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Community reinforcement approach and family training

From Wikipedia, the free encyclopedia

Community Reinforcement Approach and Family Training (CRAFT) is an approach used in behavioral therapy, often in the treatment of substance use disorders.[1] CRAFT therapists guide the families of individuals with substance use disorders to improve communication skills and encourage their loved ones to enter treatment.[2]

Overview

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Developed in the late 1970s by Dr. Robert J. Meyers and colleagues, CRAFT is an adaptation of the Community Reinforcement Approach (CRA). This approach encourages individuals with substance use disorders to seek treatment by actively involving their family members.[3] By promoting the use of healthy rewards for positive behaviors, CRAFT aims to reduce the individual's resistance to finding support while simultaneously enhancing the family’s well-being.[3][4][5]

The approach has three primary goals:

  1. Engage the substance user in treatment.
  2. Reduce substance use behaviors.
  3. Improve the family members' mood and functioning.[6]

CRAFT treatment is time-limited,[4] typically involving a specified number of sessions or a set time frame determined early in the therapy process.[7]

The adolescent community reinforcement approach (A-CRA) specifically adapts CRA for adolescents with substance use issues and their caregivers.[3]

Description

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CRAFT is a motivational model of family therapy that leverages positive reinforcement. It was developed to help treatment-refusing individuals who have a substance use disorder by changing their interactions with families and friends. Its goal is to facilitate patient treatment and recovery, in addition to improving the lives of their family members.[8]

In the model, the following key terms are used:

  • Identified Patient (IP): the individual with the substance use disorder who is refusing treatment.
  • Concerned Significant Others (CSOs): the relevant family members and friends of the IP.[8]

Meyers reported that concerned significant others participating in CRAFT may experience changes in emotional functioning and independence, regardless of whether the identified patient enters treatment.[9]

CRA and CRAFT procedures

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The following CRA procedures and descriptions for the substance user are from Meyers, Roozen, and Smith:[3]: 382–384  [clarification needed]

  1. Functional Analysis of Substance
    • Explore the antecedents of a client's substance use.
    • Explore the positive and negative consequences of a client's substance use.
  2. Sobriety Sampling
    • A gentle movement toward long-term abstinence that begins with a client's agreement to sample a time-limited period of abstinence.
  3. CRA Treatment Plan
    • Establish meaningful, objective goals in client-selected areas.
    • Establish highly specified methods for obtaining those goals.
    • Tools: Happiness Scale and Goals of Counselling form.
  4. Behavior Skills Training
    • Teach three basic skills through instruction and role-playing:
    1. Problem-solving
      • Break overwhelming problems into smaller ones.
      • Address smaller problems.
    2. Communication skills
      • A positive interaction style.
    3. Drink/drug refusal training
      • Identify high-risk situations.
      • Teach assertiveness.
  5. Job Skills Training
    • Provide basic steps for obtaining and keeping a valued job.
  6. Social and Recreational Counseling
    • Provide opportunities to sample new social and recreational activities.
  7. Relapse Prevention
    • Teach clients how to identify high-risk situations.
    • Teach clients how to anticipate and cope with a relapse.
  8. Relationship Counseling
    • Enhance the interaction between the client and their partner.

Communication

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Dr. Bob Meyers:
Family Communication

Interviewer: "So, if you can, explain [to] us a little bit about how the CRAFT technique works. What's it all about?"

Dr. Bob Meyers: "Well, the CRAFT technique is a process. We bring in a family member, and what we do is we teach them how to interact differently with the drinker or the drug user. Instead of yelling and screaming when they're using drugs, we tell them to kind of just stay away from them, leave that person alone. But, then when they're sober—when they're not using drugs—we talk to them ... to tell them how much you love them, how much you care about them, how important they are to the family, and we try to help them pick their spots: when do you talk to them, when do you stay away from them.

"So, it takes a little bit of time, but we've been very successful here, being funded by the National Institutes of Health through the University of New Mexico to run a couple of scientific studies, where we've actually proven that my CRAFT intervention is much more powerful than anything that is used out there currently."[10]

From an online news clip by KRQE News at Robert J. Meyers, PhD: "CRAFT Video Clip".

