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The New And Improved Alternative To Intervention?

Posted by on in Alcoholism
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Working at an outpatient treatment center I am always interested by new methods for helping people get sober. There are constantly new theories evolving from psychology in the field of substance abuse. Community Reinforcement Approach and Family Training (CRAFT) is an unconventional means of getting an addict or alcoholic to seek help and enter treatment. Remarkably, the creators of CRAFT claim a 64% success rate compared to conventional interventions (25%) and Al-Anon (14%). This statistic is based on the percentage of people staying sober after attending outpatient under the directive of each respective system. When I looked into CRAFT I could only find a handful of sites and articles on the subject. If it is so effective, then why is this method not more widespread and more importantly what is it?

What is CRAFT?

The basis of CRAFT is quite simple. Instead of using threats and confrontation to convince an addict or alcoholic to get help, the family or therapist of the person uses what they call a “motivational model of help”. Unlike many other ways of dealing with substance abuse CRAFT is based on reward-based positive reinforcement. Instead of punishing or condemning a person when they abuse drugs, CRAFT rewards the person for abstinence and good behavior. When someone is abusing drugs CRAFT suggests that the family distance themselves emotional and physically until the person sobers up. The core idea behind CRAFT is in the interaction between family and the alcoholic when they are sober. CRAFT aims to make sobriety seem desirable and appealing, so that someone with a substance abuse problem realizes what their addiction is making them miss out on.

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.

According to the creators of the program an addict will enter treatment only when the reasons not to use outweigh the reasons to continue using.  By making sobriety seem more attractive they claim to be “raising the bottom” of the person so that they do not have to experience dire consequences before seeking help. CRAFT makes sobriety more attractive by showing the addict or alcoholic the fun activities possible only when sober. When sober the family gives affection, kindness, and attention to the person and ceases this if the person begins using again.  CRAFT also puts an emphasis on improving communication of the family members and instituting non-violent communication into dialogue.

What Makes CRAFT so effective?

According to Nate Azrin, the creator of the program, CRAFT claims that positive re-enforcement is simply superior to negative re-enforcement in changing addictive behaviors. While this may be true, I find another huge reason why CRAFT claims a success rate almost triple the other leading methods. CRAFT does not force the alcoholic to enter treatment, instead they promote the idea. Under CRAFT the alcoholic enters treatment and seeks help willingly which will lead to more success. Getting sober requires the person to be completely willing and motivated, so someone entering treatment in this mindset will have a greater chance of staying sober. The ideas behind CRAFT are very interesting and inventive. I suggest more research and first-hand experiences of actual cases should be published in order to get a better understanding of this alternative approach to get people to seek help.

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