Factors for dissemination and implementation of community reinforcement and family training in Japan: A pilot study

Community Reinforcement and Family Training (CRAFT) is an evidence-based training-program, specifically geared to assist family members of identified patients with problems in the area of substance use, autism, psychosis, "hikikomori", etc. The purpose of this qualitative research is to examine therapists' barriers and facilitators to apply CRAFT in general practice, by means of interviews and questionnaire surveys.in Japan.

By using snowball sampling techniques, nine Japanese therapists were recruited. Subsequently, these therapists had the ambition to enroll the CRAFT certification process, according an advance therapist-expert feedback system based on audio-tapes. Assessment about therapists' barriers and facilitators aimed to disseminate and implement CRAFT were completed online during a 30-60 minutes semi-structured interview. Furthermore, implementation outcomes measures were also collected.

Data of nine therapists were collected showing multiple aspects that promote or impede the application of CRAFT in daily routine practice. In general, it was shown that private costs for attending expert training and coding, working with a protocol, may impede the dissemination of CRAFT in Japan.

CRAFT is well-received by Japanese therapists, although some barriers remain that need to be addressed to promote a more widely dissemination.