The CRAFT Method for Substance Abuse Intervention

Community Reinforcement and Family Training, or the CRAFT method, is a way to help loved ones and family members of someone with a substance use disorder steer them away from their addictive behavior. Also known as the CRAFT Approach, the CRAFT Model, or the CRAFT Program, it’s a distinct variant of a typical intervention.

What Is the CRAFT Method?

The CRAFT method contrasts with a traditional intervention. In traditional interventions, family and friends will get together and confront someone struggling with substance abuse. These interventions aim to get the person into a rehab program. The CRAFT method encourages close significant others, called CSOs, to reward a loved one when they show self-control or choose sobriety.

Here’s what you should know about a CRAFT intervention:

• Families are encouraged to take a step back and let the person with a substance use disorder experience the full weight of the consequences of their use.
• The method’s philosophy is more scientifically driven than traditional interventions. The idea is that you don’t reinforce bad behavior; instead, you reinforce good behavior.
• There are currently nationwide training programs for therapists.

Robert J. Meyers and William R. Miller developed the methodology in the late 1970s, adapting it from another method called the Community Reinforcement Approach (CRA). The Community Reinforcement Approach focuses on the idea that someone’s surroundings and community are significant contributors to how they engage in substance abuse. With that in mind, Meyers and Miller theorized it would help if someone’s community played a role in motivating them to make a change. Since the 1970s, Meyers has written several books on the topic, and he also helps other therapists learn how to work with the loved ones of people struggling with addiction.

How Is CRAFT Different from Other Interventions?

While there are different approaches to interventions, older methods are generally based on the idea that your loved one must accept help or you will distance yourself from that person. With CRAFT, rather than distance themselves from someone unwilling to get help, families learn strategies that allow them to support their loved ones and communicate with them.

Within a CRAFT intervention, you can expect to: 

• Take care of yourselves as a family
• Learn communication approaches that increase the likelihood of the loved one making a change
• Help your child or loved one without taking those gut-wrenching steps of just letting them figure it out for themselves
• Use a “menu-driven” approach: there are different procedures families can choose from in the CRAFT “menu” based on their needs.

The point where treatment begins will depend on the severity of a loved one’s addiction, their behavior, and how open they are to change. The approach is personalized based on a family’s unique history, experiences, and emotional state.

In traditional interventions, what often ends up happening is that the person with the addiction becomes angry, defensive, and more estranged from their family than ever before. With the CRAFT alternative method, there’s more mutual respect. Some describe it as more humane.

Goals of the CRAFT Method

The ultimate goal of the CRAFT method is to get someone dealing with an addiction to admit they have a problem and then get help. This is what makes it similar to other intervention approaches. There are also other goals, though.

For example, with this method, there is a goal of helping the person’s loved ones prioritize their mental health and increase their happiness. Loved ones may be experiencing high exposure levels to stress and anxiety because of the addiction of their family members, including:

• Violence and abuse
• Financial repercussions
• Poor relationship satisfaction
• Mental health issues like low self-esteem and anxiety

Through the CRAFT method, family members can learn how to feel confident and empowered to play an active role in helping their loved ones get help and treatment.

What Does the CRAFT Method Look Like?

The CRAFT method is a set of therapy techniques modified from the community reinforcement approach, with a specific application for people who misuse substances. Rather than targeting someone directly who has an addiction, in this method, the concerned significant others are the focus. The concerned significant others are known as CSOs. CSOs learn how to help the identified patients, or IPs.

The CRAFT method helps teach CSOs how to:

• Change their behaviors, reactions, and expectations toward the IP
• Reduce or eliminate substance use and addiction behaviors in the IP
• Help motivate the IP to get treatment
• Value their own self-care as they work with the IP

In CRAFT, CSOs work with a therapist to learn the components of the method. They usually learn the steps in the method in a support group setting. Sessions are usually around 10-14 hours in total, broken up into hour-long increments. Each session focuses on one component.

These sessions generally include:

• Deciding if it’s a good fit: CSOs work with a therapist to determine if they’re a good match for this treatment model. One factor that’s weighed here is whether there will be a threat of new or continued violence toward the CSO if treatment is initiated.
• Functional analysis: CSOs will work on identifying triggers and consequences of using substances for the IP. During this time, CSOs work on overcoming their distorted perceptions about reward and punishment.
• Communication training: focuses on learning to be clear, direct and respectful.
• Positive reinforcement: CSOs learn how to provide positive reinforcement for sober behaviors rather than punishments, like verbal praise or tangible items. This helps rebuild the broken relationship and increases the likelihood of positive behaviors.
• Natural consequences: training includes allowing natural consequences for drug or alcohol use rather than trying to punish the person with the substance use disorder. CRAFT philosophies believe that health, legal, social and career consequences are enough to end addictive behaviors.
• Self-care: The CSO learns how to find ways to improve their own lives and regain their identity. They are encouraged to reward their positive behaviors.
• Opportunities for treatment: Rather than putting extreme pressure on the IP, the CRAFT method teaches CSOs to be mindful of where openings might occur to have the discussion. The CSO will talk about options when they spot an opening and have a plan for rapid intake.
• Family therapy: If the IP goes to a treatment program that uses family support programs, then the CSO will stay engaged in the process.

What Are the Benefits of Using CRAFT?

The biggest advantage of using CRAFT is that it encourages healthy and constructive change, framed positively. The goal is about changing behavior not just for the person struggling with addiction but also for their loved ones.

Research shows that family members who go through the CRAFT process tend to feel better overall, regardless of whether their loved one agrees to go to treatment or not.

The skills families learn through CRAFT are something they can use over the long term. They’re not just beneficial as you try to encourage someone to get treatment. They can create a strong foundation for family communication for years to come and help create lasting change.

Is CRAFT Effective?

Some trials prove the CRAFT method is an effective way to get people dealing with addiction to recognize the problem and get help. Consider the research:

• Early research with the CRAFT model has shown that individuals with drug or alcohol addictions enter treatment around 64% of the time when the family undergoes a CRAFT intervention.
• Later studies showed that people enter treatment 64% to 74% of the time after the family engages in a CRAFT intervention.

These rates of treatment engagement are higher than those seen for Al-Anon or a Johnson Intervention. When these methods are used, 17-30% of people with addictions enter treatment.

One important thing to note with this method is that it can take time and patience. The studies cited above tracked the family members for six months before they went onto phase two. Phase two is when the addicted person begins the process of getting help. Consistency is key with the CRAFT method.

Finding Help For Your Loved One

For those seeking treatment for a loved one, The Recovery Village Ridgefield offers a full continuum of addiction treatment programs in the Portland, Oregon metro and the state of Washington. Levels of care range from residential treatment to outpatient and aftercare options. If you’d like to learn more about our drug and alcohol addiction treatment programs or get started on the journey to recovery, contact us today.