Community reinforcement and family training: an effective option to engage treatment-resistant substance-abusing individuals in treatment
Correction(s) for this article
-
Erratum
- Volume 105Issue 11Addiction
- pages: 2040-2040
- First Published online: October 6, 2010
Hendrik G. Roozen,
Ranne De Waart,
Petra Van Der Kroft,
Corresponding Author
Hendrik G. Roozen
Erasmus University Medical Centre, Department of Forensic Psychiatry, Rotterdam, the Netherlands,
Novadic-Kentron, Research & Development, Vught, the Netherlands and
Hendrik G. Roozen, Erasmus University Medical Centre, Department of Forensic Psychiatry, PO Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail: [email protected]Search for more papers by this authorRanne De Waart
Centrum Maliebaan, Centre for Addiction, Utrecht, the Netherlands
Search for more papers by this authorPetra Van Der Kroft
Erasmus University Medical Centre, Department of Forensic Psychiatry, Rotterdam, the Netherlands,
Search for more papers by this authorHendrik G. Roozen,
Ranne De Waart,
Petra Van Der Kroft,
Corresponding Author
Hendrik G. Roozen
Erasmus University Medical Centre, Department of Forensic Psychiatry, Rotterdam, the Netherlands,
Novadic-Kentron, Research & Development, Vught, the Netherlands and
Hendrik G. Roozen, Erasmus University Medical Centre, Department of Forensic Psychiatry, PO Box 2040, 3000 CA Rotterdam, the Netherlands. E-mail: [email protected]Search for more papers by this authorRanne De Waart
Centrum Maliebaan, Centre for Addiction, Utrecht, the Netherlands
Search for more papers by this authorPetra Van Der Kroft
Erasmus University Medical Centre, Department of Forensic Psychiatry, Rotterdam, the Netherlands,
Search for more papers by this authorABSTRACT
Aims Many individuals with substance use disorders are opposed to seeking formal treatment, often leading to disruptive relationships with concerned significant others (CSOs). This is disturbing, as untreated individuals are often associated with a variety of other addiction-related problems. Community Reinforcement and Family Training (CRAFT) provides an option to the more traditional treatment and intervention approaches. The objective of this systematic review was to compare CRAFT with the Alcoholics Anonymous/Narcotics Anonymous (Al-Anon/Nar-Anon) model and the Johnson Institute intervention in terms of its ability to engage patients in treatment and improve the functioning of CSOs.
Methods The electronic databases PubMed, PsycINFO, EMBASE, CINAHL and the Cochrane Library were consulted. Four high-quality randomized controlled trials were identified, with a total sample of 264 CSOs. Data were synthesized to quantify the effect with 95% confidence intervals, using the random effects model.
Results CRAFT produced three times more patient engagement than Al-Anon/Nar-Anon [relative risk (RR) 3.25, 95% confidence interval (CI) 2.11–5.02, P < 0.0001; numbers needed to treat (NNT) = 2] and twice the engagement of the Johnson Institute intervention (RR 2.15, 95% CI 1.28–3.62, P = 0.004; NNT = 3). Overall, CRAFT encouraged approximately two-thirds of treatment-resistant patients to attend treatment, typically for four to six CRAFT sessions. CSOs showed marked psychosocial and physical improvements whether they were assigned to CRAFT, Al-Anon/Nar-Anon or the Johnson Institute intervention within the 6-month treatment window.
Conclusion CRAFT has been found to be superior in engaging treatment-resistant substance-abusing individuals compared with the traditional programmes.
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