Community Reinforcement Approach

Many are familiar with programs using a 12-step system or support groups for treating someone suffering from substance abuse, but sometimes, the first hurdle is getting the dependent to actually agree to go.

CRAFT – A Community Reinforcement Approach

There are various groups and methods meant to support those who do not suffer from addiction, but deal with someone who does. Some of these groups advocate distancing yourself as much as possible from the effects and behaviors of the person dealing with addiction, rather than exhaust time on ineffective attempts at convincing them they need help. On the opposite end of the spectrum, methods use aggressive interventions where family and friends of a dependent, confront them directly and try to convince them to commit to rehabilitation on the spot.

Community Reinforcement And Family Training (CRAFT) is a lesser known, but very effective method of getting someone suffering from addiction to seek help. The basic theory behind the method goes back as far as the 70s but was approached somewhat informally in 80s. Current methods involving therapists specifically trained in CRAFT, to guide Caring Significant Others (CSOs) was developed in the 1990s.

CRAFT is designed to help those who suffer from addiction ease into treatment with gradual lifestyle changes and adapting to these changes. It can be difficult to treat people who are not self-motivated, but through positive reinforcement of good behaviors, the CRAFT process is designed to help people open up to change, and embrace the idea of starting therapy.

Stressing Positive Reinforcement Rather Than Punishment

Those who suffer from addiction are familiar to suffering. No matter whether they hurt themselves, hurt others, lose jobs, divorce, go broke – none of it motivates the dependent to stop the addiction. Punishment just doesn’t work because they’re used to it.

The point of CRAFT is to eliminate negative punishment for their substance abuse, and instead enhance positive reinforcement for actions that lead toward sobriety. The intention is to help the dependent realize for themselves, that abstinence is more rewarding than using. They are allowed to suffer the negative consequences of their addiction, while at the same time helping them realize how rewarding it is to not take part in addictive behaviors.

By helping the dependent to them see that they can take action to help themselves, this makes them feel powerful in their recovery efforts. Approaching them with empathy and guidance rather than post-behavioral punishment, this allows them to recognize the advantages of good behavior versus bad behavior, like abusing drugs or alcohol. Praise for even the most simple accomplishments keeps them approaching success and keeps them enthusiastic about the process.

How Does The CRAFT Method Work?

Most people suffering from addiction say that they are influenced most by family and friends. Often, it’s negative influences that got them to become addicted in the first place, so it makes sense that CSOs would have the most impact on getting them to stop.

The CRAFT method involves engaging the dependent in a conversational style, rather than lecturing style. The CSOs are guided through techniques by a counselor trained in the CRAFT method:

1. Identify motivators – Observe and communicate behaviors the dependent exhibits that are rewarding to them and do not involve drugs or alcohol. At the same time, help them identify ways their abuse has hurt themselves and others.
2. Set goals for sobriety – Rather than overwhelm them with long-term goals, guide them through a series of short steps that keep them going in a positive direction, and let them take part in setting these goals. By giving them input and choices on how to move forward, this helps them realize they can take active part in their success.
3. Identify drinking triggers/patterns – Figure out what occurs in their lives that makes using drugs or alcohol, their first go-to. By figuring out what “sets them off”, you can help them redirect what they do to assuage the situation from using to something more productive.
4. Choose ways to have positive experiences that don’t involve drinking – Part of this facilitating access to activities that don’t involve using or lessening barriers to therapy. It starts with working with them to determine things they can do and places they can go to positive effect such as avoiding bars or people who use drugs. But it may include assisting their access to positive people, places and activities through providing them phones, transportation, a job, etc.
5. Practice new behaviors – Interact with them in ways that they can see how participating in new behaviors enhances their lives free from substance abuse. This can include role playing where you show the person what to do should a given situation arise.
6. Get significant others involved – CSOs are taught communication tools, how to avoid non-productive involvement such as enabling, and how to avoid conflict. They are counseled on how to increase positive reinforcement when the abuser exhibits improvement, or withdraw when the abuser exhibits addictive behavior.

Efficacy Of And Further Benefits Of The CRAFT Method

Studies show that when the CRAFT method is employed, there is 2-3 times more engagement from the dependent in taking steps toward recovery. Seven out of ten proceed to attend treatment.

Treatment can begin very quickly, and there is generally no wait time. Once a counselor trained in the CRAFT method, is notified that someone is open to the process, they often will make themselves available immediately. They know the importance of leaping on the enthusiasm of the person who needs help so as to not allow their openness to the process to fade. The earlier the process is initiated, the better it works.

CRAFT is very effective on an outpatient basis. It can be combined with other types of therapy such as counseling, or deterrent medications such as Antabuse.

CRAFT is also very beneficial to CSOs. The person seeking the help in the first place is usually someone who loves or cares for the person suffering from addiction. Going through a process that stresses positivity, and increasingly results in more and more positive behavior, there is a great relief both physically and emotionally to those who have suffered so directly from the dependent’s negative behaviors.

The approach is very flexible. It has shown to be successful with special needs communities, with war veterans, or ethnic or cultural minorities with their own, unique beliefs and lifestyle. Their traditions and methods can be worked into the process. It has also has high success rates outside of the United States.

Learning More About The CRAFT Method

If therapists who practice the CRAFT method are not available in your area, books for learning the process are available. In addition, DrugRehab.org can help you find out more about the process and determine whether you and those you care about can benefit from it. Contact us to find out more.