CSOs are trained in various strategies to accomplish treatment goals, including positive reinforcement, communication skills, and natural consequences. There are seven steps in the CRAFT model for implementing these strategies.[11]

  1. Be brief
  2. Be positive
  3. Refer to specific behaviors
  4. Label your feelings
  5. Offer an understanding statement – for example: "I appreciate that you have these concerns"[12]
  6. Accept partial responsibility – for example: "It's not about accepting responsibility for things you are not responsible for"[12]
  7. Offer to help

The overarching goals for the strategies for communicating are to help decrease defensiveness on the part of the loved one that the CSO is speaking to, increases the chance that the message is really going to be heard.[11]

A Conversation:
Engaging v. Detaching

Dr. Nicole Kosanke: "Of course, all of us get to the point of frustration, ... it's pretty hard not to if you're dealing with a situation like this with your child. So, at times, yes, you're going to be frustrated and put your hands up. But, as a general rule, staying engaged and managing your feelings, asking people for help, asking people to give feedback directly to [your child]—all of that communicates a sense of engagement, rather than detaching. And, it also communicates a sense of love and caring for your child, which ultimately — even when you're detaching — that's what you have inside, and that's a real ingredient for helping impact someone [to] change."

Dr. Josh King: "I would say this [engagement] is almost the opposite of detaching. ... [Detachment] is either you can give them the feedback or not [as if] the best thing you can do is step away, which I don't agree with. I think when you step away, you have no impact on the ability to make change."

Dr. Nicole Kosanke: "In [the example] situation, you're also inviting the community to have an impact on your child. CRAFT stands for 'Community Reinforcement and Family Training.' It's the community that we're really talking about. We're talking about the community having an impact on your child in a global sense. [The ultimate goal is] to impact that person's motivation in a more healthy direction."[13]

The "Hitting Bottom" Myth

[It is one of the myths that] no one enters treatment until they "hit bottom" so using CRAFT while your loved one is still functioning is a waste of time.

People enter treatment when the reasons not to use outweigh the reasons to use. And as research has clearly shown, family members can help shift the balance so that the [substance] user develops enough reasons to stop.[5]

From Robert J. Meyers, PhD, "CRAFT: An Alternative to Intervention".
Compatibility

CRA can be combined with other treatment methods. For example, ... CRA has recently [in 1999] been combined with motivational interviewing to form an integrated treatment. Similarly, CRA is consistent with involvement in 12-step programs.[14]

From William R. Miller, PhD, et al. "The Community-Reinforcement Approach" published in the Alcohol Research and Health journal by NIAAA .

CRAFT view

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Motivation & Abstinence

Even the most extreme "disease model" programs that profess solely neurochemical origins of addiction ultimately rely upon the client's volitional abstinence (Milam & Ketcham, 1981).[15]

Studies in the 1960s clearly demonstrated that even chronically dependent drinkers with access to alcohol could regulate their drinking given sufficient incentives to do so, at least under controlled laboratory conditions (Heather & Robertson, 1983).[15]

To say that choice is involved in addictive behavior [does not ...] say that it is only a matter of choice.[15]

The majority of medical and legal professional bodies, such as the World Health Organization, the American Medical Association, and the American Bar Association, state that alcoholism is a disease, demonstrated by changes in brain chemistry. However, Dr. Gene Heyman[16] and others assert that alcoholism is not a disease. The disease theory of alcoholism—the idea that alcoholism is caused by a disease rather than being a disease itself–asserts this as well. The diagnostic assessment of alcoholism in someone can include an assessment of co-morbidity with conditions such as mental illness and domestic violence.[citation needed]

From SMART Recovery, section: Family & Friends:

The work of Robert Meyers' CRAFT Community Reinforcement Approach and Family Training program ... differs significantly from Al-Anon in that it is a behavioral program which advocates that the CSO [Concerned Significant Other] can have a positive impact on the person using substances. The CRAFT program has been demonstrated in Meyers' research to be more effective than the Vernon Johnson type intervention or Al-Anon, with fewer negative side-effects and better outcomes, whether or not the person using substances enters treatment.[17][18]

The CRAFT program uses a variety of interventions based on functional assessment, including a module to prevent domestic violence.

