A qualitative study of the therapists' experiences of working with community reinforcement and family training

Abstract

Community reinforcement and family training (CRAFT) was developed to help and support concerned significant others (CSO) of people with, for example, alcohol use disorder. The aim of this study was to investigate therapists' experiences of working with CRAFT and their experiences of the CSOs receiving CRAFT. The study has a qualitative design and is based on three focus group interviews with 17 therapists. Interviews were analysed using thematic analysis. The analysis revealed six themes and four subthemes: Concerned significant others—A special group; Help prior to CRAFT—Offering information and a shoulder; CRAFT as a new and specific method (The toolbox of CRAFT, Formats for delivering CRAFT, Introducing a diary as homework and Implementing self‐help material—Alone or in combination with sessions); Moving from a lack of structure to structure; Change in CSOs from the therapists' point of view; and Change in the therapist's role (Dilemmas—Personalising the intervention). The therapists were generally satisfied with the method and found it easy to adapt to. Moreover, working using a manual was more structured than they were used to and increased feelings of working professionally with the CSOs. Specifically, most therapists found the self‐help book useful and indispensable in their work with CRAFT, but also agreed that it could not be used as a stand‐alone intervention for most CSOs. The therapists' experiences are relevant for implementation of manualised, structured approaches and group‐based interventions more broadly.

Potential factors affecting the impact of Community Reinforcement and Family Training. Secondary Analysis of an RCT

“…In a prior, qualitative study of the experiences of the therapists, who performed the intervention in the Danish CRAFT study, the therapist considered that CRAFT worked better, if the CSO had told the IP that they participated in CRAFT. Based on what the CSOs reported on homework assignments etc., the therapists found that when the CSOs had informed the IP, it allowed the CSO and IP to have a more open discussion about the CRAFT program and other issues related to the alcohol problem (31).…”