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The Efficacy of Individual Community Reinforcement and Family Training (CRAFT) for Concerned Significant Others of Problem Gamblers

Nicole Nayoski, David C. Hodgins


Treatment options for concerned significant others (CSOs) of problem gamblers are limited, and available treatments focus exclusively on the distress of CSOs. Community Reinforcement and Family Training (CRAFT) is a comprehensive treatment program for CSOs of substance abusers that has been shown to reduce CSO distress in addition to the substance abuser's alcohol or drug behaviour. CRAFT capitalizes on the well-documented fact that family members have considerable influence on the substance abuser's decision to enter treatment. The present study modified the CRAFT approach into an individual treatment format for CSOs of problem gamblers and examined its efficacy in comparison to a CRAFT self-help workbook in a randomized clinical trial. A total of 31 participants were recruited. No statistical differences were found between the groups; however, effect sizes indicated that participants who received the CRAFT individual intervention seemed to have better outcomes than did those who received the CRAFT workbook (decreased days and dollars gambled by the gambler and improved CSO functioning). No differences between groups were found for gambler treatment entry rates over the follow-up period in terms of effect sizes. The results provide initial, but limited, support for the CRAFT approach delivered to CSOs of treatment-resistant problem gamblers in an individual treatment format compared with the self-help workbook format. Further research with larger sample sizes is needed to gauge the efficacy of the CRAFT individual intervention compared with the CRAFT self-help workbook.


problem gambling; disordered gambling; significant other; treatment; CRAFT

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