Intervention

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A study examining individuals with substance use disorders who underwent a traditional intervention, commonly known as the Johnson Intervention, found higher relapse rates than those referred to outpatient alcohol or drug treatment through other methods.[19]

Research has also identified practical and emotional challenges associated with the Johnson Intervention. Studies report that although the approach can result in treatment entry when it is carried out, only a small proportion of family members or friends who begin the process complete the intervention. Participants who do follow through often describe the approach as uncomfortable because of its confrontational nature.[4]

By contrast, research suggests that CRAFT has been more effective than the Johnson Intervention or Al-Anon and Alateen approaches in engaging individuals who are resistant to treatment. Al-Anon and Alateen are not designed to directly influence individuals with substance use disorders, but instead focus on supporting family members and others affected by a loved one's substance use.[2]

Development

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Robert J. Meyers wrote in an introduction to one of his books that "although my mother was blessed by the support and comfort she found in Al-Anon meetings, she was never able to achieve her most cherished goals of getting my father into treatment and getting him to stay sober".[20] Witnessing this as a child inspired Meyers to seek an approach that was more effective for people with those goals. The origin of CRAFT:

"Dr. 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."[21]

Having worked with Nathan Azrin in the early 1970s, whilst Azrin was developing the community reinforcement approach, Meyers started to look into using the process in other settings. CRAFT combines CRA with family training, which equips the families and friends of addicts with supportive techniques to encourage their loved ones to begin and continue treatment and provides them with defenses against addiction's damaging effects on their loved ones.

CRA

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The Community Reinforcement Approach (CRA), developed by Nathan Azrin in the early 1970s, was originally developed for individuals with alcohol use disorders, but has been employed to treat a variety of substance use disorders.

Azrin's belief that "punishment to be an ineffective method for modifying human behavior"[3] was shared with B. F. Skinner, the "most influential behaviorist of all time,"[3] and later research discovered confrontation-based treatments "were largely ineffective in decreasing the use of alcohol and other substances."[3] As such, Arin designed the Community Reinforcement Approach:

"Azrin believed that it was necessary to alter the environment in which people with alcohol problems live so that they received strong reinforcement for sober behavior from their community, including family, work, and friends. As part of this strategy, the program emphasizes helping clients discover new, enjoyable activities that do not revolve around alcohol, and teaching them the skills necessary for participating in those activities."[3]

The CRA technique has "been found to be effective in outpatient setting."[4][22] It uses operant conditioning based on a functional assessment of a client's drinking behavior and the use of positive reinforcement and contingency management to achieve the goal of non-drinking.[23] When combined with Disulfiram (a prescribed substance acting as aversion therapy), participants were "abstinent an average of 97% of the days during the last month of the 6-month follow-up, whereas clients treated with a combination of a 12-step program and the CRA Disulfiram compliance training were abstinent an average of 74% of the days."[4][24] A notable component of the program is the non-drinking club.[25] As of 2007, applications of community reinforcement to public policy have become a focus of study.[26]

Recent developments

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As of 2009, CRAFT and CRA programs were not widespread among addiction counselors. The adoption of evidence-based treatments has been slow.[27] Instead, many addiction counselors were tied to a twelve-step model. The National Institute on Drug Abuse (NIDA), a federally funded organization aiding scientific research into addiction, has supported CRAFT intervention techniques among others.[28] In 2007, CRAFT was being used in 25 clinics in the United States.[29]

