A Brief CRAFT Parental Support Program Focused on Helping Children with Autism Spectrum Disorder and Other Neurodevelopmental Problems: a Pilot Study
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Parents who have either young or adult children with autism frequently report high stress levels due to children’s episodes of aggression, self-inflicted harm, and conduct problems. However, the number of evidence-based programs to assist parents of individuals with autism during the transition to adulthood is scarce. A novel treatment option is Community Reinforcement and Family Training (CRAFT). CRAFT is a useful treatment package originally designed to engage resistant substance users into treatment by working with their concerned significant others (CSO). The underlying operant-based belief is that environmental contingencies play an important role in supporting an identified patient (IP) to treatment or community/welfare support resources. Furthermore, CRAFT is geared to (re)connect CSOs to formal and informal social and recreational networks and reducing CSOs’ physical and psychological distress. The aim of this cross-sectional pilot study is to examine the unilateral effects of a brief CRAFT intervention on the well-being of both IPs with autism and CSOs.
Sixteen CSOs were included in the CRAFT program, consisting of three 60-min group sessions.
The CSOs pre-post analyses demonstrated statistically significant improvements with respect to The General Health Questionnaire-28 (GHQ-28). However, no statistically significant improvements were observed for IPs.
CRAFT seems a promising approach to facilitate quality of health improvements in CSOs with young or adult children with autism spectrum disorder. However, more research is needed to confirm the role of CRAFT with respect to this diagnostic group.
KeywordsCommunity Reinforcement and Family Training (CRAFT) Autism Transition Adulthood Family support
We gratefully acknowledge the participating parents and families for their time and ongoing support. Furthermore, we want to thank both Dr. Meyers, who is the US developer and researcher of CRAFT, and Ms. Sato, who is CRAFT workshop agency member in Japan.
Authors’ Specific Contribution
Author AY designed and executed the study. Author HR collaborated with the design and writing of the study. Both authors analyzed the data and wrote the paper. Both authors collaborated in the writing and editing of the final manuscript.
Compliance with Ethical Standards
The IRB on research ethics in Sapporo Gakuin University approved this present study.
All participants gave their written informed consent, which was completed upon the initial assessment.
Conflict of Interest
The second author HR receives honoraria for providing CRAFT workshops at universities, mental health institutes, conferences, and local city governments. In addition, HR receives royalties from publishers for scientific books and chapters. The first author AY reports no conflicts of interest.
- Cohen, J. (1994). The earth is round (p<.05). American Psychologis t, 49(12), 997–1003.Google Scholar
- Dawson, G. (1989). Autism: nature, diagnosis, and treatment. New York: Guilford Press.Google Scholar
- Fein, D., Dizon, P., Paul., J. & Levin, H. (2005). Brief report: pervasive developmental disorder can evolve into ADHD: case illustrations. Journal of Autism and Developmental Disorders, 35(4), 525–526.Google Scholar
- Henninger. N. A. & Taylor, J. L. (2013). Outcomes in adults with autism spectrum disorders: a historical perspective. Autism, 17(1), 103–116.Google Scholar
- Howlin, P. (1997). Autism: preparing for adulthood. London: Routledge.Google Scholar
- Japanese Health, Labor and Welfare Ministry, (2018). http://www.mhlw.go.jp/seisaku/2010/02/02.htm. (in Japanese).
- Kondo, N., Miyazawa, H., Sakai, M., Kiyota, Y., Kitahata, Y., Kuroda, Y., … Miyata, R. (2008). Shishunki hikikomori ni okeru seishin igakuteki shougai no jittai haaku ni kan suru kenkyuu (research on the psychiatric disorders in adolescents with social withdrawal) Kokoro no kenkou kagaku kenkyuu. 49-63.(in Japanese).Google Scholar
- Manuel, J. K., Austin, J. L., Miller, W. R., McCrady, B. S., Tonigan, J. S., Meyers, R. J., & …Bogenschutz, M. P. (2012). Community reinforcement and family training: a pilot comparison of group and self-directed delivery. Journal of Substance Abuse Treatment, 43, 129–136.Google Scholar
- Matson, J. L., Mahan, S., Hess, J. A., Fodstad, J. C., & Neal, D. (2010). Progression of challenging behaviors in children and adolescents with autism spectrum disorders as measured by the autism spectrum disorders-problem behaviors for children (ASD-PBC). Research in Autism Spectrum Disorders, 4, 400–404.CrossRefGoogle Scholar
- Meyers, R.J., Miller, W.R., Smith, J.E., & Tonigan, J.S. (2002). A randomized trial of two methods for engaging treatment-refusing drug users through concerned significant others. Journal of Consulting and Clinical Psychology, 70(5), 1182-1185.Google Scholar
- Miller, W.R., Meyers, R.J., & Tonigan, J.S. (1999). Engaging the unmotivated in treatment for alcohol problems: a comparison of three strategies for intervention through family members. Journal of Consulting and Clinical Psychology, 67(5), 688-697.Google Scholar
- Nakagawa, Y., & Daiboh, I. (1985). Manual of general health. Nihonbunkakagakusya, Tokyo: Questionnaire Japanese Version (in Japanese).Google Scholar
- Ospina, M. B., Krebs, S. J., Clark, B., Karkhaneh, M., Hartling, L., Tjosvold, L., et al. (2008) Behavioural and Developmental Interventions for Autism Spectrum Disorder: A Clinical Systematic Review. PLoS ONE 3 (11):e3755Google Scholar
- Roozen, H. G., Meyers, R. J. & Smith, J. E. (2015). Community Reinforcement and Family Training (CRAFT): Klinische procedures voor het trainen van familieleden van problematisch alcohol- en druggebruikers. Houten: Bohn Stafleu van Loghum. (in Dutch).Google Scholar
- Sakai, M., Hirakawa S., Nonaka, S., Okazaki., Seo, K., Yokose, Y., ... Mizoguchi, A. (2015). Effectiveness of community reinforcement and family training (CRAFT) for parents of individuals with “Hikikomori”(CRAFT). Japanese journal of behavior therapy.41(3), 167–178. (in Japanese).Google Scholar
- Schuetze, M., Rohr, C. S., Dewey, D., McCrimmon, A., & Bray, S. (2017). Reinforcement learning in autism spectrum disorder. Frontiers in Psychology, 21(8), 1–15.Google Scholar
- Smith, J. E., & Meyers, R. J. (2004). Motivating substance abusers to enter treatment: working with family members. New York: Guilford Press.Google Scholar
- Sokolova, E., Oerlemans, A. M., Romelse, N. N., Groot, P., Hartman, C. A., Glennon, J. C., et al. (2017). A causal and mediation analysis of the comorbidity between attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Journal of Autism and Developmental Disorders, 47, 1595–1604.CrossRefPubMedPubMedCentralGoogle Scholar
- Yamamoto, A. (2015). Community reinforcement and family training (CRAFT) for individuals with autistic spectrum disorder (ASD) during and after adolescence. Japanese journal of behavior therapy, 41(3), 193–203 (in Japanese).Google Scholar