Efficacy of the Community Reinforcement and Family Training for concerned significant others of treatment-refusing individuals with alcohol dependence: A randomized controlled trial
Abstract
Background The Community Reinforcement and Family Training (CRAFT) is a promising approach for Concerned Significant Others (CSOs) of alcohol-dependent individuals (ADI) that aims to engage treatment-refusing patients in alcohol treatment and to improve CSO functioning. To date, only two randomized controlled trials (RCTs) of CRAFT-based treatment for CSOs of ADI are available, both conducted in the U.S. For the first time, this study analyses the efficacy of CRAFT in a sample of CSOs outside of the U.S.Methods Participants were recruited through the treatment system (general practitioners, psychotherapists, addiction counselling services) and through media solicitation. After brief screening, 94CSOs were randomly allocated to an immediate intervention condition (II) or a wait list condition (WL) that received the CRAFT intervention after 3 months. Data for the follow-up assessments at 3 and 6 months was provided by 78CSOs (II N=42; WL N=36). In addition, a follow-up assessment (f-u) was conducted after 12 months (Response rate 92%).Results At 3-month f-u, II revealed significant higher ADI engagement rates (40.5%) compared to WL (13.9%); after WL received the CRAFT intervention, engagement rates did not differ between both groups at 6- and 12-month f-u. CSOs in both groups reported significant improvements in terms of mental health and family cohesion after having received the intervention, i.e. II at 3-months f-u and WL at 6-month f-u.Conclusions Data show that CRAFT is effective for treating CSOs of alcohol dependent individuals in terms of treatment engagement and improvement of CSOs mental health and family cohesion.
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Improvements in problem-focused coping could have contributed to reduced depressive symptoms, which in turn may have enhanced overall life satisfaction.
“Specifically, improvements in problem-focused coping could have contributed to reduced depressive symptoms, which in turn may have enhanced overall life satisfaction.”
From Online community reinforcement and family training (CRAFT) for rural concerned significant others: A randomized controlled trial (2026) · cites this paper as Bischof et al., 2016
Face-to-face CRAFT trials in the USA and Europe have reported improved mental health, quality of life and relational functioning for the CSO, as well as reduced substance use of the IP.
“Face-to-face CRAFT trials in the United States of America (USA) and Europe have reported improved mental health, quality of life and relational functioning for the CSO, as well as reduced substance use of the IP (Bischof et al., 2016”
From Online community reinforcement and family training (CRAFT) for rural concerned significant others: A randomized controlled trial (2026) · cites this paper as Bischof et al., 2016
Previous research has shown negative correlations between problem-focused coping style and depressive symptoms.
“Previous research has shown negative correlations between problem-focused coping style and depressive symptoms (Bischof et al., 2016”
From Online community reinforcement and family training (CRAFT) for rural concerned significant others: A randomized controlled trial (2026) · cites this paper as Bischof et al., 2016
CRAFT has demonstrated cross-cultural effectiveness.
“CRAFT has demonstrated cross-cultural effectiveness (Archer et al., 2020”
From Online community reinforcement and family training (CRAFT) for rural concerned significant others: A randomized controlled trial (2026) · cites this paper as Bischof et al., 2016
Previous research has shown that improvements in CSO wellbeing following CRAFT can be sustained at longer follow-up periods.
“Previous research has shown that improvements in CSO wellbeing following CRAFT can be sustained at longer follow-up periods (Bischof et al., 2016”
From Online community reinforcement and family training (CRAFT) for rural concerned significant others: A randomized controlled trial (2026) · cites this paper as Bischof et al., 2016
CRAFT has been shown to improve the loved ones' mental health.
“and mental health (63).”
From Initial insights from a quality improvement initiative to develop an evidence-informed young adult substance use program (2022) · cites this paper as [63]
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- Authors
- Bischof, G., Iwen, J., Freyer-Adam, J., & Rumpf, H.-J.
- Affiliations
- University of Lübeck (DE)
- Universität Hamburg (DE)
- Corresponding author
- Bischof, Gallus
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2016-06
- Volume
- 163
- Pages
- 179-185
- ISSN
- 0376-8716 (ISSN-L)
- OpenAlex
- W2340930823
- Cited by
- 81
- References
- 30
- Citations by year
- 2026: 8 · 2025: 13 · 2024: 11 · 2023: 9 · 2022: 13 · 2021: 10 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 1
- FWCI
- 4.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drug and Alcohol Dependence (publishedVersion)
- PubMed (publishedVersion)
- Funders
- German Federal Ministry of Research and Education (01GX0702)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Keywords
- Community Reinforcement and Family Training, concerned significant others, alcoholism, family intervention, treatment engagement, family cohesion, alcoholism treatment
- MeSH terms
- Adult, Alcoholism, Counseling, Family Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Reinforcement, Psychology, Residence Characteristics, Treatment Refusal, Behavior, Addictive, Treatment Outcome
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