However, CRAFT has been adopted by a number of commercial and self-help organizations in the United States. Meyers and the Treatment Research Institute (TRI) worked with Cadence Online to create a Parent CRAFT course where parents pay a one-off fee for a series of videos presenting the CRAFT process, aimed at teaching them skills to meet the risks of substance use in their adolescent children. An undisclosed "major share" [30] of the revenues goes to TRI. Meyer's work was partially funded with a grant from NIDA.[30] Allies in Recovery provides a series of videos, eBook, blog, live calls, and other services to families of people with addiction based on the CRAFT method. The states of Massachusetts, Rhode Island, and Mississippi are providing free access for all residents to the Allies in Recovery service.[31] Based in Rhode Island, Resources Education Support Together (REST) is a peer-led mutual aid group that uses CRAFT and the Allies in Recovery service for its members.[32]

Founded in 2018, We The Village began focusing on supporting families and clinicians in addressing substance use disorders through the evidence-based Community Reinforcement and Family Training (CRAFT) approach. Founded by Jane Macky, the organization collaborates with Dr. Robert J. Meyers, to provide online training programs for families and professionals. We The Village's work is supported by funding from the National Institute on Drug Abuse (NIDA),[33] ensuring its programs are rigorously tested and accessible online.

We The Village is currently conducting a fully powered Randomized Controlled Trial (RCT), funded by NIDA, to compare two digital interventions: CRAFT-A (a digitally automated version of CRAFT with group coaching) and PEER support.[34] The trial aims to assess outcomes such as treatment entry and retention, family members' well-being, and knowledge of CRAFT principles.

Research and outcomes

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CRAFT vs. Alternatives

70% of people who use CRAFT are likely to get their loved into treatment as opposed to 30% of people using an intervention ... . And then, for Al-Anon, you've got like 12% of people getting their loved one into treatment. Now, that's sort of not a fair comparison because Al-Anon is not designed to get someone else to do something. Al-Anon is specifically designed to help the family member feel better, and that it does quite well, but in terms of influencing change in the loved one [—the substance user], not so well. And, the only reason to make those comparisons ... is simply because there are no other options in our society. So, if you go to a therapist or a clergyman or something and say "my kid is smoking too much pot, and I don't know what to do about it," they are going to send you to Al-Anon or a therapist, or talk to you about getting an intervention [not CRAFT]. So, those are the options [to CRAFT] we have in the world.

Dr. Nicole Kosanke in an online video by cmc: Center for Motivation and Change at YouTube: "Intro to CRAFT: CRAFT vs Alternatives ".

CRAFT compared with other approaches

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An offshoot of the community reinforcement approach is the community reinforcement approach and family training.[35] This program is designed to help family members of people who use substances feel empowered to engage in treatment. Community reinforcement approach and family training (CRAFT) has helped family members to get their loved ones into treatment.[35][36] The rates of success have varied somewhat by study but seem to cluster around 70%.[36][37][38][39] CRAFT is one of the only family-aimed treatments with proven results for getting people with drug or alcohol problems into treatment.[36] The program uses a variety of interventions based on functional assessment including a module to prevent domestic violence. Partners are trained to use positive reinforcement, various communication skills and natural consequences.

Intervention for alcohol use

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Results and Safety

On results: People who adopt [CRAFT] experience a variety of results. Some do indeed arrive at the point where they know that letting go is the only way of moving forward.[40]

On safety: As always, the most important objective is to remain safe.[41]

Drs. Robert J. Meyers and Brenda L. Wolfe, from Get Your Loved One Sober.

From an article on the American Psychological Association (APA) website about the success of CRAFT in substance use treatment and intervention,[42] these are the success outcomes for engaging drinkers into treatment:

  1. 64% – CRAFT
  2. 23% – Johnson Intervention
  3. 13% – Twelve-Step Facilitation (TSF)

Elsewhere, Robert Meyers has clarified that Twelve-Step Facilitation used in the Miller et Al's comparative study of 130 caretakers of problem drinkers was a control group structured to "simulate the kind of care and guidance CSO's would traditionally receive from attending Al-Anon meetings... treatments were delivered one-on-one and included up to 12 hours of therapy."[20]

