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Community Reinforcement and Family Training (CRAFT) for engaging clients in treatment

Substance Use Disorders: Treatment for Adults
  Literature review updated September 2016.

Community Reinforcement and Family Training (CRAFT) is a program for significant others and family members of those with substance abuse or dependence. In 12 to 14 ndividual sessions, family and friends are taught effective strategies for helping their loved one to change, to enroll in treatment, to feel better themselves.
 
ALL
META-ANALYSIS
CITATIONS

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the program impacts measured in the research literature (for example, impacts on crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases. See Estimating Program Effects Using Effect Sizes for additional information on how we estimate effect sizes.

The effect size may be adjusted from the unadjusted effect size estimated in the meta-analysis. Historically, WSIPP adjusted effect sizes to some programs based on the methodological characteristics of the study. For programs reviewed in 2024 or later, we do not make additional adjustments, and we use the unadjusted effect size whenever we run a benefit-cost analysis.

Research shows the magnitude of effects may change over time. For those effect sizes, we estimate outcome-based adjustments, which we apply between the first time ES is estimated and the second time ES is estimated. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured Primary or secondary participant No. of effect sizes Treatment N Effect sizes (ES) and standard errors (SE) Unadjusted effect size (random effects model)
ES SE Age ES p-value
Illicit drug use disorder
Clinical diagnosis of illicit drug use disorder or symptoms measured on a validated scale. When possible, we exclude cannabis/marijuana use disorder from this outcome.
 39 Primary 1 16 0.000 0.000 40 0.000 1.000
Engagement/Retention
Retention and engagement in treatment or care.
 39 Primary 5 138 1.223 0.324 40 1.223 0.001
Major depressive disorder
Clinical diagnosis of major depression or symptoms measured on a validated scale.
 39 Secondary 1 45 -0.068 0.254 40 -0.068 0.788

Citations Used in the Meta-Analysis

Bischof, G., Iwen, J., Freyer-Adam, J., & Rumpf, H.J. (2016). Efficacy of the Community Reinforcement and Family Training for concerned significant others of treatment-refusing individuals with alcohol dependence: A randomized controlled trial. Drug and Alcohol Dependence, 163, 179-85.

Brigham, G.S., Slesnick, N., Winhusen, T.M., Lewis, D.F., Guo, X., & Somoza, E. (2014). A randomized pilot clinical trial to evaluate the efficacy of Community Reinforcement and Family Training for Treatment Retention (CRAFT-T) for improving outcomes for patients completing opioid detoxification. Drug and Alcohol Dependence, 138, 240-243.

Kirby, K.C., Marlowe, D.B., Festinger, D.S., Garvey, K.A., & LaMonaca, V. (1999). Community reinforcement training for family and significant others of drug abusers: a unilateral intervention to increase treatment entry of drug users. Drug and Alcohol Dependence, 56(1), 85-96.

Miller, W.R., Meyers, R.J., & Tonigan, J.S. (1999). Engaging the unmotivated in treatment for alcohol problems: A comparison of three intervention strategies for intervention through family members. Journal of Consulting and Clinical Psychology, 67(5), 688-697.

Sisson, R.W., & Azrin, N.H. (1986). Family-member involvement to initiate and promote treatment of problem drinkers. Journal of Behavior Therapy and Experimental Psychiatry, 17(1), 15-21.