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Cited by 95Substance Abuse Treatment and OutcomesGambling Behavior and TreatmentsCounseling, Therapy, and Family Dynamics

Community reinforcement and family training and rates of treatment entry: a systematic review.

Open access
Archer, Marc, Harwood, Hannah, Stevelink, Sharon, Rafferty, Laura, Greenberg, Neil·2020·Addiction
DOI 10.1111/add.14901
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Abstract

BACKGROUND AND AIMS: Adaptations with different modes of delivery and target addictions have found highly divergent rates of success for Community Reinforcement Approach and Family Training (CRAFT). This study aims to clarify which (1) treatment components and (2) participant characteristics contribute to rates of identified patient (IP) treatment entry. METHOD: Systematic review of CRAFT evaluation studies of all designs (controlled and uncontrolled) with data synthesis and narrative analysis of addiction treatment services and university research departments in North America and Europe. RESULTS: A total of 691 concerned significant others (CSOs), predominately female spouses/parents, participating in 20 distinct treatment conditions from 14 studies. The main outcome of IP treatment entry rate reported by CSOs up to 12 months after starting CRAFT with key predictors/correlates including IP addiction, IP-CSO relationship, CRAFT modality and integration of treatment for IP. Meta-analysis found CRAFT to be twice as effective as controls/comparison groups. Multi-modality treatment, including both individual and group sessions, yielded the highest IP treatment entry rates (77 and 86%), with progressively lower rates for individual (12.5-71%), group (60%) and self-directed workbook (13.3-40%) modalities. While all five studies targeting gambling addiction had consistently low rates (12.5-23%), other treatment components, including therapist training, treatment fidelity and integrating treatment for the IP, were implicated. CONCLUSIONS: Adaptations of Community Reinforcement Approach and Family Training for different delivery modalities and addictions have yielded widely varying rates of treatment engagement for the identified patient, with those offering the most comprehensive support to the concerned significant other, including individual and group sessions, having highest levels of engagement success.

Integrity signals

Registry

Crossref · 10.1111/add.14901

Cites

40 of 40 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

8 of 43 cited sources checked · 2 supported · 2 flagged · accuracy not yet measured

  • Premisecitation

    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].”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [21] 21. Kirby K. C., Benishek L. A., Kerwin M. E., Dugosh K. L., Carpenedo C. M., Bresani E., et al. Analyzing components of community reinforcement and family training (CRAFT): is treatment entry training sufficient? Psychol Addict Behav 2017; 31: 818-27. source

      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)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites [22] 22. Nayoski N., Hodgins D. C. The efficacy of individual commu- nity reinforcement and family training (CRAFT) for concerned significant others of problem gamblers. J Gambl Is- sues 2016; 33: 189-212. source
  • Premisecitation

    Recent innovations in online CRAFT delivery for military families have been singularly focused on CSO wellbeing/relationship quality.

    “Recent innovations in online CRAFT delivery for military families have, in fact, been singularly focused on this [34]”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [34] 34. Osilla K. C., Trail T. E., Pedersen E. R., Gore K. L., Tolpadi A., Rodriguez L. M. Efficacy of a web-based intervention for con- cerned spouses of service members and veterans with alcohol misuse. J Marital Fam Ther 2018; 44: 292-306. source

      In “Partners Connect: A Web-Based Adaption of CRAFT for Military CPs,” the authors describe improving concerned partners’ mental health and communication as the intervention’s primary goal. “Singularly focused” overstates this: the same section also describes a hoped-for reduction in partners’ drinking and assesses outcomes for service members and veterans. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
  • Premisecitation

    Brigham et al. found a significant effect on retention only when the IP was the CSO's adult child.

