CRAFT Behavior Therapy Phase 2 Study: Tx Entry Component

描述(由申请人提供)： 吸毒的后果不仅限于吸毒者，还波及到他们的家人和重要的其他人(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患病率。行为治疗干预措施，如应急管理(CM)和社区强化方法(CRA)已成为治疗药物滥用最有效的方法之一。以经济为基础的CM并不被治疗提供者很好地接受，但我们的研究表明，社会增强剂被广泛接受。由于民间社会组织受到吸毒对吸毒者和他们自己的负面影响的困扰，他们可能是一个特别投资于通过CRA学习和实施社会增强剂的社会社区。 在这项申请中，我们提出了第二阶段行为疗法开发研究，针对民间社会组织的干预措施，称为社区强化和家庭培训(CREAT)。这一干预措施教会了民间社会组织如何实施CRA，增加了吸毒者进入治疗并减少药物使用的可能性，并改善了民间社会组织的情绪和功能。迈耶斯、米勒和首席研究员之前进行的研究已经实现了第一阶段研究的目标，包括在操作上定义和标准化手册中的工艺原则和技术。此外，早期II阶段研究在三个对照临床试验中证明了该疗法的有效性(Kirby等人，1999；Meyers等人，2002；Miller等人，1999)。这个第二阶段的项目将复制以前的发现，并确定和探索工艺的活性成分。具体地说，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(TANET)部分是否必要且足以产生吸毒者治疗进入的主要和最一致的结果。探索飞船组件的主要贡献将是双重的。首先，识别治疗的有效成分可以帮助集中后续对作用机制的研究，提高我们的科学理解，并可能导致干预质量的提高；其次，识别手工艺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有利于社区。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益处。

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.