Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents

Kirby, Kimberly C.; Versek, Brian; Kerwin, Mary Louise E.; Meyers, Kathleen; Benishek, Lois A.; Bresani, Elena; Washio, Yukiko; Arria, Amelia M.; Meyers, Robert J.

doi:10.1080/1067828x.2013.777379

Cited by 31 publications

(23 citation statements)

References 64 publications

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“…Strength-based strategies such as these are consistent with established family-based treatment engagement procedures for ASU and associated problems (e.g., Alexander, Waldron, Robbins, & Neeb, 2013; Liddle, 2002; Szapocznik, Zarate, Duff, & Muir, 2013). Likewise, these physician-caregiver adaptations to RT are consistent with empirically validated family-based clinical procedures that mobilize caregiver support to influence highly resistant adolescents to enroll in SU treatment (Kirby et al, 2015; Waldron, Kern-Jones, Turner, Petersen, & Ozechowski, 2007). …”

Section: Referral To Treatmentsupporting

confidence: 55%

SBIRT-A: Adapting SBIRT to Maximize Developmental Fit for Adolescents in Primary Care

Ozechowski

Becker

Hogue

2016

Journal of Substance Abuse Treatment

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The Screening, Brief Intervention and Referral to Treatment (SBIRT) model is widely recommended as part of routine visits in pediatric primary care despite a dearth of evidence on its effectiveness, feasibility, and developmental appropriateness for adolescents in this setting. The purpose of this article is to explicate ways that SBIRT may be tailored to better serve adolescents in primary care under a set of recommended adaptations that we refer to collectively as SBIRT-A or Screening, Brief Intervention, and Referral to Treatment for Adolescents. Each component of the SBIRT-A framework incorporates recommendations to optimize developmental fit with adolescents based on extant empirical research, developmental theory, and well-documented barriers to service delivery in primary care. Commonalities across proposed adaptations include reliance upon proactive methods to identify and engage youth; innovation in service delivery aimed at improving the consistency and reach of interventions; and a family-focused approach to engagement, assessment, and intervention. Specific recommendations include taking advantage of every clinical encounter with the family to screen, involving caregivers in assessments and brief interventions, leveraging technology to administer brief interventions and booster sessions, and patient- and family-centered procedures for treatment referral and engagement. The adaptations proposed in this article have the potential to enhance the detection of adolescents with SU problems in primary care, the consistency of intervention provision, and engagement of this typically recalcitrant population into appropriate treatment.

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Section: Referral To Treatmentsupporting

confidence: 55%

SBIRT-A: Adapting SBIRT to Maximize Developmental Fit for Adolescents in Primary Care

Ozechowski

Becker

Hogue

2016

Journal of Substance Abuse Treatment

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“…addiction severity, race/ethnicity, SP relationship type—e.g., parents, spouse) benefit most from SP involvement in INSPIRE; and [ 3 ] assess the patient, provider, and clinic-level factors thought to influence implementation, effectiveness, and sustainability of buprenorphine and INSPIRE. We hypothesize that patients with SPs participating in INSPIRE will have greater buprenorphine retention than patients whose SPs are not participating in INSPIRE, and, consistent with existing CRAFT trials, SPs will experience improved health and quality of life [ 19 – 29 ].…”

Section: Specific Aims and Hypothesesmentioning

confidence: 99%

“…CRAFT is typically composed of 12 individualized sessions that focus on positive communication and other behavioral strategies to help the SP influence their person’s drinking or drug use, and change their negative interactions [ 16 , 17 ]. Studies show that when an SP receives individualized CRAFT, their person is two to three times more likely to initiate alcohol or drug treatment within 6 months compared to SPs who attend Johnson or 12-step interventions [ 19 – 24 ]. SPs in CRAFT also report improvements in their depression, anger expression toward partner, relationship satisfaction, and family conflict.…”

Section: Introductionmentioning

confidence: 99%

Study design to evaluate a group-based therapy for support persons of adults on buprenorphine/naloxone

Osilla

Becker

Ecola

et al. 2020

Addict Sci Clin Pract

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Background Opioid use disorders (OUDs) have devastating effects on individuals, families, and communities. While medication treatments for OUD save lives and are increasingly utilized, rates of treatment dropout are very high. In addition, most existing medication treatments for OUD may often neglect the impact of untreated OUD on relationships and ignore the potential role support persons (SPs) could have on encouraging long-term recovery, which can also impact patient treatment retention. Methods/design The current study adapts Community Reinforcement and Family Training (CRAFT) for use with SPs (family member, spouse or friend) of patients using buprenorphine/naloxone (buprenorphine) in an outpatient community clinic setting. The study will evaluate whether the adapted intervention, also known as integrating support persons into recovery (INSPIRE), is effective in increasing patient retention on buprenorphine when compared to usual care. We will utilize a two-group randomized design where patients starting or restarting buprenorphine will be screened for support person status and recruited with their support person if eligible. Support persons will be randomly assigned to the INSPIRE intervention, which will consist of 10 rolling group sessions led by two facilitators. Patients and SPs will each be assessed at baseline, 3 months post-baseline, and 12 months post-baseline. Patient electronic medical record data will be collected at six and 12 months post-baseline. We will examine mechanisms of intervention effectiveness and also conduct pre/post-implementation surveys with clinic staff to assess issues that would affect sustainability. Discussion Incorporating the patient’s support system may be an important way to improve treatment retention in medication treatments for OUD. If SPs can serve to support patient retention, this study would significantly advance work to help support the delivery of effective treatments that prevent the devastating consequences associated with OUD. Trial registration This study was registered with ClinicalTrials.gov, NCT04239235. Registered 27 January 2020, https://clinicaltrials.gov/ct2/show/NCT04239235 .

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“…When adolescents are not ready to engage in treatment, caregivers can learn skills to increase an adolescent’s motivation to engage in care through a caregiver focused intervention, the Community Reinforcement and Family Training approach [58]. Community Reinforcement and Family Training has been shown to be effective in motivating youth to engage in care, decreasing their substance use regardless of engagement in care, and improving the lives of caregivers by strengthening their self-care skills [59]. When an adolescent is willing to engage in care, family therapy can be a very effective intervention to decrease adolescent substance use by addressing family risk factors that may be contributing to an adolescent’s substance use [60].…”

Section: Adolescent Opioid Use Disorder Treatmentmentioning

confidence: 99%

Opioid Use Disorders in Adolescents—Updates in Assessment and Management

2018

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Purpose of review: To review information specific to adolescents regarding trends in opioid use, risk factors for opioid misuse, medical co-morbidity, and treatment updates. Recent findings: Although opioid misuse in adolescents is uncommon, it is associated with morbidity and mortality such as hepatitis C and overdose. Adolescents commonly start with prescription opioid misuse before transitioning to heroin use. The existing literature supports the use of buprenorphine/naloxone for the treatment of adolescent opioid use disorders. Safe medication storage and disposal is important to decrease adolescent prescription opioid misuse. Summary: Opioid misuse occurs in adolescents and pediatric providers need to remain up to date.

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Developing Community Reinforcement and Family Training (CRAFT) for Parents of Treatment-Resistant Adolescents

Cited by 31 publications

References 64 publications

SBIRT-A: Adapting SBIRT to Maximize Developmental Fit for Adolescents in Primary Care

SBIRT-A: Adapting SBIRT to Maximize Developmental Fit for Adolescents in Primary Care

Study design to evaluate a group-based therapy for support persons of adults on buprenorphine/naloxone

Opioid Use Disorders in Adolescents—Updates in Assessment and Management

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