    “They found a significant effect on retention only when the IP was the CSO's adult child”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [37] 37. Brigham G., Slesnick N., Winhusen T., Lewis D., Guo X., Somoza E. A randomized pilot clinical trial to evaluate the ef- ficacy of community reinforcement and family training for treatment retention (CRAFT-T) for improving outcomes for patients completing opioid detoxification. Drug Alcohol Depend [internet] 2014; 138: 240-3. Available at:; http:// onlinelibrary.wiley.com/o/cochrane/clcentral/articles/306/ CN-00989306/frame.html. source

      The Results (section 3.3) report a significant retention effect for IPs with parental-family CSOs, while the overall effect approached but did not reach significance. The Methods (section 2.4) define that subgroup to include parents, aunts, grandparents, and siblings—not only CSOs whose adult child was the IP. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
  • Findingreasoning

    With one exception, type of CSO-IP relationship was not associated with IP treatment entry.

    “With one exception, type of CSO-IP relationship was not associated with IP treatment entry.”
    Quote in the paperSubstantial claim
  • Findingreasoning

    Overall, the nature of the CSO-IP relationship was not a determining factor for IP treatment entry.

    “Overall, the nature of the CSO-IP relationship was not a determining factor for IP treatment entry”
    Quote in the paperSubstantial claim
  • May combine two claims. 23
  • Classified as probably not a substantial claim. 21
  • The quote only partly states this claim. 1

  • May combine two claims.

    Premisecitation

    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].”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites [18] 18. Manuel J. K., Austin J. L., Miller W. R., McCrady B. S., Tonigan J. S., Meyers R. J., et al. Community reinforcement and family training: a pilot comparison of group and self-directed deliv- ery. J Subst Abuse Treat 2012; 43: 129-36. source

      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)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites [22] 22. Nayoski N., Hodgins D. C. The efficacy of individual commu- nity reinforcement and family training (CRAFT) for concerned significant others of problem gamblers. J Gambl Is- sues 2016; 33: 189-212. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    This review was conducted in accordance with the PRISMA Statement.

    “This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement [26] (see Fig. 1).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [26] 26. Moher D., Liberati A., Tetzlaff J., Altman D. G., the PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6: e1000097. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The review used a PRISMA flow diagram for the study search and inclusion process.

    “Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram of the study search and inclusion process”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [26] 26. Moher D., Liberati A., Tetzlaff J., Altman D. G., the PRISMA Group Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009; 6: e1000097. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Addictive disorders have pervasive negative consequences for partners, family members and friends (CSOs), who are at heightened risk of abuse, physical and mental health problems.

    “Addictive disorders also have pervasive negative consequences for partners, family members and friends [concerned significant others (CSOs)] who, through intimate proximity, are at heightened risk of abuse, physical and mental health problems [7,8].”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [7] 7. Lipari RN, Van Horn S. L. Children living with parents who have a substance use disorder. The CBHSQ Report: August 24, 2017. Rockville, MD: Center for Behavioral Health Statis- tics and Quality, Substance Abuse and Mental Health Services Administration; 2017.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [8] 8. Lander L., Howsare J., Byrne M. The impact of substance use disorders on families and children: from theory to practice. Soc Work Public Health 2013; 28: 194-205. source

      The sections on parental substance abuse and child abuse report increased risks of abuse and poorer physical and mental-health outcomes for children in families affected by substance use disorders. The paper supports negative consequences for family members, especially children, but does not establish the stated heightened risks for friends or for partners and other family members as a group. Page numbers were unavailable in our copy. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    Prolonged untreated addiction can cause problems for the individual and their family, and delayed treatment, often provided during a crisis, is both less effective and more costly.

    “Prolonged untreated addiction can cause problems for the individual and their family, and delayed treatment, often provided during a crisis, is both less effective and more costly [6].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [6] 6. Murphy D., Palmer E., Westwood G., Busuttil W., Greenberg N. Do alcohol misuse, service utilisation, and demographic char- acteristics differ between UK veterans and members of the general public attending an NHS general hospital? J Clin Med 2016; 5: pii: E95. source

      The Discussion (section 4; page not provided) suggests that veterans may seek help later and that earlier help could reduce costly hospital use, but it frames this as a question rather than a demonstrated effect. The paper does not establish that delayed treatment occurs during crises, is less effective, or causes problems for families. (LLM, conf=0.84)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Findingcitation

    The four treatment conditions achieving rates in excess of 70% were those offering multi-modality treatment and two that explicitly stated that additional crisis/emergency sessions were available.

