Effective medication-based treatment could prevent overdose deaths and help over 2 million Americans recover from opioid use disorder (OUD), but only a fraction access specialty treatment or receive anFDA-approved medication. Community Reinforcement and Family Training (CRAFT) works with familymembers to get treatment resistant individuals (Identified Persons; IPs) into treatment, and 68% of familiescoached in CRAFT achieve treatment entry for their IP; about twice as many as comparison groups. However,most addiction professionals (counselors) are not trained in CRAFT or deliver it with questionable fidelity. Thegoal of this project is to develop and evaluate the technical feasibility and commercial viability of ascalable digital counselor training program for CRAFT. The Counselor product would be tailored toprepare counselors to work with family members of individuals with OUD. It will allow counselors to deliverhigh-fidelity CRAFT and significantly benefit IPs and their families affected by OUD by addressing the criticalbarrier of access to a leading evidence-based approach to family involvement in addiction recovery. Currentmethods for training counselors and disseminating ESTs, including CRAFT, rely on brief online or in-personworkshops. However, research shows this format is minimally effective in facilitating adoption andimplementation of ESTs. A more efficacious model includes ongoing counselor training with feedback andcoaching. This project will develop an enhanced training model for CRAFT and digitize it to maximizescalability. In this project, we will: Produce the digital counselor training prototype and coaching process,tailored to OUD - with stakeholder input (Aim 1); Conduct a pilot study of 3 levels of digital training (Level 1-Digital tutorial only [T]; Level 2 -Tutorial & digital training materials for self-study [TM]; Level 3 - Tutorial, digitalmaterials, feedback and coaching [TMC]) to establish feasibility, acceptability, and examine the effects oftraining on CRAFT knowledge, fidelity, and treatment entry and retention (Aim 2). Validation of feasibility andcommercial merit in the Phase I pilot study will provide substantiation to advance to Phase II. In addition tooptimizing the product based on Phase I learnings and stakeholder input, Phase II goals will includecompleting development of a supervised machine learning (SML) automated coding system that will scorecounselor-submitted digital audiotapes of CRAFT sessions and generate written feedback includingsuggestions for improvement. This will allow us to demonstrate digital training efficacy at scale and commercialreadiness (Aim 3). We will conduct a fully-powered randomized control trial comparing all piloted outcomes forthe 3 training level conditions (Aim 4). These studies form the basis to demonstrate commercial readiness andvalue to purchasers.
Public Health Relevance Statement: The goal of this project is to develop a scalable digital program to train behavioral addiction professionals
(counselors) to high-fidelity levels in Community Reinforcement and Family Training (CRAFT) with the ultimate
goal of increasing opioid use disorder (OUD) treatment entry rates. On average 68% of families coached in
CRAFT achieve treatment entry for a loved one with OUD and this could help over 2 million Americans recover
from OUD with effective treatment.
Project Terms:
