Digital CRAFT Training for Drug Addiction

Overseen By Calum Handley

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: We The Village, Inc.

Disqualifiers: Non-English speaking, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 2 Jurisdictions This treatment is already approved in other countries

Compensation: Varies

Number of Visits: Unknown

240 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests different levels of digital training for therapists using CRAFT (Community Reinforcement and Family Training), a method to help people with drug addiction. The goal is to evaluate the effectiveness of digital tutorials, self-study materials, and coaching in improving therapy skills and patient outcomes. Participants will be randomly assigned to one of three groups, each receiving varying levels of digital resources and support. Ideal candidates are U.S.-based counselors who work with clients affected by opioid use disorder and have not previously trained in CRAFT. As an unphased trial, this study provides a unique opportunity for therapists to enhance their skills and contribute to innovative research in addiction treatment.

Will I have to stop taking my current medications?

The trial protocol does not specify whether participants must stop taking their current medications.

What prior data suggests that this digital training is safe for participants?

Research has shown that the CRAFT (Community Reinforcement and Family Training) approach is generally manageable for families. This method assists families dealing with a loved one’s substance abuse. CRAFT avoids medication, eliminating drug-related side effects. Instead, it teaches skills such as communication, problem-solving, and self-care, aiming to improve family relationships and encourage the loved one to seek help.

No evidence links CRAFT to major negative effects. The approach emphasizes positive interactions and conflict reduction, which helps lower stress and anxiety for both participants and their loved ones. As a behavioral program, it carries lower risks compared to treatments involving medication. Overall, CRAFT is considered a safe way to support families in challenging situations. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Digital CRAFT Training for drug addiction because it offers a unique, interactive approach to treatment. Unlike traditional methods, which often rely on in-person therapy sessions, this digital program provides a comprehensive online curriculum. It includes videos, texts, quizzes, and interactive feedback, all accessible from home. The program's flexibility and accessibility mean it can reach more people who may otherwise struggle to access traditional care. Additionally, the option for personalized feedback and coaching helps tailor the treatment to individual needs, potentially improving outcomes and engagement.

What evidence suggests that this trial's digital CRAFT training treatments could be effective for drug addiction?

Research has shown that CRAFT (Community Reinforcement and Family Training) helps families guide their loved ones into treatment for substance use problems. Studies indicate that CRAFT not only improves the mental health of family members but also increases the likelihood of their loved ones starting treatment. This method teaches family members how to support positive changes and reduce drug use in their loved ones. In this trial, participants will experience different digital versions of CRAFT. One group will receive a digital tutorial, another will receive the tutorial plus additional training materials, and a third group will receive the tutorial, training materials, and additional feedback and coaching. Early evidence suggests that digital training can effectively make these strategies more accessible. ^{6 7 8 9 10}

Are You a Good Fit for This Trial?

This trial is for professionals working with families affected by opioid use disorder (OUD). Participants should be interested in learning about the Community Reinforcement and Family Training (CRAFT) approach to maximize treatment rates of OUD.

Inclusion Criteria

Work in a counselor-related profession

Report having access to a computer and smartphone with internet access, email, and word processing capability

Provide valid locator information to allow research and CRAFT training staff to contact them to schedule study-related appointments

Exclusion Criteria

Participated in the Qualitative Review aspect of the study

Does not complete the baseline assessment requirements

I do not agree to participate in the study.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Digital Training

Participants engage in digital training through tutorials, materials, and coaching over a 6-month period

6 months

Weekly digital engagement

Follow-up

Participants are monitored for CRAFT knowledge, fidelity, and treatment entry/retention at 3 and 6 months

6 months

What Are the Treatments Tested in This Trial?

Interventions

• CRAFT Training

Trial Overview The study tests three levels of digital training on CRAFT: a basic tutorial, a tutorial with self-study materials, and a comprehensive package including feedback and coaching. The effectiveness will be measured through knowledge acquisition, fidelity to the method, and impact on treatment entry/retention.

How Is the Trial Designed?

Group I: TMC - Digital Tutorial plus training Materials plus feedback and Coaching Experimental Treatment 3 Interventions

Participants receive the digital tutorial (T) plus the digital Training materials (TM), plus they submit audio recordings of sessions with clients and receive feedback on their application of CRAFT and receive group coaching on how to improve.

