Drs. Robert J. Meyers and Jane Ellen Smith of the University of New Mexico developed the CRAFT program to teach families how to impact their loved one while avoiding both detachment and confrontation, the respective strategies of Al-Anon (a 12-Step based approach), and traditional (Johnson Institute-style) interventions in which the substance user is confronted by family members and friends during a surprise meeting. While all three approaches have been found to improve family members’ functioning and relationship satisfaction, CRAFT has proven to be significantly more effective in engaging loved ones in comparison to the Johnson Institute Intervention or Al-Anon/Nar-Anon facilitation therapy.
CRAFT is a skills-based program that impacts families in multiple areas of their lives, including self-care, pleasurable activities, problem solving, and goal setting. At the same time, CRAFT addresses their loved one’s resistance to change. CRAFT teaches families behavioral and motivational strategies for interacting with their loved one. Participants learn, for example, the power of positive reinforcement for positive behavior (and of withdrawing it for unwanted behavior), and how to use positive communication skills to improve interactions and maximize their influence.
Specifically, CRAFT teaches several skills, including:
Understanding a loved one’s triggers to use substances
Positive communication strategies
Positive reinforcement strategies – rewarding non-using behavior
Problem-solving
Self-care
Domestic violence precautions
Getting a loved one to accept help
Many of these skills are valuable for the family even if their loved one does not enter treatment or has already begun the treatment process. Additionally, the skills remain essential over the long run for families in navigating and maintaining a positive trajectory for themselves as well as for their loved one. CRAFT is not a quick fix, but rather an approach that can benefit both the substance user and the family in the short and long terms with a holistic plan of action and a more optimistic view.
Community Reinforcement Approach and Family Training (CRAFT) is a scientifically based intervention designed to help concerned significant others (CSOs) to engage treatment-refusing substance abusers into treatment. This method was developed with the belief that since family members can, and do make important contribution in other areas of addiction treatment (i.e. family and couples therapy), that the CSO can play a powerful role in helping to engage the substance user who is in denial to submit to treatment. In addition, it is often the substance user who reports that family pressure or influence is the reason sought treatment. Also, CSOs who attend the CRAFT program also benefit by becoming more independent and reducing their depression, anxiety and anger symptoms even if their loved one does not enter treatment.
CRAFT uses an overall positive approach and steers clear of any confrontation. CRAFT is a culturally sensitive program that works with the client’s values and beliefs to develop an appropriate treatment plan. The program emphasizes learning new skills to cope with old problems. Some of the components include how to stay safe, outlining the context in which substance abusing behaviour occurs, teaching CSOs how to use positive reinforcers (rewards) and how to let the substance user experience the natural consequences for their using behaviour.
No one has better information about the substance user’s behaviour patterns than a close family member. CRAFT teaches the CSO how to use this information in a motivational way to increase the chance of the substance user entering treatment. CRAFT research has shown that almost 7 out of 10 people who use the program get their substance user to attend treatment.