Community Reinforcement Approach (CRA)
Community Reinforcement Approach and Family Training (CRAFT)
Community Reinforcement Approach (CRA) and Community Reinforcement Approach and Family Training (CRAFT) are globally recognised evidence based treatment methods for drug abuse and alcohol addiction.
CRAFT suggests conversational techniques, helpful questions, and ways of responding to a substance abuser’s (often bad) behavior. It’s like an etiquette guide for dealing with addicts. Yet its goals are much more ambitious: By making loved ones feel listened to, empowered, and supported, CRAFT’s proponents say, family members can motivate them to seek help and ultimately help the rehabilitation process.
CRAFT takes aim at one of the most puzzling problems in addiction treatment: In the US, of the 20 million people who suffer from a substance abuse disorder, 19 million of them — 95 percent — say they don’t need help or rehab, according to the 2013 National Survey on Drug Use and Health. That is remarkably high regardless of symptoms or their severity. Even 90 percent of the over 18 million people who experience substance-related withdrawal symptoms — trembling hands, seizures, hallucinations — don’t believe they need addiction care.
In a study of 130 families published in 1999, nearly two-thirds of the participants who took CRAFT classes saw substance-abusing family members who had resisted treatment change their minds and get help — more than three times the rate of families who attended AA meetings.
CRAFT starts with a provocative premise: Most substance abusers aren’t in denial, but rather are ambivalent and guarded. They know their drug use causes problems, but they don’t want to admit it because doing so risks the loss of all sorts of things: their dignity, possibly their freedom, not to mention access to the benefits of the drug itself.
With CRAFT, family members learn ways to lower loved ones’ defenses and encourage them to speak candidly. The advice essentially boils down to simple steps like asking open-ended questions, complimenting positive behaviors, and echoing the person’s concerns in a nonjudgmental way. Next, they learn to devise ways to improve their home life (without fixing or minimizing the ill effects of the drinking or drug use). When the struggling loved one feels understood and safe, the reasoning goes, he or she will be more willing to be vulnerable, to seek help.
Gentle as the CRAFT method sounds, research indicates it is effective.
Lyndon has the only people in Australia accredited to deliver, supervise and train in these methods. Our study with the National Drug and Alcohol Research Centre at UNSW validated the CRA approach with Aboriginal Australians across rural NSW and found to be effective with methamphetamine users and responsive to the ice epidemic.
For more information on CRAFT and training opportunities, please call us on 1300 LYNDON