Community Reinforcement and Family Training (CRAFT) goes digital: Randomized pilot trial for families of individuals with opioid use problems.

Community Reinforcement and Family Training (CRAFT) for concerned significant others (CSOs) of individuals with substance use problems (IP) is an efficacious in-person intervention warranting broader dissemination. However, previous web-based delivery studies have not achieved the increases in IP treatment entry seen with in-person studies. We developed two online CRAFT programs closely aligned with the in-person CRAFT protocol and pilot tested their efficacy and feasibility. We block randomized 45 CSOs (15/arm) of IPs with opioid use problems to receive 12 weeks of web-based peer support (PEER) or weekly web-based CRAFT modules with videoconference coaching either in groups (CRAFT-G) or individually (CRAFT-I). Though not statistically significant, more CSOs reported new IP treatment entry in CRAFT-G (76.9%; OR = 5.00, 95% CI [0.03, 3.41], p = .056) and CRAFT-I (72.7%, OR = 4.01, 95% CI [-0.23, 3.20], p = .106) compared to PEER (40.0%), and more CRAFT-G participants reported their IP was in medication treatment at 12 weeks compared to PEER (76.9% vs. 40.0%, OR = 5.00, 95% CI [0.19, 0.98], p = .11). CRAFT-G had significantly improved physical health (p = .025) and mood (p = .015), and both CRAFT-G (p = .018) and CRAFT-I (p = .012) showed increased relationship satisfaction compared to PEER. CSO engagement was similar across conditions. Results must be interpreted cautiously as the study was exploratory and small, and some results were not statistically significant. This pilot study is the first to suggest that online CRAFT programs have the potential to replicate in-person effects, possibly because it did not shorten or significantly alter the in-person protocol when adapting it to a digital format. (PsycInfo Database Record (c) 2026 APA, all rights reserved).