Sisson and Azrin (1986) recruited 12 adult women with an alcoholic husband, brother, or father and randomly assigned them either to an early version of CRAFT or to a traditional intervention. Results indicated that CRAFT was considerably more successful in getting the persons with substance abuse into treatment and reducing their alcohol consumption in comparison to the Al-Anon group. Miller et al. (1999) conducted a controlled comparison of CRAFT, the Johnson Intervention, and Al-Anon facilitation (TSF) that randomized 130 caregivers of problem drinkers to receive 12 hours of contact in one of the three conditions. CRAFT and TSF had better retention than the Johnson Intervention. Consistent with previous studies, participants tended to drop out of the latter intervention in order to avoid the family confrontation with the drinker. The CRAFT intervention also engaged substantially more drinkers into treatment (64% vs 23% Johnson and 13% TSF).[42]

Fig. 1. Comparison of success outcomes engaging drinkers into Treatment.

Comparisons

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One experiment 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"[43] ) 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%.[44][45] Another study compared CRAFT, Al-Anon facilitation therapy, and a 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%).[46]

Intervention for substance use

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From the same article on the American Psychological Association (APA) website about the success of CRAFT in substance use treatment and intervention,[42] these are the success outcomes for persons abusing drugs to enter treatment (the success outcomes were nearly the same as the alcohol use disorder outcomes):

  1. 64% – CRAFT
  2. 17% – Caregivers' Twelve-step Group (TSG)

From the article:

Kirby et al. (1999) randomly assigned 32 caregivers of drug users to CRAFT or a 12-step self-help group (TSG). Caregivers who were assigned to CRAFT attended more sessions than those in TSG and were more likely to complete a full course of counseling during which the persons abusing drugs were far more likely to enter treatment (64% vs 17%). Reductions in drug use occurred during the study, but there was no group x time interaction. Meyers et al. (2002) replicated and extended those findings with drug users with similar positive effects on engagement of the drug abusing family members in treatment.[42]

Note: When the articles states "there was no group x time interaction," it simply means the CRAFT outcome (64%) and the TSF outcome (17%) remained the same over time, even though there was a reduction in drug use during the study.[47]

Parallel study
[edit]

In a parallel study sponsored by the National Institute on Drug Abuse that focused on people who use other substances, family members receiving CRAFT successfully engaged 74 percent of initially unmotivated drug users in treatment (Meyers et al. 1999).[14]

Professional organizations

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CRAFT is a model of Clinical behavior analysis which is of interest to the following professional organizations.

  1. The Association for Behavior Analysis International (ABAI) has a special interest group in clinical behavior analysis.[48]
  2. The Association for Behavioral and Cognitive Therapies (ABCT) also has an interest group in behavior analysis, which focuses on clinical behavior analysis. In addition, ABCT has a special interest group on addictions.[49][50]

