CRAFT Behavior Therapy Phase 2 Study: Tx Entry Component

描述（由申请人提供）： 药物滥用的后果不仅限于吸毒者，还波及其家庭和有关的重要他人（民间社会组织）。研究表明，吸毒者的民间社会组织增加了疾病、家庭暴力以及情绪和功能问题的发生率。行为治疗干预，如应急管理（CM）和社区强化方法（CRA）一直是最有效的药物滥用治疗方法之一。基于财务的CM不被治疗提供者很好地接受，但我们的研究表明，社会咨询师被广泛接受。由于民间社会组织对吸毒者和他们自己的负面影响感到困扰，他们可能是一个特别致力于通过CRA学习和实施社会强化措施的社会社区。 在这个应用程序中，我们提出了第二阶段的行为治疗发展研究的干预民间社会组织被称为社区强化和家庭训练（CRAFT）。这种干预措施教会民间社会组织如何实施CRA，增加吸毒者接受治疗的可能性，减少吸毒，改善民间社会组织的情绪和运作。Meyers、米勒和主要研究者先前进行的研究已经完成了第一阶段研究的目标，包括在手册中操作性地定义和标准化CRAFT的原理和技术。此外，早期II期研究在三个对照临床试验中证明了该疗法的功效（Kirby等人，1999; Meyers等人，2002;米勒等人，1999年）。这个第二阶段项目将复制以前的研究结果，并确定和探索CRAFT的积极组成部分。具体来说，我们将使用随机对照2x2设计，这将使我们能够确定治疗进入培训（TEnT）组件是否是必要的，并足以产生CRAFT的主要和最一致的结果-药物使用者的治疗进入。探索CRAFT的组成部分的主要贡献将是双重的。首先，确定治疗的有效成分可以帮助关注后续的作用机制研究，提高我们的科学理解，并可能导致干预质量的提高，其次，确定CRAFT的无效成分可以帮助减少其长度和成本，使已经被接受的行为干预更加社区友好。因此，拟议的研究将对吸毒者及其民间社会组织产生科学和实际的好处。

DESCRIPTION (provided by applicant): The consequences of drug abuse are not limited to drug users; they also extend to their families and concerned significant others (CSOs). Research shows that CSOs of drug users have increased prevalence of illness, domestic violence, and problems in mood and functioning. Behavior therapy interventions, such as contingency management (CM) and the community reinforcement approach (CRA) have been among the most effective treatments for drug abuse. Financially-based CM is not well accepted by treatment providers, but our research indicates that social reinforcers are widely accepted. Because CSOs are troubled by the negative effects of drug use on the drug user and themselves, they may be a social community that is particularly invested in learning and implementing social reinforcers through CRA. In this application, we propose Stage II Behavior Therapy Development research on an intervention for CSOs known as Community Reinforcement and Family Training (CRAFT). This intervention teaches CSOs how to implement CRA, increasing the likelihood that the drug user will enter treatment and reduce drug use and improving CSO mood and functioning. Previous research conducted by Meyers, Miller and the principal investigator has accomplished the goals of Stage I research, including operationally defining and standardizing principles and techniques of CRAFT in manuals. In addition, early Stage II research demonstrated the efficacy of the therapy in three controlled clinical trials (Kirby et al., 1999; Meyers et al., 2002; Miller et al., 1999). This Stage II project will replicate previous findings and identify and explore the active components of CRAFT. Specifically, we will use a randomized controlled 2x2 design that will allow us to determine if the Treatment Entry Training (TEnT) component is necessary and sufficient to produce the primary and most consistent outcome of CRAFT -- treatment entry of the drug user. The main contributions of exploring the components of CRAFT will be twofold. First, identifying effective components of treatment can help focus subsequent studies of mechanisms of action, improving our scientific understanding and possibly leading to improvements in the quality of the intervention and second, identifying ineffective components of CRAFT can help reduce its length and cost, making a behavioral intervention that is already acceptable even more community-friendly. Thus, the proposed research will have both scientific and practical benefits for drug users and their CSOs.