Analyzing components of Community Reinforcement and Family Training (CRAFT): Is treatment entry training sufficient?

Kirby, Kimberly C.; Benishek, Lois A.; Kerwin, MaryLouise E.; Dugosh, Karen L.; Carpenedo, Carolyn M.; Bresani, Elena; Haugh, James A.; Washio, Yukiko; Meyers, Robert J.

doi:10.1037/adb0000306

Cited by 51Substance Abuse Treatment and OutcomesCounseling, Therapy, and Family DynamicsOpioid Use Disorder Treatment

Analyzing components of Community Reinforcement and Family Training (CRAFT): Is treatment entry training sufficient?

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Kirby, Kimberly C., Benishek, Lois A., Kerwin, MaryLouise E., Dugosh, Karen L., Carpenedo, Carolyn M., Bresani, Elena, Haugh, James A., Washio, Yukiko +1 more·2017·Psychology of Addictive Behaviors

DOI 10.1037/adb0000306PMC PMC5690811

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Abstract

Community Reinforcement and Family Training (CRAFT) assists family members with a treatment-resistant loved one. The most consistent outcome of CRAFT is increased treatment entry of the identified treatment-resistant person (IP). This led us to question whether all 6 components of CRAFT are necessary. In a randomized clinical trial, 115 concerned significant others (CSOs) of an IP received 12-14 sessions of the full CRAFT intervention, 4-6 sessions focused on Treatment Entry Training (TEnT), or 12-14 sessions of Al-Anon/Nar-Anon Facilitation (ANF). We monitored treatment entry, attendance, and substance use of the IP and the CSO's mood and functioning. Data were collected at baseline and 4, 6, and 9 months after the baseline. We found significant reductions in time to treatment entry (χ(2)2 = 8.89, p = .01) and greater treatment entry rates for CRAFT (62%; odds ratio [OR] = 2.7, 95% confidence interval [CI] = 1.1-6.9) and TEnT (63%; OR = 2.9, 95% CI = 1.2-7.5) compared with ANF (37%), but CRAFT and TEnT did not differ significantly from each other (OR = 1.1, 95% CI = 0.4-2.7). No between-group differences in IP drug use were reported by CSOs, but days of drug use decreased over time for all groups (F(3, 277) = 13.47, p < .0001). Similarly, CSO mood and functioning did not differ between the 3 conditions but improved over time (p < .0001 for all significant measures). We replicated the results of previous trials demonstrating that CRAFT produces greater treatment entry rates than ANF and found similar treatment entry rates for CRAFT and TEnT. This suggests that treatment entry training is sufficient for producing the best established outcome of CRAFT. (PsycINFO Database Record

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Rates of IP treatment entry across recent CRAFT innovations have been highly divergent, ranging from >60% down to 12.5%.
“Rates of IP treatment entry across these innovations have been highly divergent, ranging from the previously established levels of > 60% [21] down to 12.5% [22].”
From Community reinforcement and family training and rates of treatment entry: a systematic review. (2020) · cites this paper as [21]
The citation to this paper is attached to the 12.5% end of the range. Results §3.4.1 reports initial IP treatment-entry rates of 62% for CRAFT, 63% for TEnT, and 37% for ANF—not 12.5%. Results §3.4.3 separately reports a 29% transfer rate among IPs who attended brief treatment. (LLM, conf=0.87)
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Additional file 1 of Primary Outcome from a cluster-randomized trial of three formats for delivering Community Reinforcement and Family Training (CRAFT) to the significant others of problem drinkers
Hellum, R., Bilberg, R., Andersen, K., Bischof, G., Hesse, M., & Nielsen, A. S. (2022) · Figshare · doi:10.6084/m9.figshare.19746371
Additional file 2 of ‘Before, we ended up in conflicts, now we can provide support’—Experiences of Community Reinforcement and Family Training (CRAFT) for parents of young adults with hazardous substance use
Siljeholm, O., Eckerström, J., Molander, O., Sundbye, J., & Hammarberg, A. (2024) · Figshare · doi:10.6084/m9.figshare.26082711
Additional file 2 of Primary Outcome from a cluster-randomized trial of three formats for delivering Community Reinforcement and Family Training (CRAFT) to the significant others of problem drinkers
Hellum, R., Bilberg, R., Andersen, K., Bischof, G., Hesse, M., & Nielsen, A. S. (2022) · Figshare · doi:10.6084/m9.figshare.19746374
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Self-citation
Community Reinforcement and Family Training (CRAFT)
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Community Reinforcement and Family Training: A pilot comparison of group and self-directed delivery
Manuel, J. K., Austin, J. L., Miller, W. R., McCrady, B. S., Tonigan, J. S., Meyers, R. J., Smith, J. E., & Bogenschutz, M. P. (2012) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2011.10.020 · Cited by 55 · see citing works
Self-citation
Community Reinforcement and Family Training (CRAFT)
Pylypciw, M., Sutherland, A., & Smith, J. E. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-29009-1.00138-4

Authors: Kirby, K. C., Benishek, L. A., Kerwin, M. E., Dugosh, K. L., Carpenedo, C. M., Bresani, E., Haugh, J. A., Washio, Y., & Meyers, R. J.
Affiliations: Treatment Research Institute (US)
Christiana Care Health System (US)
University of New Mexico (US)
ORCID: Kirby, Kimberly C.
Dugosh, Karen L.
Washio, Yukiko
Venue: Psychology of Addictive Behaviors
Publisher: American Psychological Association (APA)
Published: 2017-11
Volume: 31
Issue: 7
Pages: 818-827
ISSN: 0893-164X (ISSN-L)
1939-1501
DOI: 10.1037/adb0000306
PMC: PMC5690811
OpenAlex: W2750022066
Cited by: 51
References: 31
Citations by year: 2026: 6 · 2025: 8 · 2024: 9 · 2023: 6 · 2022: 9 · 2021: 5 · 2020: 1 · 2019: 5 · 2018: 2
FWCI: 1.71
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: other-oa
www.apa.org/pubs/journals/resources/open-access.aspx (am, 296 d)
Locations: Psychology of Addictive Behaviors (publishedVersion, other-oa)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (R01 DA018696, P50 DA027841)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords: Community Reinforcement and Family Training, concerned significant others, family intervention, substance use, treatment attendance, intervention components
MeSH terms: Adult, Family, Family Therapy, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Reinforcement, Psychology, Treatment Outcome, Substance-Related Disorders

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Analyzing components of Community Reinforcement and Family Training (CRAFT): Is treatment entry training sufficient?

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