The consequences of drug abuse are not limited to drug users; they also extend to their families and concerned significant others (CSOs). Research shows that CSOs of drug users have increased prevalence of illness, domestic violence, and problems in mood and functioning. Behavior therapy interventions, such as contingency management (CM) and the community reinforcement approach (CRA) have been among the most effective treatments for drug abuse. Financially-based CM is not well accepted by treatment providers, but our research indicates that social reinforcers are widely accepted. Because CSOs are troubled by the negative effects of drug use on the drug user and themselves, they may be a social community that is particularly invested in learning and implementing social reinforcers through CRA. In this application, we propose Stage II Behavior Therapy Development research on an intervention for CSOs known as Community Reinforcement and Family Training (CRAFT). This intervention teaches CSOs how to implement CRA, increasing the likelihood that the drug user will enter treatment and reduce drug use and improving CSO mood and functioning. Previous research conducted by Meyers, Miller and the principal investigator has accomplished the goals of Stage I research, including operationally defining and standardizing principles and techniques of CRAFT in manuals. In addition, early Stage II research demonstrated the efficacy of the therapy in three controlled clinical trials (Kirby et al., 1999; Meyers et al., 2002; Miller et al., 1999). This Stage II project will replicate previous findings and identify and explore the active components of CRAFT. Specifically, we will use a randomized controlled 2x2 design that will allow us to determine if the Treatment Entry Training (TEnT) component is necessary and sufficient to produce the primary and most consistent outcome of CRAFT -- treatment entry of the drug user. The main contributions of exploring the components of CRAFT will be twofold. First, identifying effective components of treatment can help focus subsequent studies of mechanisms of action, improving our scientific understanding and possibly leading to improvements in the quality of the intervention and second, identifying ineffective components of CRAFT can help reduce its length and cost, making a behavioral intervention that is already acceptable even more community-friendly. Thus, the proposed research will have both scientific and practical benefits for drug users and their CSOs.
| Kirby, Kimberly C; Benishek, Lois A; Kerwin, MaryLouise E et al. (2017) Analyzing components of Community Reinforcement and Family Training (CRAFT): Is treatment entry training sufficient? Psychol Addict Behav 31:818-827 |
| Hudson, Clifton R; Kirby, Kimberly C; Clements, Nicolle T et al. (2014) Social adjustment of women with and without a substance-abusing partner. J Psychoactive Drugs 46:106-13 |
| Benishek, Lois A; Carter, Meridith; Clements, Nicolle T et al. (2012) Psychometric assessment of a self-administered version of the Significant Other Survey. Psychol Addict Behav 26:986-93 |
