Treatment Research Institute.
Department of Psychology.
Psychol Addict Behav. 2017 Nov;31(7):818-827. doi: 10.1037/adb0000306. Epub 2017 Aug 24.
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
社区强化和家庭训练（CRAFT）帮助有治疗抵抗的亲人的家庭成员。CRAFT 最一致的结果是增加了被确定为治疗抵抗者（IP）的治疗进入率。这让我们质疑 CRAFT 的所有 6 个组成部分是否都是必要的。在一项随机临床试验中，115 名有治疗抵抗者的相关重要他人（CSO）接受了 12-14 节完整的 CRAFT 干预、4-6 节重点关注治疗进入培训（TEnT）或 12-14 节 Al-Anon/Nar-Anon 促进（ANF）。我们监测了 IP 和 CSO 的治疗进入、出勤率和物质使用情况，以及 CSO 的情绪和功能。数据在基线和基线后 4、6 和 9 个月收集。我们发现治疗进入时间有显著减少（χ(2)2 = 8.89，p =.01），CRAFT（62%；优势比[OR] = 2.7，95%置信区间[CI] = 1.1-6.9）和 TEnT（63%；OR = 2.9，95% CI = 1.2-7.5）的治疗进入率更高，而 ANF（37%）则较低，但 CRAFT 和 TEnT 之间没有显著差异（OR = 1.1，95% CI = 0.4-2.7）。CSO 没有报告 IP 药物使用的组间差异，但所有组的药物使用天数随着时间的推移而减少（F(3, 277) = 13.47，p <.0001）。同样，CSO 的情绪和功能在 3 种情况下没有差异，但随着时间的推移有所改善（所有显著指标的 p <.0001）。我们复制了之前的试验结果，表明 CRAFT 产生的治疗进入率高于 ANF，并且发现 CRAFT 和 TEnT 的治疗进入率相似。这表明治疗进入培训足以产生 CRAFT 的最佳既定结果。
