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Review analysis

This entry is our analysis of a review or synthesis of research findings added to the Effectiveness Bank. The original review was not published by Findings; click Title to order a copy. Free reprints may be available from the authors – click prepared e-mail. Links to other documents. Hover over for notes. Click to highlight passage referred to. Unfold extra text Unfold supplementary text The Summary conveys the findings and views expressed in the review.

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Community reinforcement and family training: an effective option to engage treatment-resistant substance-abusing individuals in treatment.

Roozen H.G., de Waart, van der Kroft P.
Addiction: 2010, 105, p. 1729–1738.
Unable to obtain a copy by clicking title? Try asking the author for a reprint by adapting this prepared e-mail or by writing to Dr Roozen at h.roozen@erasmusmc.nl.

Review concludes that neither confrontation nor disengagement from a family member work as well at engaging them in treatment as an approach based on systematically organising the intended patient's social environment to reward treatment entry.

Summary 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 randomised 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 and twice the engagement of the Johnson Institute intervention. 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 six-month treatment window.

Conclusion CRAFT has been found to be superior in engaging treatment-resistant substance-abusing individuals compared with the traditional programmes.

Last revised 03 January 2011

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