    “The four treatment conditions achieving rates in excess of 70% were those offering multi-modality treatment [16,17] and two that explicitly stated that additional (crisis/emergency) sessions were available [15,19].”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [16] 16. Sisson R. W., Azrin N. H. Family-member involvement to ini- tiate and promote treatment of problem drinkers. J Behav Ther Exp Psychiatry 1986; 17: 15-21. source
    • cites [17] 17. Meyers R. J., Miller W. R., Smith J. E., Tonigan J. S. A random- ized trial of two methods for engaging treatment-refusing drug users through concerned significant others. J Consult Clin Psychol 2002; 70: 1182-5. source
    • cites [15] 15. Meyers R. J., Mille W. R., Hill D. E., Tonigan J. S. Community reinforcement and family training (CRAFT): engaging unmotivated drug users in treatment. J Subst Abuse 1998; 10: 291-308. source
    • cites [19] 19. Waldron H. B., Kern-Jones S., Turner C. W., Peterson T. R., Ozechowski T. J. Engaging resistant adolescents in drug abuse treatment. J Subst Abuse Treat 2007; 32: 133-42. source

  • May combine two claims.

    Findingown data

    None of the five treatment condition groups for problem gambling included an integrated IP treatment, and these interventions demonstrated the lowest levels of IP treatment entry (12.5-23%).

    “This was not the case in any of the five treatment condition groups for problem gambling, meaning that IP treatment for gambling would need to be sought independently, and these interventions demonstrated the lowest levels of IP treatment entry (12.5-23%).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Fourteen of the 20 treatment condition groups included an integrated treatment for the IP provided by or linked directly to the same team providing the CRAFT intervention, with IP treatment entry rates of 52-86%.

    “Fourteen of the 20 treatment condition groups included an 'integrated' treatment for the IP provided by or linked directly to the same team providing the CRAFT intervention (IP treatment entry rates of 52-86%).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Neither CSO age nor sex appeared to be associated with IP treatment entry rates.

    “Neither CSO age nor sex appeared to be associated with IP treatment entry rates.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    The only problem-gambling study that included CRAFT therapists provided therapists with just a 6-hour training session on CRAFT, and this treatment group had the lowest of all IP treatment entry rates (12.5%).

    “The only problemgambling study which included CRAFT therapists (i.e. was not workbook-focused) provided therapists with just a 6-hour training session on CRAFT [22], and this treatment group had the lowest of all IP treatment entry rates (12.5%).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] 22. Nayoski N., Hodgins D. C. The efficacy of individual commu- nity reinforcement and family training (CRAFT) for concerned significant others of problem gamblers. J Gambl Is- sues 2016; 33: 189-212. source

  • May combine two claims.

    Findingown data

    The largest proportion of IPs were reported to be spouse/partner of the CSO in 12 treatment condition groups, adult children in six, and adolescent/young adult children in the remaining two.

    “The largest proportion of IPs were reported to be spouse/partner of the CSO in 12 of the treatment condition groups, adult children in six and adolescent/young adult children in the remaining two.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The majority of CSOs were female in all 20 groups, ranging from 72 to 100%.

    “The majority of CSOs were female in all 20 groups, ranging from 72 to 100%.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    The more effective CRAFT interventions tended to include several key treatment characteristics: individual therapy modality, thorough training and supervision for therapists, and integrated addiction treatments for IPs.

    “The more effective CRAFT interventions tended to include several 'key' treatment characteristics: individual therapy modality, thorough training and supervision for therapists and integrated addiction treatments for IPs.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Likelihood of the IP entering treatment seems to be associated with the breadth of the treatment offered to the CSO, and not the number of sessions offered or completed.

    “Likelihood of the IP entering treatment seems to be associated with the breadth of the treatment offered to the CSO, and not the number of sessions offered or completed.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Therapist competence and adherence to treatment programme have both been found to be associated with positive patient outcomes in community reinforcement approach (CRA) treatment for patients.