Group II: TM - Digital Tutorial plus training Materials Experimental Treatment 2 Interventions

Participants receive the digital tutorial (T), plus access to 15 additional in depth modules of digital training materials also released weekly alongside the tutorial modules. Modules remain available during the 6-month study timeframe. Participants receive weekly contact encouraging engagement in all of the materials available to them.

Group III: T - Digital Tutorial overview Active Control 1 Intervention

A digital tutorial consisting of a curriculum dashboard for review of 20 modules, including videos, PDFs, text and quizzes, which are to be unlocked sequentially over seven weeks. Modules remain available during the 6-month study timeframe. Participants receive weekly contact encouraging engagement in all of the materials available to them.

CRAFT Training is already approved in United States, Canada for the following indications:

Approved in United States as Community Reinforcement and Family Training for:

• Substance use disorder treatment support for family members and friends

Approved in Canada as Community Reinforcement and Family Training for:

• Substance use disorder treatment support for family members and friends

Who Is Running the Clinical Trial?

We The Village, Inc.

Lead Sponsor

Trials

4

Recruited

540+

National Institute on Drug Abuse (NIDA)

Collaborator

Trials

2,658

Recruited

3,409,000+

Public Health Management Corporation

Collaborator

Trials

18

Recruited

5,500+

Published Research Related to This Trial

Community Reinforcement and Family Training (CRAFT) is significantly more effective than traditional programs like Al-Anon/Nar-Anon and the Johnson Institute in engaging treatment-resistant individuals with substance use disorders, achieving three times more patient engagement than Al-Anon/Nar-Anon and twice that of the Johnson Institute.

CRAFT not only helps engage patients in treatment but also leads to marked psychosocial and physical improvements for concerned significant others (CSOs), with about two-thirds of treatment-resistant patients attending treatment after just four to six CRAFT sessions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community reinforcement and family training: an effective option to engage treatment-resistant substance-abusing individuals in treatment. Roozen, HG., de Waart, R., van der Kroft, P.[2022]

The Community Reinforcement and Family Training (CRAFT) approach significantly increased treatment engagement rates for alcohol-dependent individuals (40.5% in the immediate intervention group compared to 13.9% in the waitlist group) at the 3-month follow-up.

Both groups of concerned significant others (CSOs) reported improvements in mental health and family cohesion after receiving the CRAFT intervention, indicating its effectiveness in enhancing the well-being of CSOs regardless of the timing of the intervention.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of the Community Reinforcement and Family Training for concerned significant others of treatment-refusing individuals with alcohol dependence: A randomized controlled trial. Bischof, G., Iwen, J., Freyer-Adam, J., et al.[2019]

The study aims to implement and evaluate the effectiveness of Community Reinforcement and Family Training (CRAFT) for concerned significant others (CSOs) of individuals with alcohol use disorder, involving 405 participants from 24 outpatient clinics in Denmark.

The trial will compare three CRAFT interventions (individual, group, and self-help) over 6 weeks to determine which is most effective in motivating problem drinkers to seek treatment, with outcomes assessed at baseline, 3 months, and 6 months.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community reinforcement and family training (CRAFT) - design of a cluster randomized controlled trial comparing individual, group and self-help interventions. Hellum, R., Nielsen, AS., Bischof, G., et al.[2023]

The project aims to train parents to help their treatment-resistant adolescents enter community-based treatment, adapting the Community Reinforcement and Family Training (CRAFT) approach specifically for this age group.

Initial pilot results suggest that the tailored CRAFT program could effectively support parents in managing their child's substance abuse, although controlled trials are still needed to validate these findings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents. Kirby, KC., Versek, B., Kerwin, ME., et al.[2022]

Community Reinforcement and Family Training (CRAFT) was found to be beneficial for concerned significant others (CSOs) of individuals with alcohol problems, regardless of whether it was delivered in individual or group sessions, based on interviews with 11 female participants.

Key components of CRAFT, such as the 'Communication Element' that focuses on positive reinforcement and understanding alcohol use disorder (AUD), were particularly helpful, along with the acceptance and non-judgmental attitudes from facilitators.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How concerned significant others experience Community Reinforcement and Family Training (CRAFT) - a qualitative study. Hellum, R., Bilberg, R., Bischof, G., et al.[2022]

The Community Reinforcement Approach and Family Training (CRAFT) was found to be twice as effective as control groups in helping concerned significant others (CSOs) engage identified patients (IPs) in treatment, based on a systematic review of 14 studies involving 691 participants.

