What Is the CRAFT Approach to Substance Abuse Intervention?

The CRAFT approach to substance abuse intervention teaches family members how to support and communicate with someone who has a substance use problem. This approach focuses on using positive reinforcement to combat substance use problems and encourage steps toward sobriety and recovery.

What Is the CRAFT Approach?

Community Reinforcement and Family Training (CRAFT) is intended to help family members of addicts learn how to steer their loved one away from substance abuse. It is a great method for someone that's refusing treatment or refusing to admit they are no longer in control of how much they consume.

Instead of an old-school intervention where the family and friends get together and ask the person to enroll in a rehabilitation program, the CRAFT method encourages close significant others (which the program calls CSOs) to reward their loved one when they choose sobriety or show control.

Another critical aspect of this method is that it encourages families to step back and allow bad consequences to happen when the person consumes.

Uses for the CRAFT Method

CRAFT was designed as an intervention for people with substance use problems. The goal is to help increase how often people with addiction engage in treatment.

While the goal is to get people into treatment, CRAFT's target population is the family members of people who misuse drugs and alcohol.

This method can be used by family members who have alcohol use disorder or substance use disorders. It has also been used by concerned loved ones of people with gambling addictions.

History of the CRAFT Method

The CRAFT method was founded by Robert J. Meyers and William R. Miller in the late 1970s. It's an adapted version of another intervention method called the CRA, which stands for Community Reinforcement Approach.

Since CRA therapy determined that a person's community and surroundings can have a lot to do with how often they engage in substance abuse, Meyers and Miller thought it would be helpful to get the person's community involved in helping them change.

Meyers has since written multiple books on the topic and expanded on the approach by helping other therapists learn how to work with the loved ones of addicts. Today, there are training programs for therapists and many CRAFT-certified therapists across the country.

When Is the CRAFT Method Used?

When you realize that the person dealing with addiction in your life is at risk of hurting themselves and others, it's time to consider the CRAFT method. Dr. Umhau encourages people to remember that the CRAFT method is not an intervention.

"In an intervention, everyone kind of gangs up [on the person who is abusing substances] and tells them to go into treatment," says Umhau. "Well, what if they never do get treatment and they’re mad at you, and they just lose contact with the family?"

How to Use the CRAFT Method

By positive reinforcement, the CRAFT method means recognizing the person who is abusing substances when they don't drink or consume. This could mean that you do or say something nice for them.

More specifically, the CRAFT method encourages these practices:

• Identify triggers: Figure out when the person who is addicted to substances is most tempted to use. Is it when they're upset? Is it a particular time of day? This can also help loved ones determine if they're causing an unintentional trigger.
• Improve communication: Communicate clearly with the user (and vice versa) in every aspect of their lives.
• Focus on positive reinforcement: Use positive reinforcement consistently to encourage non-using and pro-social behaviors.
• Employ natural consequences: Take away positive reinforcement when the person is using and let them face the consequences on their own.
• Identify emotional barriers: Assess, determine, and address the things that could be making them unhappy. It also encourages loved ones to reward themselves when they work toward improving their own circumstances.
• Work with a therapist: In working with a CRAFT-certified therapist, learn about ideal times to bring up treatment to someone with a substance use disorder. Then, learn how to immediately act on it if the person struggling with addiction agrees.
• Continue offering support: Support the loved one through therapy, and be patient if the person addicted to substances drops out of therapy prematurely.

Impact of the CRAFT Method

In trials, the CRAFT Method has proven to be effective at getting people who are dealing with an addiction to admit that they have a problem and seek therapy.

When concerned family members signed up to take on the CRAFT method under clinical supervision to determine the program's effectiveness, 62% of the group ended up getting their loved ones into treatment.

For comparison, only around 37% of substance users who had loved ones who participated in Al-Anon and Nar-Anon interventions went on to seek treatment.

A 2020 systematic review published in the journal Addiction found that CRAFT was twice as effective as the control and comparison groups. Individual and group sessions were linked to the highest treatment entry rates at 77% and 86%, respectively.

Potential Pitfalls of the CRAFT Method

One of the hardest parts about the CRAFT method is that family members must learn to let their loved one fail. This could mean that the person feels really sick, misses days of work, or misses out on important family moments. They may also feel anger or resentment toward the family as a result.

The CRAFT program wants family members to let the person struggling with addiction see the harm they're causing themselves and others. This can impact families, especially if the family counts on the person to work and follow through with their responsibilities.

Training with CRAFT-certified therapists can be more expensive, and some of them focus entirely on this one method of treatment. When looking for a therapist for your loved one or the impacted family members, search through their website to see what training and methodologies they've studied.

Keep in Mind

There is no single treatment option that is right for everyone. If you have a family member with a substance use problem, research your options and consider talking to a therapist to help determine which method might be right for your family and situation. CRAFT can be a great choice for many people, but you may find that support groups like Al-Anon and Nar-Anon can also be beneficial.