent interventions, led to his development of MDFT.

Over the next 25 years, Liddle and colleagues Gayle Dakof, Cynthia Rowe, and others tested the program in randomized controlled trials with demographically, socioeconomically, ethnically and culturally diverse populations around the United States (read more about these trials here). Process studies focused on understanding how and why it works, refining the treatment, testing new components, and applying different versions of MDFT in a range of real-world settings.

In 2001 MDFT implementation began in the state of Connecticut in collaboration with the Department of Children of Families and five community-based agencies. Demonstrating the sustainability of the MDFT approach, today all five agencies continue to implement successful MDFT programs. Since this initial statewide collaboration, MDFT implementation has grown considerably. Today there are more than 20 MDFT programs employing over 100 full time clinicians in Connecticut. Over 150 MDFT teams operate in other states in the U.S. and across Europe.

MDFT International, a 501(c)(3) non-profit, was established in 2009 to facilitate quality replication of the MDFT program. MDFT International provides initial and ongoing implementation support to community settings in substance abuse, mental health, juvenile justice, and child welfare practice settings. The MDFT Academy, based in Leiden in the Netherlands, supports MDFT implementation in the Netherlands and throughout Europe.

In addition to training providers through MDFT International, Liddle and colleagues at the University of Miami Miller School of Medicine continue to develop new variations of the approach, study the model's long-term effects, and conduct research to improve MDFT.