Background and Aims Adaptations with different modes of delivery and target addictions have found highly divergent rates of success for Community Reinforcement Approach and Family Training (CRAFT). This study aims to clarify which 1. treatment components and 2. participant characteristics contribute to rates of identified patient (IP) treatment entry. METHOD Systematic review of CRAFT evaluation studies of all designs (controlled and uncontrolled) with data synthesis and narrative analysis of addiction treatment services and university research departments in North America and Europe. RESULTS A total of 691 concerned significant others (CSOs), predominately female spouses/parents, participating in 20 distinct treatment conditions from 14 studies. The main outcome of IP treatment entry rate reported by CSOs up to 12 months after starting CRAFT with key predictors/correlates including IP addiction, IP-CSO relationship, CRAFT modality and integration of treatment for IP. Meta-analysis found CRAFT to be twice as effective as controls/comparison groups. Multi-modality treatment, including both individual and group sessions, yielded the highest IP treatment entry rates (77% and 86%), with progressively lower rates for individual (12.5%-71%), group (60%), and self-directed workbook (13.3%-40%) modalities. While all five studies targeting gambling addiction had consistently low rates (12.5% to 23%), other treatment components including therapist training, treatment fidelity, and integrating treatment for the IP were implicated. CONCLUSIONS Adaptations of Community Reinforcement Approach and Family Training (CRAFT) for different delivery modalities and addictions have yielded widely varying rates of treatment engagement for the identified patient, with those offering the most comprehensive support to the concerned significant other, including individual and group sessions, having highest levels of engagement success.

中文翻译：

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社区强化和家庭培训以及治疗进入率：系统评价

背景和目标 不同的交付方式和目标成瘾的适应已经发现社区强化方法和家庭培训 (CRAFT) 的成功率非常不同。本研究旨在阐明哪些 1. 治疗成分和 2. 参与者特征有助于确定患者 (IP) 治疗进入率。方法 对所有设计（受控和非受控）的 CRAFT 评估研究进行系统审查，并对北美和欧洲的成瘾治疗服务和大学研究部门进行数据合成和叙述分析。结果 共有 691 名重要他人 (CSO)，主要是女性配偶/父母，参与了 14 项研究的 20 种不同治疗条件。CSO 在开始 CRAFT 后长达 12 个月报告的 IP 治疗进入率的主要结果，包括 IP 成瘾、IP-CSO 关系、CRAFT 模式和 IP 治疗整合等关键预测因素/相关性。荟萃分析发现 CRAFT 的有效性是对照组/比较组的两倍。多模式治疗，包括个人和小组会议，产生最高的 IP 治疗进入率（77% 和 86%），个人 (12.5%-71%)、小组 (60%) 和自我治疗的进入率逐渐降低指导工作簿 (13.3%-40%) 模式。虽然针对赌博成瘾的所有五项研究的比率一直很低（12.5% 到 23%），但涉及其他治疗成分，包括治疗师培训、治疗保真度和 IP 综合治疗。