Community Reinforcement and Family Training: A pilot comparison of group and self-directed delivery
Open accessAbstract
In a randomized clinical pilot study, 40 concerned significant others (CSOs) of treatment-refusing alcohol- and drug-using individuals were randomized to either Community Reinforcement and Family Training (CRAFT) conducted in a group format (Group CRAFT) or a Self-Directed CRAFT condition. Although results indicated no significant between-group difference in engaging treatment-refusing substance-using individuals (referred to as identified patients or IPs) into treatment, the engagement rate in Group CRAFT was similar to rates previously reported with individual CRAFT. For the intent-to-treat analysis, 60% of Group CRAFT CSOs engaged their loved one into treatment, as compared with 40% in Self-Directed CRAFT. Of CSOs in the Group condition who received at least one session of group therapy, 71% engaged their IP into treatment. CSOs in both conditions reported improvements in family cohesion and conflict at the 3- and 6-month follow-up, replicating prior CRAFT findings.
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The use of a self-directed workbook in one treatment condition has proved extremely effective, while hardly effective at all in another.
“For example, the use of a self-directed workbook in one treatment condition has proved extremely effective [18], while hardly effective at all in another [22], and the rates of entry from gamblingfocused studies have been consistently low [20,22,23].”
From Community reinforcement and family training and rates of treatment entry: a systematic review. (2020) · cites this paper as [18]
The citation [22] is attached to the claim that the self-directed workbook was hardly effective at all. Results §3.3 reports that 40% of participants in the Self-Directed CRAFT condition engaged their loved one in treatment, with no statistically significant difference from the group condition; the Discussion also says this rate exceeded those of comparison conditions in previous studies. That is contrary to the cited characterization. (LLM, conf=0.88)
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Experimental — accuracy not yet measuredCRAFT has been shown to improve family functioning.
“improve family functioning (58, 60)”
From Initial insights from a quality improvement initiative to develop an evidence-informed young adult substance use program (2022) · cites this paper as [58]
CRAFT supports individuals in understanding and implementing positive contingencies and natural consequences, positive communication and motivational strategies, and self-care strategies to improve their personal well-being.
“which supports individuals in understanding and implementing: positive contingencies and natural consequences, positive communication and motivational strategies, and self-care strategies to improve their personal well-being (58).”
From Initial insights from a quality improvement initiative to develop an evidence-informed young adult substance use program (2022) · cites this paper as [58]
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References 30 · Cited by 55
Research works printed but not linked: 1
- Moos RH Moos BS 1986 Family Environment Scale manual 2 Palo Alto, CA Consulting Psychologists Press
- Authors
- Manuel, J. K., Austin, J. L., Miller, W. R., McCrady, B. S., Tonigan, J. S., Meyers, R. J., Smith, J. E., & Bogenschutz, M. P.
- Affiliations
- University of California, San Francisco (US)
- University of New Mexico (US)
- Corresponding author
- Manuel, Jennifer K.
- ORCID
- Venue
- Journal of Substance Abuse Treatment
- Publisher
- Elsevier BV
- Published
- 2012-07
- Volume
- 43
- Issue
- 1
- Pages
- 129-136
- ISSN
- 0740-5472 (ISSN-L)
- PMC
- PMC3331969
- OpenAlex
- W2011228682
- Cited by
- 55
- References
- 30
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 6 · 2022: 10 · 2021: 6 · 2020: 3 · 2019: 7 · 2018: 5 · 2017: 2 · 2016: 3 · 2015: 1 · 2014: 2 · 2012: 2
- FWCI
- 0.96
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Substance Abuse Treatment (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Psychological Association
- National Institute on Alcohol Abuse and Alcoholism (K24AA016555)
- National Institute on Drug Abuse (T32DA007250)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- Community Reinforcement and Family Training, concerned significant others, group therapy, self-guided intervention, treatment engagement, family cohesion, family conflict, alcoholism, drug use disorders
- MeSH terms
- Adult, Aged, Alcoholism, Family Therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Pilot Projects, Reinforcement, Social, Time Factors, Treatment Refusal, Substance-Related Disorders
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