Multi-modality treatment approaches, which included both individual and group sessions, resulted in the highest rates of IP treatment entry (up to 86%), while adaptations targeting gambling addiction showed consistently low engagement rates, highlighting the importance of treatment delivery methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Community reinforcement and family training and rates of treatment entry: a systematic review. Archer, M., Harwood, H., Stevelink, S., et al.[2021]

In a study involving 249 concerned significant others (CSOs) of individuals with alcohol problems, the Community Reinforcement and Family Training (CRAFT) intervention showed that 29% of those receiving group or individual sessions reported their loved ones engaged in treatment after three months, compared to 15% for those using self-administered materials.

While the results suggested that group or individual formats may be more effective than self-administered CRAFT, the differences were not statistically significant, indicating that all formats may have potential benefits for encouraging treatment engagement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Primary Outcome from a cluster-randomized trial of three formats for delivering Community Reinforcement and Family Training (CRAFT) to the significant others of problem drinkers. Hellum, R., Bilberg, R., Andersen, K., et al.[2022]

The internet-based Community Reinforcement Approach and Family Training (iCRAFT) program did not significantly increase the likelihood of individuals with alcohol use disorders seeking treatment compared to a wait-list group, with only 10 out of 94 participants initiating treatment during the study.

However, participants in the iCRAFT program experienced short-term improvements in depressive symptoms, quality of life, and relational happiness, suggesting some benefits for concerned significant others despite the lack of impact on treatment-seeking behavior.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of an Internet-Based Community Reinforcement and Family Training Program to Increase Treatment Engagement for AUD and to Improve Psychiatric Health for CSOs: A Randomized Controlled Trial. EÉk, N., Romberg, K., Siljeholm, O., et al.[2020]

The Community Reinforcement Approach (CRA) is designed to help individuals with substance abuse issues by modifying their environment to make sobriety more rewarding than substance use, focusing on community support from family, friends, and social activities.

The Community Reinforcement and Family Training (CRAFT) program targets individuals who resist treatment by involving their family and friends to encourage them to seek help, demonstrating a unique approach to engaging treatment-refusing individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Community Reinforcement Approach. Meyers, RJ., Smith, JE., Lash, DN.[2019]

Citations

1. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/27141840/

Efficacy of the Community Reinforcement and Family ... Data show that CRAFT is effective for treating CSOs of alcohol dependent individuals in terms of treatment engagement and improvement of CSOs mental health and ...

2. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0899328999000036

Community reinforcement and family training (CRAFT) CRAFT is a program where CSOs are trained to modify a loved one's drug use and engage them in treatment through unilateral family therapy.

3. apa.org apa.org/monitor/2017/12/underappreciated-intervention

An underappreciated intervention The CRAFT model is giving family and friends the skills they need to help get loved ones treatment for substance use problems.

4. bmcpublichealth.biomedcentral.com bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-6632-5

Community reinforcement and family training (CRAFT) | Full Text The aim of this study is to implement CRAFT interventions into the daily routine of Danish community alcohol treatment centers, and investigate ...

5. link.springer.com link.springer.com/chapter/10.1007/978-3-031-82583-5_19

Community Reinforcement Approach and Family Training ... CRAFT is aimed at offering addiction-affected family members (AFMs) both support and strategies to increase the likelihood that the person with addictive ...

6. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC4394369/

Developing Community Reinforcement and Family ... CRAFT also provides 13) safety training, which teaches CSOs how to recognize and address situations with potential for physical violence. Finally, the CRAFT ...

7. youtube.com youtube.com/watch?v=hlYFcXb0JBk

CRAFT: Community Reinforcement And Family Training There are three goals in craft one is to reduce your loved ones harmful use your loved one being your family member that's struggling with substance abuse.

8. ccsme.org ccsme.org/product/community-reinforcement-and-family-training-craft/

Community Reinforcement and Family Training (CRAFT) CRAFT is a unique therapeutic approach with strong research support in helping people to take good care of themselves while also doing what's in their control.

9. ptsd.va.gov ptsd.va.gov/apps/craftsud/

CRAFT: Community Reinforcement And Family Training CRAFT is designed to help you make things better. This course is for anyone facing the effects of alcohol and/or substance abuse in a partner or family ...

10. drugfree.org drugfree.org/article/craft-community-reinforcement-family-training/

The CRAFT Approach CRAFT is an approach for families who have a loved one struggling with substances, but who is not really interested in making changes or getting help.