CRAFT Behavior Therapy Phase 2 Study: Tx Entry Component

滥用药物的后果不仅限于吸毒者；它们还延伸到他们的家人和 关心重要的其他人(民间社会组织)。研究表明，吸毒者的民间社会组织增加了流行率 疾病、家庭暴力以及情绪和功能问题。行为治疗干预，如 作为应急管理(CM)和社区强化方法(CRA)的一部分 对药物滥用最有效的治疗方法。基于经济的CM不被治疗很好地接受 但我们的研究表明，社会增强剂被广泛接受。因为民间社会组织 被吸毒对吸毒者和他们自己的负面影响所困扰，他们可能是一种社会 特别投资于通过CRA学习和实施社会增强者的社区。 在这项应用中，我们提出了第二阶段行为疗法开发研究，旨在干预 民间社会组织被称为社区加强和家庭培训(手工)。这种干预教会了民间社会组织 如何实施CRA，增加吸毒者进入治疗和减少毒品的可能性 利用和改善CSO的情绪和功能。迈耶斯、米勒和 首席调查员已经完成了第一阶段研究的目标，包括在业务上确定和 在手册中规范工艺的原则和技术。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年；Miller等人，1999年)。这个第二阶段的项目将复制以前的发现，并确定和探索 工艺品的活性成分。具体地说，我们将使用随机对照2x2设计，它将允许 美国确定治疗进入培训(帐篷)部分是否必要和足以产生 技术的主要和最一致的结果--吸毒者的治疗进入。主 探索飞船部件的贡献将是双重的。第一，确定有效成分 的治疗可以帮助集中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；第二， 识别工艺的无效部件可以帮助减少其长度和成本，使行为 已经可以接受的干预，甚至更有利于社区。因此，拟议的研究将 对吸毒者及其民间社会组织既有科学上的好处，也有实际的好处。

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.