    “Therapist competence and adherence to treatment programme have both been found to be associated with positive patient outcomes in community reinforcement approach (CRA) treatment for patients [32].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [32] 32. Campos-Melady M., Smith J. E., Meyers R. J., Godley S. H., Godley M. D. The effect of therapists' adherence and compe- tence in delivering the adolescent community reinforcement approach on client outcomes. Psychol Addict Behav 2017; 31: 117-29. source

  • May combine two claims.

    Interpretationreasoning

    Level of IP treatment entry may be associated with the ease by which treatment can be accessed and/or the inclusion of both the CSO and the IP with the same service provider.

    “Thus, level of IP treatment entry may be associated with the ease by which treatment can be accessed and/or the inclusion of both the CSO and the IP with the same service provider.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Quality ratings across the 14 included studies tended to be low: two studies received a 'moderate' rating, and the remaining 12 a 'weak' rating.

    “Quality ratings across the 14 included studies tended to be low: two studies received a 'moderate' rating, and the remaining 12 a 'weak' rating.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The potential to provide a relatively personalized treatment fit to the specific circumstances of each CSO may contribute to these positive outcomes.

    “The potential to provide a relatively personalized treatment fit to the specific circumstances of each CSO may contribute to these positive outcomes.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Smith & Meyers instruct therapists that CRAFT should be delivered flexibly to meet the idiosyncratic needs of each CSO, in terms of which components are included and at which stage in treatment.

    “This inference is consistent with Smith & Meyers' instruction to therapists that, in terms of which components are included and at which stage in treatment, CRAFT should be delivered flexibly to meet the idiosyncratic needs of each CSO [11].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [11] 11. Smith J. E., Meyers R. J. Motivating Substance Abusers to Enter Treatment: Working with Family Members. New York, NY: Guilford Press; 2004.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    The range of results strongly suggest that 'more is more' and 'less is less' in terms of CRAFT treatment characteristics.

    “The range of results strongly suggest that 'more is more' and 'less is less' in terms of CRAFT treatment characteristics”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    CRAFT utilizes the unique position of CSOs and aims to improve their understanding of addiction and to modify their own behaviour to foster a supportive environment and increase the IP's motivation to seek help.

    “Community Reinforcement Approach and Family Training (CRAFT) utilizes the unique position of CSOs and aims to improve their understanding of addition and to modify their own behaviour to foster a supportive environment and increase the identified patient's (IP's) motivation to seek help [11].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11] 11. Smith J. E., Meyers R. J. Motivating Substance Abusers to Enter Treatment: Working with Family Members. New York, NY: Guilford Press; 2004.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The analysis was not pre-registered.

    “the analysis was not pre-registered”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Two researchers rated the 14 studies using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies (EPHPP).

    “Two researchers (H.H. and M.A.) rated the 14 studies using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies (EPHPP [30]).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] 30. Thomas B. H., Ciliska D., Dobbins M., Micucci S. A process for systematically reviewing the literature: providing the research evidence for public health nursing interventions. Worldviews Evid Based Nurs 2004; 1: 176-84. Accessed date January 25th, 2019. source

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). The quote only partly states this claim.

    Interpretationreasoning

    An assertive stance on the part of the CSO enhances outcomes.

    “which is intriguingly consistent with the idea posited above that an assertive stance on the part of the CSO enhances outcomes”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationreasoning

    Country of origin and regional variations in service availability may impact the success rates of CRAFT in general.

    “Given that these five studies were all conducted in Canada, country of origin and regional variations in service availability may impact the success rates of CRAFT in general.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Treatment entry rates for IPs with substance use disorders have been consistently high; most studies achieve >60%, with the earliest evaluation of CRAFT reporting a rate of 86%.

    “Treatment entry rates for IPs with substance use disorders (SUDs) have been consistently high; most studies achieve > 60% [13][14][15], with the earliest evaluation of CRAFT reporting a rate of 86% [16].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [13][14][15]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [16] 16. Sisson R. W., Azrin N. H. Family-member involvement to ini- tiate and promote treatment of problem drinkers. J Behav Ther Exp Psychiatry 1986; 17: 15-21. source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Fewer than 10% of the 15 million people in the United States with an alcohol use disorder seek professional help.

