CRAFT

CRAFT: An Alternative to Intervention

by Robert J. Meyers, Ph.D.

Summary

* The CRAFT method relies on nonconfrontational methods to encourage loved ones to enter addiction treatment.
* The method also can help family members improve the quality of their lives.
* CRAFT's effectiveness has been proven through scientific study.

Do you have a substance-using loved one who refuses treatment? The CRAFT program may help. CRAFT - Community Reinforcement and Family Training - teaches the use of healthy rewards to encourage positive behaviors. Plus, it focuses on helping both the substance user and the family.

The CRAFT goals are to teach you how to encourage your substance user to reduce use and enter treatment. The other goal is to help you enhance your own quality of life. This non-confrontational approach teaches you how to figure out the best times and strategies to make small but powerful changes. And it will show you how to do so in a fashion that reduces relationship conflict.

Experts have based CRAFT on solid science. People from many walks of life have used it successfully to help their loved ones and themselves. Whether you are the parent, spouse, romantic partner, adult child or friend of the substance user, research tells us that you too can succeed with this program. The methods are effective and easy to learn . CRAFT allows family members to feel good about their efforts on behalf of their loved ones.
When a CRAFT Program is Not Available in Your Community

CRAFT can easily be learned on your own. The 2004 book, Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening by Robert J. Meyers and Brenda L. Wolfe, was written to bring CRAFT right into your home. It helps you change the way you think about your situation and teaches you how to help your loved one learn to enjoy a sober lifestyle. The authors also help you rethink your own lifestyle to make it safer and saner regardless of what your loved one does. If you are also working with a therapist, we recommend that you alert your counselor to the CRAFT manual for therapists, Motivating Substance Abusers to Enter Treatment: Working with Family Members.
FIVE THINGS TO KNOW ABOUT CRAFT

1. CRAFT is a motivational model of help based on research that consistently finds motivational treatments to be superior to confrontational ones.


CRAFT shows you how to develop your loved one's motivation to change by helping you figure out how to appropriately reward healthy behavior. You learn how to make sober activities more attractive to your loved one, and drug- or alcohol-using activities less inviting. In this way, you minimize conflict and maximize cooperative relationship-enhancing interactions with your loved one.


2. More than two-thirds of family members who use CRAFT successfully engage their substance using loved ones in treatment.


This stands in sharp contrast to confrontational interventions that result in fewer than one-third of substance users entering treatment. The graph depicts one of the alcohol studies that contrasted CRAFT with both intervention and a modified approach supported by Al-Anon, a support group for family members of people with alcoholism.





3. Evidence suggests that substance users who are pushed into treatment by a traditional confrontational intervention are more likely to relapse than clients who are encouraged into treatment with less confrontational means.

4. Family members who use CRAFT experience greater improvements in their emotional and physical health than do those who use confrontational methods to try to help their loved ones.

5. People who use CRAFT are more likely to see the process through to success than those who use confrontational methods.


CRAFT programs have extremely low dropout rates, while over 75% of the people who try to use traditional interventions quit. The dropouts report that the confrontational techniques are too distressing and they worry about doing permanent damage to their relationship with the substance user.





FIVE MYTHS ABOUT CRAFT

1. CRAFT's system of offering and withdrawing "rewards" such as your affection and attention is just another way of enabling someone who is using substances. And enabling is bad.


Receiving affection and compliments for non-using behavior makes that behavior more enjoyable for your loved one. So, being nice when your loved one is engaged in sober activities makes it more likely that she or he continues those behaviors. One might say that you are "enabling" healthy behavior. Furthermore, CRAFT specifically teaches you how to withdraw rewards when the person is using - and this is the opposite of the traditional concept of enabling.



2. 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 user develops enough reasons to stop. You can increase your loved one's reasons to not use by making sober time more enjoyable than using time. When she or he is not using, enjoy good times together. When she or he does use, withdraw yourself from the situation. The more pleasure your loved one experiences while sober, the less attractive getting drunk or high will be. So it is never too early to use the CRAFT alternative to nagging and threatening.



3. Most substance users overdo it all the time so it is impossible to do anything to lessen the severity of their use.
To the contrary, CRAFT teaches you how to map out your loved one's patterns to figure out the best ways to alter them. You learn two critical skills that allow you to do this. One is to identify the early triggers and signs of a drinking or drugging episode. The other is to determine which consequences you can influence or orchestrate yourself to begin to manage those episodes.



4. If you love someone, it is cruel to allow him or her to sleep in vomit or endure public humiliation when you have the power to fix those things.

Substance use creates messes. It causes missed work, embarrassing public behavior, vomit, wrecked relationships and worse. When it is your own loved one who gets into these messes, it is very difficult to just stand by and let him or her suffer. However, fixing the messes and protecting your loved one from his or her poor choices only makes it okay for those choices to be repeated. This may indeed be the most difficult lesson of CRAFT. With the exception of allowing truly dangerous behavior, let your loved deal with his or her own messes. These are called natural consequences and are powerful motivators to rethink one's behavior choices.



5. Once your loved one agrees to stop using or enter treatment, your job is done.


Between agreeing to enter treatment and making an appointment, a thousand things will change a substance user's mind. Your job, as a successful CRAFT practicer, is to select a therapist and be sure that he or she is ready to see your loved one within a day or two. From there, your support of treatment is invaluable. It can make the difference between your loved one dropping out of treatment or joining you in a happier, healthier life.