Evaluation of Community Reinforcement and Family Therapy in the UK military community

Figures & data

Table 1. Outline of UKV-CRAFT Therapy Sessions.

Session	Situations/Problems Examined	Skills Learned
What are common mental disorders, PTSD, and alcohol use disorder (AUD)?	Behaviours of someone experiencing a common mental disorder PTSD, or AUD Effects on family and friends	Better understanding of common mental disorders, PTSD, alcohol use disorder Better understanding of what it is like to experience these disorders
Safety Planning	Angry/aggressive behaviour Abuse in relationships	Your right to be safe and not accept abuse in any form How to respond to aggression/violence How to create a safety plan
Increasing positive behaviours	Reduction or absence of happy, healthy and helpful behaviours (e.g. family meals, exercising, housework)	How to use rewards to increase positive behaviours (e.g. express gratitude, favourite food/activity) Understanding that the process of changing habits takes time
Improving your communication skills	Withdrawn and/or irritable loved one Reluctance/refusal to communicate	Features of effective communication (e.g. respectful, honest, to the point, not rushed, focused) How to choose a good time to talk
Improving problem-solving	Any problems in loved one’s behaviour and/or relationship (e.g. absent from home/family, drinking too much, angry outbursts)	Seven-step problem solving (i.e. identify problem, suggest, evaluate, select, plan and implement solutions, review)
Responding to problem behaviours	Entrenched habits and/or behaviour patterns and CSO’s habitual response (e.g. loved one gets publicly drunk and CSO gets angry)	How to analyse patterns of behaviour-response How to develop and test new ways of responding (e.g. allow loved one to get drunk, calmly explain upset, leave, and discuss when sober)
Goal setting	The potential of making changes to be overwhelming	How to set realisable goals that are SMART: Specific, Measurable, Achievable, Relevant, Time-specific
Self-care	Putting all of one’s time and energy into loved one’s needs Feeling anxious, depressed, stressed, hopeless, etc.	Understanding the importance of taking care of oneself How to reward oneself (e.g. small treats, activities) Importance of increasing social support Wellbeing-focused activities (e.g. mindfulness, exercise)
Understanding professional help and treatment options	The potential of the range of services and treatments available to be baffling	Understanding the roles and services offered (e.g. GP, psychologist, PWP, psychiatrist, Veteran’s Gateway, Royal British Legion)
How to help your veteran/service person consider professional help	Talking about getting help can be very difficult Many people are resistant to, and reject, the idea that they need help	Understanding that a strong relationship makes it easier to discuss difficult issues Understanding that there are times and ways when communication is more effective How to anticipate, and plan to respond to, barriers to help-seeking
Supporting my veteran/service person’s recovery	Sticking to treatment can be difficult There are lots of causes for dropping out of treatment	How to support a loved one’s treatment by being available, accessible, continuing to learn about their needs and the process How to be resilient, prepared for bumps in the road, and ready to keep going

Note. Each session was delivered at a rate of one per week for 6–12 weeks.

Table 2. List of Stakeholders Interviewed.

Interviewee ID	Organisation	Job Title
Stakeholder 1:	AFF (Army Families Federation)	Health and Additional Needs Specialist
Stakeholder 2:	Not available*	Not available*
Stakeholder 3:	Not available*	Not available*
Stakeholder 4:	Army Families Federation	Regional Manager (Scotland, Wales, Northern Ireland)
Stakeholder 5:	TGP Wales	Restorative Practitioner
Stakeholder 6:	Help for Heroes Hidden Wounds	Acting Head of Psychological Wellbeing
Stakeholder 7:	Veterans NHS Wales	Director and Clinical Lead Consultant
Stakeholder 8:	Welsh Government	Armed Forces Covenant Manager
Stakeholder 9:	Royal Air Force Families Federation (RAF-FF)	Dispersed Families Project Manager
Stakeholder 10:	NHS England	Medical Director for Armed Forces and Veterans Health
Stakeholder 11:	Walking with the Wounded	Clinical Lead
Stakeholder 12:	Transition Intervention and Liaison Service (TILS)^a	Lead Clinical Psychologist Prison In-Reach Service & Service Co-ordinator
Stakeholder 13:	Change Step Wales	Project Manager
Stakeholder 14:	NHS England	Lead National Armed Forces Commissioning Strategy and Policy Team
Stakeholder 15:	Royal British Legion	Assistant Director Responsible for Delivery of Veterans’ Gateway

^aAt the time of interview, this service name was correct. The service is now known as OP Courage.

*Explicit consent to report this information not given.

Figure 1. Themes developed from interviews about UKV-CRAFT.

Data availability statement

The participants of this study did not give written consent for their data to be shared publicly, so due to the sensitive nature of the research supporting data is not available.