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CRAFT

Typically nearly anyone knows someone in his/her family who has an alcohol or drug problem. These individuals do not typically seek treatment, whereas it has been indicated that these individuals seek treatment 6 to 10 years after the initiation of drug use. The myriad of negative repercussions on the family members often affect their health and personal lives. Especially intimate partners often report depression, anxiety disorders, post-traumatic stress disorder and low self-esteem and are often subject to aggression and violence.

A relatively new treatment has been developed to help the intimate partners to 1) recognize and safely respond to any potential for aggression and violence, 2) to improve communication with the substance user, 3) to decrease stress, 4) to improve self efficacy, and finally, 5) to assist in engaging the unwilling substance user into therapy. This treatment is hosted by the acronym CRAFT (Community Reinforcement and Family Training) and is based on the Community Reinforcement Approach (CRA). The underlying operant based belief is that environmental contingencies are key in encouraging or discouraging substance use. The CRAFT approach has been the subject of extensive research and engagement rates for resistant drinkers vary from 64 percent to 86 percent. CRAFT relies upon skills training and other strategies that lead to personal independence and improved self-efficacy and self-esteem.

The core features of the CRAFT program are: problem focused, skills based, active during sessions by using role-plays, and keeping active between sessions through assignments.

These features are necessary to change the CSO’s behavior and concomitantly to learn to shift the motivational balance by reinforcing non-using behavior and ignoring using behavior of the individual to diminish alcohol and drug abuse. As a result subsequent periods of abstinence become increasingly enjoyable and the consumer is stimulated to develop reasons to enter treatment conducive to foster abstinence, while getting drunk or high becomes less attractive. In this perspective, intimate partners, family members and close friends can make important contributions in assisting the substance-using individual.