Center for Evidence-based Partnerships Virginia FFT Fidelity and Outcome Report

Coverage Period: July 2025 - September 2025

Author

Ashley Robinson and Michael Southam-Gerow

LAST UPDATED

November 5, 2025

CEP-Va logo

PUBLISHED: Nov 05, 2025

Statement of Purpose

Functional Family Therapy (FFT) is an evidence-based program (EBP) for youth ages 11-18 exhibiting behavioral or emotional problems and their families. The current report is prepared by the Center for Evidence-based Partnerships in Virginia (CEP-Va) and presents relevant fidelity and outcome data in Virginia per the Family First Prevention Services Act (FFPSA) from July 1, 2025, through September 30, 2025.

The CEP-Va Fidelity Model for FFT

CEP-Va has developed fidelity and outcome models for fidelity reporting for all evidence-based programs in the Family First Prevention Plan developed by Virginia’s Department of Social Services (VDSS) and approved by the Administration for Children and Families. For each model, we used the empirical literature and recommendations from the treatment developer. Pragmatic issues were also considered when developing the models, including data availability and burden on provider companies, practitioners, and/or families. All final models were approved by the EBP developer or the EBP training company selected by VDSS. Model is detailed here.

Historical Status of Virginia FFT Team Workforce and Caseloads

Team and Case Data

Figure 1. Active Teams with Average Caseload Across Virginia

This quarter, two teams closed at the end of August, thus by the end of the quarter only 10 total cases were operating (charts in this report will reference 12 teams, as they were open for a majority of the period). Taking into consideration that two of the teams only operated for 2/3 of the quarter, the average number of active cases per team in this quarter (weighted for how long the cases were open) stayed relatively stable at 11.4, as seen in Figure 1.

See Table 1 for a more detailed breakdown of teams across quarters.

Table 1. Team Status Detail

Quarter Teams operating New teams Closed teams
Jul-Sep 2021 9 0 0
Oct-Dec 2021 9 0 0
Jan-Mar 2022 10 1 0
Apr-Jun 2022 9 0 1
Jul-Sep 2022 9 0 0
Oct-Dec 2022 9 0 0
Jan-Mar 2023 9 1 1
Apr-Jun 2023 9 0 0
Jul-Sep 2023 10 1 0
Oct-Dec 2023 10 0 0
Jan-Mar 2024 10 0 0
Apr-Jun 2024 10 0 0
Jul-Sep 2024 11 0 0
Oct-Dec 2024 11 0 0
Jan-Mar 2025 11 0 0
Apr-Jun 2025 12 1 0
Jul-Sep 2025 10 0 2

Full-time Therapists

Figure 2. Average Number of Team Therapists

FFT, LLC, the training organization for the model, has set a target of three therapists per team, represented by the lavender dashed line in Figure 2. In Q3 2025, the average number of therapists per team, weighted for the number of days they served on the team in the quarter and removing supervisors who don’t carry cases, dipped slightly to 3.1, influenced by two of the teams winding down for the August closures. The orange dots represent the team with the lowest number of therapists for each reporting period.

Cases per Therapist

Figure 3. Average Number of Cases per Therapist

FFT, LLC expects therapists to carry a caseload between 5 and 15 cases, as represented by the lavender dashed line. Figure 3 depicts each team’s average number of cases per therapist (gray lines), and the average across the state (orange line).

Cases are weighted by the number of days the case was active in the quarter.

Measure of Final Fidelity using Clinical Adherence and Clinical Competence Ratings

Fidelity Scores Across Teams

Figure 4. Average Final Fidelity Scores Across Virginia Teams

The final fidelity score is a combination of a clinician’s clinical adherence score, or how well the clinician applies the model components in the proper sequence, with the clinical competence score, or how skillfully the clinician applies the model. These ratings are given by supervisors during weekly case reviews, with an acceptable level of fidelity considered 3.0 or greater (on a 6-point scale), represented by the lavender area in Figure 4. The average fidelity score of all cases in the state for each quarter is depicted by the purple line, which rose to 4.12.

Figure 5. Percent of VA Teams with Average Final Fidelity Score Meeting or Exceeding the FFT Target

Another way to consider fidelity data is depicted in Figure 5: the percentage of teams averaging the FFT, LLC final fidelity score of 3.0 or higher in a given quarter. From July to September, 10 of 11 teams with available data maintained an average fidelity above the threshold.

Outcome Measures

Data for all families are included whether or not their treatment was completed in a planned fashion. Exceptions to this include cases withdrawn for funding reasons, cases where the family moved out of the service area, cases where referral sources referred a case elsewhere, or with placements that resulted from actions carried out before the start of treatment. Cases for which the status of these outcome measures was recorded as “unknown/not applicable” are also included in these calculations.

Remaining in Community

Figure 6. Percent of VA Youth Remaining in Community

FFT, LLC defines remaining in community as not being placed formally outside of the home (group home, foster home, addiction treatment facility) but may be living with a relative in the community. This quarter, 83% of youth who completed treatment were known to be living in the community at time of discharge.

Attending School

Figure 7. Percent of VA Youth Attending School

For this indicator, a youth is included if they are attending school or vocational programs, or intend to (in the cases of summer or applying to college). The reported share of known youth attending school or work this quarter dipped below the threshold to 81%.

Law Violations

Figure 8. Percent of VA Having No New Law Violations

Figure 8 illustrates the share of youth having no new arrests, either when counseling finished or if treatment ended for a reason within the therapist’s control. During this reporting period, that number dipped to 76%, with 11% of youth law violation statuses unknown.

Demographic Information

Table 2. Reported Age, Gender, and Race of Youth Receiving Treatment from July to September 2025

Summary of 232 Case Characteristics by Age, Gender, and Race
Characteristic n %
Age
10-13 57 24.4
14-16 125 53.4
17-19 50 21.4
Unknown 2 0.9
Gender
Female 109 46.6
Male 120 51.3
Nonbinary, self-described, or other 5 2.1
Race
Bi-Racial 19 8.1
Black 61 26.1
Spanish origin, Hispanic, or Latino 10 4.3
Unknown or other 24 10.3
White 120 51.3

As is consistent with previous quarters, more than half of all youth receiving FFT during this period were aged 14-16 and approximately half of all youth receiving treatment identify as white. This quarter, a more even gender divide held from last quarter; in past reports, female youth comprised approximately 40% of open cases.

Service Coverage Area

Figure 9. Provider-reported Service Coverage Areas

FFT Coverage map

Figure 9 displays the areas in the state covered by open and staffed FFT teams. This data is collected quarterly from provider agencies and reflects the localities from which teams can accept FFT referrals.