Treatment Model: COFAST

COFAST — short for Carolina Outreach Family and Systems Treatment — is a multi-systems model that recognizes how the many influences on a young person contribute to a child’s psychosocial development and success or failure with school, family, and peers. These influences include the child’s parental and family relationships, the school environment, peer influences, community characteristics, and genetic, medical, and intra-psychic factors within the child. All of these variables are considered in each case.

COFAST focuses first on the child’s home. Regardless of where the behavioral problems originate, the reactions of the family—especially the parents or parent figures—can determine if the problems become worse, get better, or stay the same.

Accordingly, most of the therapy offered by Carolina Outreach staff requires involvement by the family system and includes approaches that influence the child’s home life and the parents’ guidance, nurturance, and supervision.

Focusing on the child in-system, the COFAST model has the following characteristics:

  • Present-Focus, which entails helping the family solve its real-world problems. Present-focus provides immediate relief for family members and promotes healthy family functioning through effective problem solving.
  • Goal-Oriented, which sets therapeutic goals that address the family hierarchy and structure (power, boundaries, alliances) to change the way the family conducts its activities.
  • Systems-Based, which entails having the Carolina Outreach staff view the family as being shaped by two systems: outside in the larger social context of culture, community, other professionals, and extended family; and within, as a set of interdependent relationships, with each family member influencing, and being influenced by, other members.
  • Time-Limited, which acknowledges that therapeutic goals must have time limits in order to provide positive change for the child and family. For this reason, the COFAST team must constantly reassess a child’s therapeutic goals to keep them realistic and achievable.

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