2/3 of Treatment-Refusing Drug Abusers can be Engaged in Treatment by working with Significant Other

A series of studies of a community reinforcement and family training (CRAFT) approach to helping the significant others of drug/alcohol abusers who refuse treatment has found that approximately 2/3 can be engaged in treatment by training significant others and has found that this approach is significantly more effective that traditional 12-step approaches. The CRAFT approach is a manual guided behavioral skills training program that includes domestic violence precautions, motivational strategies, assessment of the context of the abuser's substance use, communication training, positive reinforcement training, training the significant others to reinforce themselves, and suggesting treatment to the substance abuser. The most recent of this series of studies is:

Meyers, R. J., Miller, W. R., Smith, J. E. & Tonigan, J. S. (2002). A randomized trial of two methods for engaging treatment-refusing drug users through concerned significant others. Journal of Consulting and Clinical Psychology, 70, 1182-1185. ABSTRACT - In a randomized clinical trial, 90 concerned significant others (CSOs) of treatment-refusing illicit drug useds were assigned to either (a) community reinforcement and family training (CRAFT), which teaches behavior change skills; (b) CRAFT with additional group aftercare sessions after the completion of the individual sessions; or (c) Al-Anon and Nar-Anon facilitation therapy (Al-Nat FT). All protocols recieved 12 hr of manual-guided individual treatment. Follow-up rates for the CSOs were consistently at least 96%. The CRAFT conditions were significantly more effective than Al-Nar FT in engaging initially unmotivated drug users into treatment. CRAFT alone engaged 58.6%. CRAFT + aftercare engaged 76.7%, and Al-Nar FT engaged 29.0%. No CSO engaged a treatment-refusing loved one once individual sessions had been completed.

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