This publication is a systematic Campbell review of the effect of the family therapy approach Family Behavior Therapy (FBT) for treatment for non-opioid drug use (e.g., cannabis, amphetamine, ecstasy or cocaine) among young people aged 11-21 years. Youth drug use is a severe problem worldwide. Recent reports describe concerning trends in the use of drugs by young people and a lack of available treatment. FBT is a manual-based family therapy approach that seeks to reduce drug use among youth by identifying stimuli and triggers for drug taking, and teaching self-control and other skills to correct the problem behaviors related to drug use. This approach is based on the therapeutic premise that the family carries a profound influence on child and youth development and that interventions need to be flexible and tailored to the unique characteristics of the families. It is also argued that there is a need for interventions to be problem-focused, targeting first those patterns of behavior that most directly influence the youth’s drug use.

After a rigorous search for all relevant studies conducted to date, we identified two randomized controlled trials with, respectively, 56 and 26 participants. We used meta-analysis to synthesize the empirical evidence on the effects of FBT on reduction of drug use frequency, family functioning, and risk behavior. The findings are as follows:
- On drug usage: There is no evidence that FBT has an effect on reduction of drug use frequency compared to Individual Cognitive Problem-Solving (ICPS) and supportive counseling (SC).
- On family functioning: FBT may improve family functioning as reported by parents compared to Individual Cognitive Problem-Solving (ICPS) and supportive counseling (SC). There is no evidence that FBT has an effect on family functioning as reported by youth compared to Individual Cognitive Problem-Solving (ICPS) and supportive counseling (SC).
- On risk behavior: There is no evidence that FBT has an effect on risk behavior compared to Individual Cognitive Problem-Solving (ICPS) and supportive counseling (SC).

The evidence found was limited, as only two studies with very few participants were included in the data-analysis. The quality of the evidence is also limited. We were therefore unable to draw any firm conclusion regarding the effectiveness of the treatment.

Overall, Family Behavior Therapy for the purpose of treating young people’s drug use has not been evaluated with sufficient rigor to unequivocally determine its effectiveness.