    “Estimates suggest that fewer than 10% of the 15 million people in the United States with an alcohol use disorder seek professional help [4]; similar proportions apply to gambling addiction [5].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [4] 4. Center for Behavioral Health Statistics and Quality. 2016 Na- tional Survey on Drug Use andHealth: Detailed Tables. Substance Abuse and Mental Health Services Administration, Rockville, MD 2017.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The results of this review should be considered exploratory.

    “therefore our results should be considered exploratory”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Similar proportions of people with gambling addiction seek professional help as those with alcohol use disorder.

    “Estimates suggest that fewer than 10% of the 15 million people in the United States with an alcohol use disorder seek professional help [4]; similar proportions apply to gambling addiction [5].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [5] 5. Cunningham J. A. Little use of treatment among problem gamblers. Psychiatr Serv 2005; 56: 1024-5. source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Across all domains the two raters agreed on 75% of all points rated (63 of 84) with a Cohen's kappa of 0.58 (95% CI = 0.41-0.75).

    “Across all domains the two raters agreed on 75% of all points rated (63 of 84) with a Cohen's kappa of 0.58 (95% CI = 0.41-0.75),which is just below the boundary between moderate and good agreement.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Ongoing work in the United States and United Kingdom is adapting CRAFT beyond addictive illnesses to PTSD and common mental disorders in military families.

    “Ongoing work in the United States and United Kingdom is adapting CRAFT beyond addictive illnesses to posttraumatic stress disorder (PTSD) and common mental disorders (CMD) in military families (e.g.[36]).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [36] 36. VA Office of Research and Development. Helping Families Help Veterans With PTSD and Alcohol Abuse: an RCT of VA-CRAFT. Study Protocol. 2016 [Available at: https:// clinicaltrials.gov/ct2/show/NCT01678196.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based). May combine two claims.

    Interpretationreasoning

    Gambling behaviours and effects may be more difficult to detect than those associated with substance misuse, and so contingency management on the part of the CSO could be more challenging in general.

    “One notable differentiator might be that gambling behaviours and effects may be more difficult to detect than those associated with substance misuse (e.g.inebriation), and so contingency management on the part of the CSO could be more challenging in general.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    CSOs are uniquely positioned to support behaviour change and are often credited as the main reason for seeking professional help.

    “However, CSOs are also uniquely positioned to support behaviour change and are often credited as the main reason for seeking professional help [9,10].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [9] 9. Cameron L., Leventhal E. A., Leventhal H. Symptom represen- tations and affect as determinants of care seeking in a community-dwelling, adult sample population. Health Psychol 1993; 12: 171-9. source
    • cites [10] 10. Cusack J., Deane F. P., Wilson C. J., Ciarrochi J. Who influence men to go to therapy? Reports from men attending psycholog- ical services. Int J Adv Counsel 2004; 26: 271-83. source

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Addictive disorders are characterized by diminished motivational control and intense craving for the addictive behaviour, making self-motivated treatment-seeking challenging.

    “Addictive disorders are characterized by diminished motivational control and intense craving for the addictive behaviour, making self-motivated treatment-seeking challenging [1][2][3].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [1][2][3]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    All disagreements between raters were satisfactorily resolved through discussion and with reference to the EPHPP Quality Assessment Tool Dictionary.

    “Most (14) deviations were a single 'grade' (e.g.moderate score compared to weak score) and all were satisfactorily resolved through discussion and with reference to the EPHPP Quality Assessment Tool Dictionary.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    CRAFT developed from the Community Reinforcement Approach (CRA) for substance misusers, which focuses on rewarding abstinence, therefore programmes for the CSO and IP can be congruent and overlapping.

    “CRAFT developed from the Community Reinforcement Approach (CRA) for substance misusers, which focuses on rewarding abstinence, therefore programmes for the CSO and IP can be congruent and overlapping [12].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [12] 12. Miller W. R., Meyers R. J., Hiller-Sturmhofel S. The community reinforcement approach. Alcohol Res Health 1999; 23: 116-21.

