Online community reinforcement and family training (CRAFT) for rural concerned significant others: a randomized controlled trial

Introduction: Despite Community Reinforcement and Family Training (CRAFT) being used throughout the United States of America and some parts of Europe, CRAFT has not been explored in rural Australia. This study aimed to evaluate the effectiveness on psychological scales of an online, practitioner-led delivery of Community Reinforcement and Family Training (CRAFT) in a rural Australian context. Methods: A randomized controlled trial (RCT) using a parallel-group, two-arm, superiority design, with a baseline assessment, and two follow-up assessments. Adult concerned significant others were recruited from rural areas across Australia, via Facebook and Instagram. Participants were randomized (1:1) into the CRAFT or Waitlist groups. The CRAFT intervention consisted of 6 sessions of 60 min each, conducted over 6 weeks. Participants randomized to the waitlist received reading resources from the Center for Motivation and Change (2022). The primary outcome was the psychological well-being of the participant. Psychological well-being scales included the DASS-21, SWLS, FS, and Brief-COPE. Results: 126 participants were enrolled and randomly assigned to either the CRAFT intervention (n = 64) or Waitlist (n = 62). At baseline, the mean age of participants was 51.08 years (SD = 10.88). Females comprised of 92.06 % of the sample. Most participants (86.4 %) were born in Australia and 87.9 % identified as White/Caucasian. Post-intervention scores found a statistically significant difference between the intervention and waitlist groups. This included in the intervention group, a decrease in depression scores (DASS-21), with an adjusted mean difference of −2.71 (95 % CI: −5.36 to −0.06) between interventions and waitlist group, a significant increase in Satisfaction with Life scores (SWLS), with an adjusted mean difference of 1.98 (95 % CI: 0.45 to 3.50) and a significant increase in the use of problem-focused coping with an adjusted mean difference of 2.92 (95 % CI: 1.33 to 4.51). Conclusion: Online CRAFT for rural Australians decreased depression, increased life satisfaction and increased problem-focused coping.