Attachment-Based Family Therapy (ABFT)

Date: 2012
(For resources, this is the publication date. For programs, this is the date posted.)


Type:  Program/Practice, Treatment/Services Program, Program with Evidence of Effectiveness
Organization:  Drexel University

See the NREPP Listing.


See the NREPP Listing.

Attachment-Based Family Therapy (ABFT) is a treatment for adolescents ages 12-18 that is designed to treat clinically diagnosed major depressive disorder, address suicidal ideation, and reduce dispositional anxiety. The model is based on an interpersonal theory of depression, which proposes that the quality of family relationships may precipitate, exacerbate, or prevent depression and suicidal ideation. In this model, ruptures in family relationships, such as those due to abandonment, neglect, or abuse or a harsh and negative parenting environment, influence the development of adolescent depression. Families with these attachment ruptures lack the normative secure base and safe haven context needed for an adolescent's healthy development, including the development of emotion regulation and problem-solving skills. These adolescents may experience depression resulting from the attachment ruptures themselves or from their inability to turn to the family for support in the face of trauma outside the home. ABFT aims to strengthen or repair parent-adolescent attachment bonds and improve family communication. As the normative secure base is restored, parents become a resource to help the adolescent cope with stress, experience competency, and explore autonomy. ABFT is typically delivered in 60- to 90-minute sessions conducted weekly for 12-16 weeks. Research results related to suicide ideation and other outcomes are described on the NREPP website. The treatment manual is available for $69.95, or $49.95 for members of the American Psychological Association. Additional training and resources are available from the program developer. See the NREPP website for contact information.

Designation as a "Program with Evidence of Effectiveness"

SPRC designated this intervention as a “program with evidence of effectiveness” based on its inclusion in SAMHSA’s National Registry of Evidence-Based Programs and Practices (NREPP).

Outcome(s) Reviewed (Overall Quality of Research Rating-scale of 0 to 4)*

1: Major depressive disorder (3.1)
2: Depression symptoms (3.5)
3: Suicidal ideation (3.6)
4: Anxiety symptoms (3.1)
5: Treatment session attendance (3.1)

Read more about this program’s ratings .


* NREPP changed its review criteria in 2015. This program is a “legacy program,” meaning that it was reviewed under the previous criteria. The evidence for each outcome was reviewed and scored on a scale of 0-4, with 4 indicating the highest quality of evidence and 0 indicating very poor quality of evidence. The overall rating was based on ratings of six criteria: 1) reliability of measures, 2) validity of measures, 3) intervention fidelity, 4) missing data and attrition, 5) potential confounding variables, and 6) appropriateness of analysis.  Over time, all legacy programs will be re-reviewed using the current criteria. When considering programs, we recommend (a) assessing whether the specific outcomes achieved by the program are a fit for your needs; and (b) examining the strength of evidence for each outcome. 


Implementation Essentials

  • Prior to training the peer team, crisis management protocols found in the Sources of Strength Start-up Guide should be fully implemented and local adult advisors should be identified and trained.

2012 NSSP Objectives Addressed: 

Objective 8.3: Promote timely access to assessment, intervention, and effective care for individuals with a heightened risk for suicide.
Populations:  Youth, Adolescents
Settings:  Behavioral Health Care, Outpatient Mental Health
Strategies:  Effective Care/Treatment, Treatment