Empirical Support for ABFT

To date, six studies have been carried out to demonstrate the efficacy of Attachment-Based Family Therapy (ABFT). Some of the studies focus on depression as the presenting problem (diagnosis of MDD), but suicide ideation was present and examined. Other studies focused on suicide ideation or attempts as the presenting disturbance, but usually an elevated level of depression was required for inclusion as well.

In this regard, the data to date supports the efficacy of this intervention for reducing depression and suicide ideation and preventing suicide attempts better than wait list controls and/or treatment as usual (Diamond et al, 2002; Diamond et al, 2010; Diamond, Diamond, & Levy, 2011; Israel & Diamond, 2013; Diamond, Levy & Creed, 2016; Diamond et al, 2019).

  1. Open trial (N=15): significant decrease in depression/suicidal ideation (Diamond et al, 2002)
  2. ABFT vs. wait list (N=32): significant reduction in depression, suicidal ideation and anxiety. Increase in family attachment (Diamond et al, 2002)
  3. ABFT vs. Enhanced Usual Care (N=66): Significant reduction in depression/suicidal ideation, lower attrition (Diamond et al, 2010)
  4. ABFT vs. Nondirective Supportive Therapy (N=130): Significant reduction in suicidal ideation/depression, superior to NST when higher youth reported disengagement, significant reduction in family conflict vs. NST (Diamond et al, 2019)
We also have studies that look at these disorders in specific populations either as independent studies (i.e. GLB suicidal youth) or as secondary analysis of sub groups within a study (i.e. suicidal adolescents with a history of sexual abuse). Preliminary data suggests that ABFT is effective for more severely depressed adolescents and those with a history of sexual abuse, both predictors of poor response in TORDIA, and earlier CBT study, and TADS (Arsanow et al., 2009; Barbe et al., 2004; Curry et al, 2006). ABFT has also been adapted for use with suicidal GLB adolescents in a pilot study with 10, 14-17 year olds. Also, several process studies have explored the proposed mechanisms of change (e.g., Diamond, Siqueland, & Diamond, 2003). This empirical support meets the criteria of a promising intervention (Chambless & Hollon, 1998).
Other research studies include:
  • Treatment of LGBT youth with suicide ideation (Diamond et al, 2012)
  • Aftercare for adolescents leaving the psychiatric hospital after a suicide attempt
  • ABFT compared to individual EFT for young adults with unresolved anger towards caregivers
  • Training of therapists in a community agency in Norway (Israel & Diamond, 2012)
  • Over 15 process research studies looking at the within session processes associated with change