Community reinforcement and family training: an effective option to engage treatment-resistant substance-abusing individuals in treatment
Effectiveness bank home page. Opens new windowReview 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. The summary conveys the findings and views expressed in the review.

Links to other documents. Hover over for notes. Click to highlight passage referred to. Unfold extra text Unfold supplementary text
Copy title and link | Comment/query |

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

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

Open Effectiveness Bank home page

Top 10 most closely related documents on this site. For more try a subject or free text search

STUDY 2010 A randomized pilot study of the Engaging Moms Program for family drug court

REVIEW 2011 Integrated substance abuse and child welfare services for women: a progress review

STUDY 2012 The forgotten carers: support for adult family members affected by a relative's drug problems

REVIEW 2006 Motivational arm twisting: contradiction in terms?

REVIEW 2004 Take the network into treatment

HOT TOPIC 2017 Focus on the families

STUDY 2000 Constructive response to worried parents

STUDY 2011 The family drug and alcohol court (FDAC) evaluation project: final report

STUDY 2016 After FDAC: outcomes 5 years later (final report)

REVIEW 2010 Assertive outreach strategies for narrowing the adolescent substance abuse treatment gap: implications for research, practice, and policy