Application of Alternatives for Families: A Cognitive-Behavioral Therapy to School Settings

Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) is an evidence-based treatment for families with children aged 5 to 15 years who have been affected by verbal and physical aggression in the family. AF-CBT was designed to address risks for exposure to emotional and physical aggression as well as common clinical consequences of exposure to aggression by taking a family-systems approach to strengthening individual and family functioning. Given the target population, AF-CBT also integrates monitoring of and content related to family safety. This article provides an overview of AF-CBT including a discussion of appropriate populations and modalities, AF-CBT principles, and the theoretical basis of AF-CBT. The treatment is divided into three phases: (a) engagement and psychoeducation, (b) individual skill building, and (c) family applications and routines. The authors review each of these phases, the specific components and content of AF-CBT, and its empirical support. AF-CBT was one of the first treatments for physical aggression to be considered an evidence-based treatment. Information is provided on the opportunities and challenges of applying AF-CBT in schools, cultural considerations in AF-CBT's implementation, and how to obtain training in AF-CBT. Specifically, the authors provide details on the role of school psychologists in the delivery of AF-CBT, for example, as direct service providers or as important referral sources. The authors also provide details on topics that psychologists and schools might want to consider in determining whether AF-CBT is a good fit for them and their setting.