See also

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References

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  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: url-status (link)
  2. ^ a b Lee, Katherine (2017). "An underappreciated intervention". Monitor on Psychology. 48 (11): 18.
  3. ^ a b c d e f g h 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. ^ a b c d e 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.
  5. ^ a b Meyers, Robert J. "CRAFT: An Alternative to Intervention". HBO.
  6. ^ 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.
  7. ^ "Different types of therapy". United Kingdom: Brighton Therapy Works. Archived from the original on April 29, 2021. Retrieved January 23, 2014.
  8. ^ a b Foote, Jeff; Manuel, Jennifer K. (2009). "Adapting the CRAFT approach for use in group therapy". Journal of Behavior Analysis in Health, Sports, Fitness and Medicine. 2 (1): 110. doi:10.1037/h0100378.
  9. ^ "CRAFT". www.robertjmeyersphd.com. Robert J. Meyers, PhD. Retrieved January 20, 2014.
  10. ^ Dr. Bob Meyers, PhD: "CRAFT Technique" Creator (2007). Craft Video Clip (wmv (Windows Media Video)). krqe.com (video). Albuquerque, New Mexico: KRQE News. Retrieved January 23, 2014. Time: 1:20 to 2:09
  11. ^ a b Dr. Josh King, Psy. D., Center for Motivation and Change (CMC), and Dr. Nicole Kosanke, PhD, Director of Evaluations and Family Services at CMC. CRAFT Series: Positive Communication When You're Angry 1/3 (video). The Center for Motivation and Change (CMC). Event occurs at 2:41 to 3:26, 12:12 to 12:30. Retrieved January 23, 2014.
  12. ^ a b Dr. Josh King, Psy. D., Center for Motivation and Change (CMC), and Dr. Nicole Kosanke, PhD, Director of Evaluations and Family Services at CMC. CRAFT Series: Positive Communication When You're Angry 2/3 (video). The Center for Motivation and Change (CMC). Event occurs at 0:30 to 1:06, 1:15 to 1:18, 7:35 to 8:21. Retrieved January 23, 2014.
  13. ^ Dr. Josh King, Psy. D., Center for Motivation and Change (CMC), and Dr. Nicole Kosanke, PhD, Director of Evaluations and Family Services at CMC. CRAFT Series Part 3: Negative Consequences vs Detaching (4/5) (video). The Center for Motivation and Change (CMC). Event occurs at 5:59 to 8:17. Retrieved January 23, 2014.
  14. ^ a b 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
  15. ^ a b c Miller, William (1998). "Toward a Motivational Definition and Understanding of Addiction". Motivational Interviewing Newsletter for Trainers. 5 (3). International Association of Motivational Interviewing Trainers: 2–6. Archived from the original on April 19, 2013. Retrieved January 22, 2014.
  16. ^ Heyman, Gene M. (2010). Addiction: A Disorder of Choice (paperback). Cambridge, MA: Harvard University Press (published October 2010). ISBN 978-0-674-05727-2. Retrieved January 21, 2014.
  17. ^ Smith, J.E. & Meyers, R.J. (2004) Motivating Substance Abusers to Enter Treatment: Working with Family Members; Guilford Press
  18. ^ Meyers, RJ & Wolfe, B. (2004) Get Your Loved One Sober: Alternative to Nagging, Pleading and Threatening by Meyers, Hazelden Press
  19. ^ "The Johnson intervention and relapse during outpatient treatment". American Journal of Drug and Alcohol Abuse 22.n3 (August 1996): pp36
  20. ^ a b Meyers, R.J.; Wolfe, B.L. (2009). Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening. Hazelden Publishing. p. xvii. ISBN 978-1-59285-775-3. Retrieved January 14, 2020.
  21. ^ "What Is CRAFT". www.motivationandchange.com. The Center for Motivation and Change (CMC). Retrieved January 23, 2014.
  22. ^ Dutcher, L. W., Anderson, R., Moore, M., Luna-Anderson, C., Meyers, R.J., Delaney, Harold D., and Smith, J.E. (2009). Community Reinforcement and Family Training (CRAFT): An Effectiveness Study. Journal of Behavior Analysis of Sports, Health Fitness and Behavioral Medicine, 2 (1), "Archived copy" (PDF). Archived from the original (PDF) on December 29, 2010. Retrieved January 21, 2014.{{cite web}}: CS1 maint: archived copy as title (link)
  23. ^ Hunt, G.M.; Azrin, N.H. (1973). "A community-reinforcement approach to alcoholism". Behaviour Research and Therapy. 11 (1): 91–104. doi:10.1016/0005-7967(73)90072-7. PMID 4781962.
