The CRAFT approach is a system for helping family members change the way that they are interact with a drug user or someone is drinking too much. The aim of CRAFT is to help that person get into treatment and on the road to recovery from drugs and alcohol.

The amazing thing about family members is that they know a ton about their drug or alcohol using family member. They know when the person drinks, what he or she is like when using drugs or alcohol, what the person’s moods are when they drink, and what the person is like when he or she sobers up. The family member has tons of information, but doesn’t know what to do with it. That’s where CRAFT comes in. CRAFT provides a comprehensive strategy for how to interact with drinking and drugging family members in a way that has been shown to work to get their loved into treatment and to get their life back from addiction.

CRAFT (Community Reinforcement Approach to Family Training) originated at the University of New Mexico and was developed by Robert Meyers, Ph.D. and colleagues. Research on CRAFT shows that about 70% of families who receive CRAFT are able to get their loved ones into treatment within a year (Miller, Meyers, & Tonigan, 1999). CRAFT also helps family members improve their own lives, whether their loved one ends up seeking treatment or not.

CRAFT teaches family members to do the following:

  1. Identify their loved one’s triggers for and results of their use.
  2. Break the patterns that lead to or increase a loved one’s drinking or using.
  3. Develop and improve communication skills to more effectively express their needs and requests.
  4. Help their loved one access effective addiction treatment resources when he/she expresses interest in treatment.
  5. Learn or re-learn how to take care of themselves and reconnect with their values, so that regardless of their loved one’s use, they can still lead a life that is centered on their values and not their loved one’s drug/alcohol use.
  6. If violence or the potential for violence exists, help family members identify triggers for violence and develop plans to keep themselves (and their children) safe.

 

How is CRAFT different from other approaches for dealing with addicted family members?

CRAFT vs. Interventions

The most common type of intervention used is the Johnson Intervention, which was developed by Vernon Johnson in the 1960s. The basic ideas behind this type of intervention are:  1.) a person with addiction is in extreme denial about their use of substances; 2.) only direct confrontation with family members about the negative effects of their use will enable the person to seek treatment (Jaffe, 2010; Meyers et al., 2005). In an intervention, an interventionist or counselor meets with family members and concerned others (e.g., friends, partners, employers) prior to the actual intervention and helps them prepare for the meeting (i.e., the intervention). During the intervention the interventionist helps guide the family members and concerned others express the effects of their loved one’s use in a factual and non-judgmental way. If the person is willing to accept help, then treatment options will be presented to him/her. Research on the Johnson Intervention shows that it can be effective for getting people with addictions into treatment, but that only 30% of family members are willing to actually go through with the intervention after being trained, probably because the method is so confrontive (Meyers et al., 2005).

In addition to CRAFT being more effective as the Johnson Intervention in getting people with addictions into treatment, because more families go through actually use it (about 70% of families who learned CRAFT were able to get their loved ones into treatment within a year, Miller, Meyers, & Tonigan, 1999).  However, CRAFT differs from the Johnson Intervention in several ways.

  • CRAFT is non-confrontational. In CRAFT, you will not learn to confront your loved one to break through their denial. Instead, you will learn how to break your unintentional participation in patterns related to their loved one’s use. You will learn how to stop your engagement in these patterns in ways that keep you safe, set appropriate boundaries, and are consistent with the type of person you want to be. For example, a mother who often calls her son’s employer to say that he is too sick to come into work, when he is really too hungover to come into work, will stop making these calls. Instead, she will calmly express that she is no longer willing to call in sick for her son and offer to help him get ready for work if he wishes to do so.
  • CRAFT is about learning skills to improve your relationship with yourself and with your loved one. In CRAFT, you will learn practical skills that you can tailor to your own unique situation to help disengage yourself from the pattern of your loved one’s use. You will also learn ways to take back your life from your loved one’s addiction and to reconnect with the things that are important to you.
  • CRAFT gives you the power to make changes in your loved one and your own lives. Instead of a time-limited intervention where you learn skills on how to confront your loved one, you will learn skills that you can use throughout your life and in many different domains.

CRAFT vs. Al-Anon/Nar-Anon

Al-Anon and similar groups (e.g., Nar-Anon) are mutual peer support groups made up of relatives of people with addictions. Al-Anon (http://www.al-anon.alateen.org/) and Nar-anon (http://www.al-anon.alateen.org/) are probably the most well-known of these groups. Al-Anon and Nar-Anon are based on the AA and NA models, but are focused on the relative’s experiences of loving a person with an addiction. Like AA and NA, Al-Anon and Nar-Anon have a spiritual (but not specific to one religion) element and use the 12 steps (the 12 steps are similar to the 12 steps in AA/NA, but emphasize the relative’s experiences) to help members cope with their loved ones’ drinking or drug use. From the limited number of research studies done on Al-Anon/Nar-Anon, it appears that Al-Anon and Nar-Anon improve family members’ well-being, but may not be very effective in getting the person with the addiction into treatment (Meyers, Villanueva, & Smith, 2005). In fact, in a study done in 1999 (Miller, Meyers, & Tonigan), approximately 1 in 10 family members who took part in Al-Anon were able to get their loved ones into treatment.

CRAFT differs from the Al-Anon/Nar-Anon in the following ways:

  • There is little to no spiritual focus in CRAFT. If a family member wishes to include spiritual or religious practices or communities as part of the skills he/she learns in CRAFT they are welcome to do so; however, there is no emphasis on using or having a “higher power” in CRAFT.
  • In CRAFT you will be empowered to make changes to your loved one and your own life. Unlike Al-Anon/Nar-Anon, you do not need to admit that you are powerless to stop your loved one’s drinking or use. Instead, you will learn ways to help your loved one stop or reduce his/her drug or alcohol use and how to take back your life from your loved one’s addiction.
  • There are no “steps” in CRAFT. You will learn skills that you can use at various times and in various situations. Although there is a sequence of learning that is often helpful to follow, once you learn the skills you will be able to use them to best fit your needs and unique situations.
  • CRAFT can be done one-on-one with a provider or in a group of other family members.

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