Faculty Bibliography

The Family Time-Out (FTO) is a trans-theoretical and trans-diagnostic therapeutic protocol designed to treat intense and chronic conflict in families for whom parent-adolescent conflict plays a salient role. This article outlines the goals, objectives, and stepwise implementation process of the FTO protocol, including the initial FTO family session, follow-up session structure, and troubleshooting of common clinical issues that arise during implementation. A companion article in this issue (Fasulo and Waugh, 2024) presents the FTO protocol’s broader clinical justification, conceptual and developmental foundation, recommended intervention style and clinical assumptions, and strategies for optimizing and managing family commitment to change.

For clinicians and families alike, addressing severe family conflict in the context of adolescent mental health treatment can be a daunting task. Most empirically supported clinical interventions aimed at reducing parent- child conflict with younger children are not suited to adolescent applications. For example, adolescents’ increased autonomy-seeking and individuation leads naturally to reduced parental behavioral leverage over adolescents relative to childhood, making traditional control-oriented parenting interventions less practical. Simultaneously, some parents’ increased anxiety about even normal adolescent risk-taking can further fuel co-escalating conflict when exacerbated by other adolescent mental health difficulties, creating a vicious cycle of coercive communication, cognitive inflexibility, and escalating conflict in parents, adolescents and even other family members. These issues can leave even seasoned clinicians feeling uncertain how to understand and mitigate family conflict that, when chronically harmful enough, can play a role in exacerbating many of the problems that are causing the conflict in the first place. To this end, this report outlines a trans-theoretical, trans-diagnostic protocol, called the Family Time-Out (FTO), aimed at minimizing chronically harmful patterns of parent-adolescent conflict. It can be used as either a stand- alone treatment, or as an adjunctive protocol incorporated into existing mental health treatment plans addressing other adolescent mental health problems.