Community reinforcement approach and family training

Community Reinforcement and Family Training (CRAFT) is a behavioural interventional approach used in the treatment of substance use disorders. CRAFT aims to improve communication and interaction patterns as well as support engagement with treatment services by working with family members of individuals diagnosed with substance use disorders.

Overview

Developed in the late 1970s by Dr. Robert J. Meyers and colleagues, CRAFT is an adaptation of the Community Reinforcement Approach (CRA). Whereas CRA works with individuals with substance abuse disorders, CRAFT works with the family of an individual with a substance use disorder to encourage them to seek treatment.

CRAFT has three primary goals:

  1. Engage the substance user in treatment.
  2. Reduce substance use behaviours.
  3. Improve the family members' mood and functioning.

CRAFT treatment is time-limited.

The adolescent community reinforcement approach (A-CRA) specifically adapts CRA for adolescents with substance use issues and their caregivers.

Research and outcomes

In a study sponsored by the National Institute on Drug Abuse, family members receiving CRAFT successfully engaged 74 percent of initially unmotivated drug users in treatment.

One study compared the two psychotherapy approaches of CRAFT and twelve-step facilitation therapies (TFT) — not to be confused with the 12-Step programs, such as Al-Anon, since TFT is a time-limited program intended to "simulate the type of support and guidance... traditionally receive[d] from attending Al-Anon meetings" — for their impacts on addicts seeking to enter treatment. The finding was that concerned significant others who participated in facilitation therapy engaged 29.0% of addicts into treatment, whereas those who went through CRAFT engaged 67.2%. Another study compared CRAFT, Al-Anon facilitation therapy, and the Johnson intervention. The study found that all of these approaches were associated with similar improvements in the functioning of concerned significant others and improvements in their relationship quality with the addicts. However, the CRAFT approach was more effective in engaging initially unmotivated problem drinkers in treatment (64%) as compared with the facilitation therapy (13%) and Johnson interventions (30%).

See also

References

  1. ↑ Canadian Centre on Substance Use and Addiction (2017). "Community Reinforcement and Family Training (The Essentials of Series)" (PDF). Canadian Centre on Substance Use and Addiction. ISBN 978-1-77178-415-3. Retrieved January 1, 2026.{{cite web}}: CS1 maint: periodical has ISBN (link) CS1 maint: url-status (link)
  2. ↑ Lee, Katherine (2017). "An underappreciated intervention". Monitor on Psychology. 48 (11): 18.
  3. 1 2 Meyers, Robert J.; Roozen, Hendrik G.; Smith, Jane Ellen (2011). "The Community Reinforcement Approach: An Update of the Evidence". Alcohol Research & Health. 33 (4). National Institute on Alcohol Abuse and Alcoholism: 380–8. PMC 3860533. PMID 23580022. Archived from the original on May 1, 2021. Retrieved January 20, 2014.p. 380
  4. ↑ Kirby, Kimberly C.; Benishek, Lois A.; Kerwin, MaryLouise E.; Dugosh, Karen L.; Carpenedo, Carolyn M.; Bresani, Elena; Haugh, James A.; Washio, Yukiko; Meyers, Robert J. (2017). "Analyzing components of Community Reinforcement and Family Training (CRAFT): Is treatment entry training sufficient?". Psychology of Addictive Behaviors. 31 (7): 818–827. doi:10.1037/adb0000306. ISSN 1939-1501. PMC 5690811. PMID 28836796.
  5. ↑ Smith, Jane Ellen; Campos-Melady, Marita; Meyers, Robert J. (Spring 2009). "CRA and CRAFT" (PDF). Journal of Behavior Analysis of Sports, Health Fitness and Behavioral Medicine. 1. 2 (1). Behavior Analyst Online. Archived from the original (PDF) on December 29, 2010. Retrieved January 21, 2014.
  6. ↑ Miller, William R.; Meyers, Robert J.; Hiller-Sturmhöfel, Susanne (1999). "The Community-Reinforcement Approach" (PDF). Alcohol Research and Health. 23 (2). National Institute on Alcohol Abuse and Alcoholism: 116–21. PMC 6760430. PMID 10890805. Archived from the original (PDF) on August 10, 2017. Retrieved January 25, 2014.p. 119
  7. ↑ Meyers, R.J.; Wolfe, B.L. (2009). Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening. Hazelden Publishing. p. A Note From Bob Meyers. ISBN 978-1-59285-775-3. Retrieved January 14, 2020.
  8. ↑ Meyers, Robert J.; Miller, William R.; Smith, Jane Ellen; Tonigan, J. Scott (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). American Psychological Association (APA): 1182–1185. doi:10.1037/0022-006x.70.5.1182. PMID 12362968.
  9. ↑ Cf. Kirby, Kimberly C; Marlowe, Douglas B; Festinger, David S; Garvey, Kerry A; LaMonaca, Vincent (1999). "Community reinforcement training for family and significant others of drug abusers: a unilateral intervention to increase treatment entry of drug users". Drug and Alcohol Dependence. 56 (1). Elsevier BV: 85–96. doi:10.1016/s0376-8716(99)00022-8. PMID 10462097.
  10. ↑ Miller, William R.; Meyers, Robert J.; Tonigan, J. Scott (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). American Psychological Association (APA): 688–697. doi:10.1037/0022-006x.67.5.688. PMID 10535235.