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The review assessed the quality of included studies using the EPHPP quality assessment tools for quantitative studies.

    “Quality assessments of included studies using the EPHPP quality assessment tools for quantitative studies.”
    Quote in the paperNot a substantial claim
37 of 37

  • The paper relies on this without support.

    It is not clear why rates of IP treatment entry have varied so widely.

    “Despite varied intervention components within the new approaches, it is not clear why rates of IP treatment entry rates have varied so widely.”

  • The paper relies on this without support.

    It is not clear which, if any, CSO and IP characteristics differentiate those who enter treatment from those who do not.

    “Moreover, it is not clear which, if any, CSO and IP characteristics differentiate those who enter treatment from those who do not (e.g.[19]).”

  • The paper relies on this without support.

    The CRAFT approach avoids characteristic features of the most widely used but less effective interventions for CSOs, specifically the acceptance of powerlessness to influence change of Al/Nar-Anon and the confrontational ultimatums of the Johnson intervention.

    “The CRAFT approach avoids characteristic features of the most widely used, but less effective, interventions for CSOs, specifically the acceptance of powerlessness to influence change of Al/Nar-Anon and the confrontational ultimatums of the Johnson intervention.”

  • The paper relies on this without support.

    The majority of those with addiction disorders do not enter treatment.

    “the majority of those with addiction disorders do not enter treatment”

  • The paper relies on this without support.

    Increases in the use of CRAFT over the past decade in countries such as the United Kingdom and Japan have not been accompanied by rigorous evaluation and research.

    “Increases in the use of CRAFT over the past decade, in countries as diverse as the United Kingdom and Japan, has not been accompanied by rigorous evaluation and research.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • The same two studies receive incompatible quality labels

    Minor

    The methods say that two studies were rated moderate and the other 12 weak. The results instead describe two studies as having received a strong rating.

  • A treatment difference is called significant and near-significant

    Minor

    The results call the 40% versus 60% difference significant, whereas the discussion calls that same comparison near-significant and gives P = 0.06.

  • Individual-treatment range excludes a reported 74% rate

    Minor

    The stated upper limit for individual treatment is 71%, although the paper reports 74% for Meyers et al. [15], whose condition is classified as individual treatment in Table 2.

  • Multi-modality heterogeneity test has too many degrees of freedom

    Minor

    The paper identifies only two multi-modality conditions, so a Q-test comparing those conditions would have one degree of freedom, not five. The reported χ2 value and P-value also align with one degree of freedom.

4 of 4

Cites

Flagged first, then by citations

Research works printed but not linked: 1

  1. Bischof G., 2013, Impact of motives on treatment outcomes for Concerned Significant Others supporting treatment‐seeking of addicts through Community Reinforcement and Family Training (CRAFT), Addiction Treatment, 14, 78

Cited by

Sorted by citations

Related

Authors
Archer, M., Harwood, H., Stevelink, S., Rafferty, L., & Greenberg, N.
Affiliations
King's College London (GB)
Corresponding author
Greenberg, Neil
ORCID
Venue
Addiction
Publisher
Wiley
Published
2020-01-03
Volume
115
Issue
6
Pages
1024-1037
ISSN
  • 0965-2140 (ISSN-L)
  • 1360-0443
DOI
10.1111/add.14901
OpenAlex
W2990689052
Cited by
95
References
39
Citations by year
2026: 10 · 2025: 25 · 2024: 15 · 2023: 13 · 2022: 19 · 2021: 9 · 2020: 4
FWCI
1.17
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Addiction (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Social Sciences › Psychology › Clinical Psychology › Gambling Behavior and Treatments
  • Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
Keywords
crafts, treatment entry, concerned significant others, treatment engagement, gambling addiction, treatment options, therapist training, intervention fidelity, substance use disorders
MeSH terms
Adult, Aged, Aged, 80 and over, Europe, Family Therapy, Female, Humans, Male, Middle Aged, North America, Patient Acceptance of Health Care, Reinforcement, Psychology, Behavior, Addictive, Spouses, Substance-Related Disorders, Young Adult

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-11.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-11.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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