From the Guidelines
The CRAFT test, also known as the CRAFFT screening tool, is a method used to screen adolescents for substance use disorders, including alcohol and drug use, by asking six specific questions related to their behavior and experiences with substances. The CRAFFT screening tool is designed to assess the risk of substance use disorders in adolescents and consists of six "yes/no" questions, with each "yes" scoring 1 point, and a score of 2 or more is generally considered a positive screening test result 1. The questions included in the CRAFFT screening tool are:
- C—Have you ever ridden in a car driven by someone (including yourself) who was “high” or had been using drugs or alcohol?
- R—Do you ever use alcohol or drugs to relax, feel better about yourself, or fit in?
- A—Do you ever use alcohol or drugs while you are by yourself, alone?
- F—Do you ever forget things that you did while using alcohol or drugs?
- F—Does your family or friends ever tell you that you should cut down on your drinking or drug use?
- T—Have you ever gotten into trouble while you were using alcohol or drugs? This screening tool has been validated for use with adolescents and has been shown to be highly sensitive and specific in identifying risky substance use behaviors 1. It is recommended by both the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the American Academy of Pediatrics (AAP) as a useful tool for identifying adolescents who may be at risk for substance use disorders 1. The CRAFFT screening tool is also advantageous due to its short administration time and lack of evidence of gender bias, making it a practical and effective tool for use in clinical settings 1. In clinical practice, the CRAFFT screening tool can be used as part of a comprehensive assessment of adolescent substance use, and a positive screen should be followed by a more thorough evaluation and potentially a brief intervention or referral to treatment 1. Overall, the CRAFFT screening tool is a valuable resource for healthcare providers to identify and address substance use disorders in adolescents, with the goal of reducing morbidity, mortality, and improving quality of life.
From the Research
Overview of the CRAFT Test
- The Community Reinforcement and Family Training (CRAFT) program is an intervention approach designed to engage treatment-refusing individuals into treatment through their family members 2, 3, 4.
- CRAFT is based on the principles of operant conditioning and aims to help family members modify their loved one's substance-using behavior and enhance treatment engagement 3.
- The program typically involves teaching concerned significant others (CSOs) skills to encourage their loved ones to enter treatment and to improve their own well-being 3, 4.
Components and Effectiveness of CRAFT
- CRAFT has been shown to be effective in engaging treatment-resistant substance-abusing individuals in treatment, with approximately two-thirds of patients attending treatment after 4-6 CRAFT sessions 4.
- The program has been compared to other interventions, such as Al-Anon/Nar-Anon and the Johnson Institute intervention, and has been found to be superior in engaging treatment-resistant individuals 4.
- Research has also explored the components of CRAFT, suggesting that treatment entry training may be sufficient for producing the best established outcome of CRAFT, which is increased treatment entry of the identified treatment-resistant person (IP) 5.
Applications and Outcomes of CRAFT
- CRAFT has been applied to various substance use disorders, including opioid use disorder, and has been found to be a promising treatment for improving treatment outcomes 6.
- The program has also been shown to improve the psychosocial and physical functioning of CSOs, regardless of whether they are assigned to CRAFT or other interventions 3, 4.
- Overall, CRAFT is a valuable approach for engaging treatment-refusing individuals in treatment and improving the well-being of their family members 2, 3, 4, 6, 5.