Community Reinforcement and Family Training for Early Psychosis (CRAFT-EP) and Substance Use in Reducing Family Members’ Distress: Preliminary Assessment of Efficacy.

Mary Shinners, BA

McLean Hospital – Research Assistant

Scientific Abstract

BACKGROUND: Substance use is associated with poor treatment outcomes in early psychosis, and often remains a challenge for clients and families. Families of individuals with psychosis and substance use can assist their loved ones by improving client-family interactions and providing a supportive environment conducive to change. Community Reinforcement and Family Training adapted for early psychosis (CRAFT-EP) works with family members to encourage substance use change, decrease families’ distress and improve client-family relationships. This poster presents preliminary descriptive results of efficacy measures regarding family distress and relationship quality.

METHODS: Participants were male and female family members (N=20) of a relative with early psychosis and a history of cannabis, alcohol, or nicotine use. Participants completed six to eight telehealth coaching sessions in an open label clinical trial. We present pre-post intervention changes in the current poster. Measures of family member distress and relationship quality include: the Beck Depression Inventory (BDI-II), the State-Trait Anxiety Inventory-Short Form (STAI-SF), the Perceived Stress Scale (PSS), the Happiness Scale, and the Relationship Happiness Scale. We calculated the estimated mean change from pre-intervention with 95% confidence intervals (CI); and standardized effect sizes (Cohen’s d).

RESULTS: Family members had substantial reductions in depression on the BDI-II (estimated mean change -5.6 [95% CI -8.7, -2.5]; d=0.8) and perceived stress on the PSS (-4.0 [-7.3, -0.6]; d=0.6). Participants demonstrated smaller decreases in anxiety on the STAI-SF (-1.1 [-2.2, -0.0]; d=0.5); and smaller increases in relationship happiness on the Relationship Happiness Scale (8.4 [0.1, 16.8]; d=0.5) and family members’ personal happiness on the Happiness Scale (3.4 [-0.8, -7.5]; d=0.4).

CONCLUSION: Results of these preliminary analyses indicate that CRAFT adapted for early psychosis may be helpful at reducing family members’ distress, particularly in terms of depression and perceived stress. Given the limited changes for certain outcomes, more focused interventions may be needed.

Supported by NIDA 1K23 DA050808-01; NCT04284813


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research Areas


Mary Grace Shinners, BA, Eleanor M. Sultana, BA Candidate, Andrea J. Wood, BS, Roger D. Weiss, MD, Dost Öngür, MD, PhD, Kim T. Mueser, PhD, James I. Hudson, MD, ScD, SM, Julie M. McCarthy, PhD

Principal Investigator

Julie McCarthy, PhD