Community reinforcement and family traning: an effective option to engage treatment-resistant substance-abusing individuals in treatment
Roozen, de Waart, & van der Kroft (2010)
Addiction, 1729-1783

Abstract

Many individuals with substance use disorders are opposed to seeking formal treatment, often leading to disruptive relationships with concerned significant others (CSO)s. Community reinforcement and Family Training (CRAFT) provides an option to the more traditional treatment and intervention approaches. CRAFT has been found to be superior in engaging treatment-resistant substance-abusing individuals compared with traditional programmes.

Introduction

The vast majority of individuals with substance use disorder refuse to be engaged into treatment.

Substance-suing individuals often have a dire impact on the lives of family members and friends, inflicting marital distress, social problems, financial troubles, aggression and violence. This co-occurs frequently with a myriad psychological problems. Many family members desperately need help to stop the disruption of their family life, to improve the ongoing substance-using individual.

Concerned significant others are not powerless and pursuing couples’ disconnection may be counterproductive. Community Reinforcement and Family Training (CRAFT) is a rigorous treatment package designed to specifically engage resistant substance users into treatment by working with their concerned significant others. Environmental contingencies play an important role in promoting treatment entry of the substance-abusing individual and reducing physical and psychological distress of the concerned significant other.

Discussion

Clinical implications

Community Reinforcement and Family holds clear promise to be a more effective treatment option. It produces a high rate of interpersonal engagement. It also produces an concerned significant other improvement in terms of anger, depression, family cohesion and relation happiness.

Community Reinforcement and Family can be implemented in routine clinical practice.

Research implications

In the Community Reinforcement and Family programme, the concerned significant other learns to communicate and interact actively with the important person more positively.

The focus on empowerment helps concerned significant others to improve their mental and physical wellbeing, allowing them to prevail over the deliberating consequences of addiction. Community Reinforcement and Family encourages empowerment by supplying family members with vital knowledge and relies upon skills training and other strategies to promote self-reliance and self-care that lead to personal independence and improved self-esteem.