  24. ^ Azrin, N.H.; Sisson, R.W.; Meyers, R.J.; Godley, M.D. (1982). "Alcoholism treatment by disulfiram and community reinforcement therapy". Journal of Behavior Therapy and Experimental Psychiatry. 3 (2): 105–112. doi:10.1016/0005-7916(82)90050-7. PMID 7130406.
  25. ^ Mallams, J.H.; Godley, M.D.; Hall, G.M.; Meyers, R.J. (1982). "A social-systems approach to resocializing alcoholics in the community". Journal of Studies on Alcohol. 43 (11): 1115–1123. doi:10.15288/jsa.1982.43.1115. PMID 7182672.
  26. ^ Milford, Jaime L.; Austin, Julia L.; Ellen Smith, Jane (2007). "Community Reinforcement and the Dissemination of Evidence-based Practice: Implications for Public Policy". International Journal of Behavioral Consultation and Therapy. 3 (1): 77–87. doi:10.1037/h0100174.
  27. ^ Foote, J. and Manuel, J.K. "Adapting the CRAFT approach for use in group therapy". The Journal for Behavior Analysis in Sports, Fitness and Medicine, 2009 Vol 2, Issue 1, (Spr). Retrieved January 13, 2020.{{cite web}}: CS1 maint: multiple names: authors list (link)
  28. ^ Purvis, G., and MacInnis, D.M. (2009). Implementation of the Community Reinforcement Approach (CRA) in a Long-Standing Addictions Outpatient Clinic. Journal of Behavior Analysis of Sports, Health, Fitness and Behavioral Medicine, 2 (1), 33–44 BAO Archived December 29, 2010, at the Wayback Machine
  29. ^ Robert J. Meyers, PhD (2007). Getting an Addict into Treatment: The CRAFT Approach (Video). HBO. Retrieved January 22, 2014. CRAFT is currently being used in 25 clinics in the United States.
  30. ^ a b "About Us". Cadence Online. 2020. Retrieved January 18, 2020.
  31. ^ "Choose Your Plan". Allies in Recovery. 2020. Retrieved January 20, 2020.
  32. ^ "REST: Resources Education Support Together". Resources Education Support Together. 2020. Retrieved January 20, 2020.
  33. ^ "RePORT ⟩ RePORTER".
  34. ^ https://ctv.veeva.com/study/scalable-digital-delivery-of-evidence-based-training-for-family-to-maximize-treatment-admission-rate [bare URL]
  35. ^ a b Smith, J.E.; Milford, J.L.; Meyers, R.J. (2004). "CRA and CRAFT: Behavioral Approaches to Treating Substance-Abusing Individuals". The Behavior Analyst Today. 5 (4): 391–403. doi:10.1037/h0100044.
  36. ^ a b c Meyers, R.J., Smith, J.E. & Lash, D.N. (2005): A Program for Engaging Treatment-Refusing Substance Abusers into Treatment: CRAFT. IJBCT, 1 (2), Page 90–100 BAO
  37. ^ Kirby, K.C.; Marlowe, D.B.; Festinger, D.S.; Garvey, K.A.; LaMonaca, V. (1999). "Community reinforcement training for family and significant others of drug abusers: Aunilateral intervention to increase treatment entry of drug users". Drug and Alcohol Dependence. 56 (1): 85–96. doi:10.1016/s0376-8716(99)00022-8. PMID 10462097.
  38. ^ Meyers, R.J.; Miller, W.R.; Hill, D.E.; Tonigan, J.S. (1999). "Community reinforcement and family training (CRAFT): Engaging unmotivated drug users in treatment". Journal of Substance Abuse. 10: 1–18.
  39. ^ Miller, W.R.; Meyers, R.J.; Tonigan, J.S. (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): 688–697. doi:10.1037/0022-006x.67.5.688. PMID 10535235.
  40. ^ Meyers, Robert J.; Wolfe, Brenda L. (2004). "The Program". Get Your Loved One Sober. Center City, Minn.: Hazelden. p. 11. ISBN 1-59285-081-2. LCCN 2003057149.
  41. ^ Meyers, Robert J.; Wolfe, Brenda L. (2004). "The Road Map". Get Your Loved One Sober. Center City, Minn.: Hazelden. p. 37. ISBN 1-59285-081-2. LCCN 2003057149.
  42. ^ a b c d "CRAFT". American Psychological Association. Retrieved January 20, 2014.
  43. ^ 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.
  44. ^ 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.
  45. ^ 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.
  46. ^ 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.
  47. ^ "Community Reinforcement and Family Training (CRAFT)" APA article
  48. ^ https://www.abainternational.org/constituents/special-interests/special-interest-groups.aspx ABAI special interest groups list
  49. ^ http://www.abct.org/Members/?m=mMembers&fa=SIG_LinkToAll ABCT special interest groups list
  50. ^ "The CRAFT Approach". Partnership to End Addiction. Retrieved October 13, 2025.
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