The CRAFT approach to substance abuse intervention teaches family members how to support and communicate with someone who has a substance use problem. This approach focuses on using positive reinforcement to combat substance use problems and encourage steps toward sobriety and recovery.
At a Glance
CRAFT can help family members support a loved one with a substance problem without relying on confrontation or shame. Instead, loved ones focus on rewarding positive behaviors to help guide behavior change with empathy and care. Let’s take a closer look at how the CRAFT approach works and how it can benefits families and individuals with substance use disorders.
What Is the CRAFT Approach?
Community Reinforcement and Family Training (CRAFT) aims to help family members guide their loved ones away from substance abuse. This method is particularly useful for individuals who refuse treatment or deny losing control over their consumption.
Unlike traditional interventions, where family and friends gather to persuade the person to enter a rehabilitation program, the CRAFT method encourages close significant others (known as CSOs in the program) to reward their loved one for choosing sobriety or displaying control.
John C. Umhau, MD, addiction specialist
The CRAFT method is much more scientific [than old intervention techniques]. It’s based on the idea you reinforce good behavior, and you don’t reinforce bad behavior.
— John C. Umhau, MD, addiction specialist
Another critical aspect of this method is that it encourages families to step back and allow bad consequences to happen when the person consumes.
While the goal is to get the person dealing with an addiction in your life to admit they have a problem and get help, the CRAFT method also helps the loved ones prioritize their mental health and improve their happiness.
Uses for the CRAFT Method
The CRAFT method was developed as an intervention to help individuals with substance use problems become more engaged in treatment.
While CRAFT aims to get people into treatment, its primary focus is on the family members of those who misuse drugs or alcohol. Concerned loved ones, including those who support people with gambling addictions, can also use this method.
History of the CRAFT Method
The CRAFT method was developed by Robert J. Meyers and William R. Miller in the late 1970s. It is an adaptation of another intervention known as the Community Reinforcement Approach (CRA).
CRA therapy identified that a person’s community and environment significantly impact their substance use. Thus, Meyers and Miller thought involving the community in the change process would be beneficial.
Meyers has written several books on the topic and expanded the approach by training other therapists to work with the loved ones of individuals with substance use issues. Today, many training programs and CRAFT-certified therapists are available nationwide.
When Is the CRAFT Method Used?
When you realize that the person dealing with addiction in your life is at risk of hurting themselves and others, it’s time to consider the CRAFT method. Dr. Umhau encourages people to remember that the CRAFT method is not an intervention.
“In an intervention, everyone kind of gangs up [on the person who is abusing substances] and tells them to go into treatment,” says Umhau. “Well, what if they never do get treatment and they’re mad at you, and they just lose contact with the family?”
The CRAFT method exercises much more control and allows family members to start exercising positive reinforcement when they realize there’s a problem.
How to Use the CRAFT Method
By positive reinforcement, the CRAFT method means recognizing the person who is abusing substances when they don’t drink or consume. This could mean that you do or say something nice for them.
More specifically, the CRAFT method encourages these practices:
- Identify triggers: Figure out when the person who is addicted to substances is most tempted to use. Is it when they’re upset? Is it a particular time of day? This can also help loved ones determine if they’re causing an unintentional trigger.
- Improve communication: Communicate clearly with the user (and vice versa) in every aspect of their lives.
- Focus on positive reinforcement: Use positive reinforcement consistently to encourage non-using and pro-social behaviors.
- Employ natural consequences: Take away positive reinforcement when the person is using and let them face the consequences on their own.
- Identify emotional barriers: Assess, determine, and address the things that could be making them unhappy. It also encourages loved ones to reward themselves when they work toward improving their own circumstances.
- Work with a therapist: In working with a CRAFT-certified therapist, learn about ideal times to bring up treatment to someone with a substance use disorder. Then, learn how to immediately act on it if the person struggling with addiction agrees.
- Continue offering support: Support the loved one through therapy, and be patient if the person addicted to substances drops out of therapy prematurely.
Impact of the CRAFT Method
In trials, the CRAFT Method has proven to be effective at getting people who are dealing with an addiction to admit that they have a problem and seek therapy.
When concerned family members signed up to take on the CRAFT method under clinical supervision to determine the program’s effectiveness, 62% of the group ended up getting their loved ones into treatment.
For comparison, only around 37% of substance users who had loved ones who participated in Al-Anon and Nar-Anon interventions went on to seek treatment.
A 2020 systematic review published in the journal Addiction found that CRAFT was twice as effective as the control and comparison groups. Individual and group sessions were linked to the highest treatment entry rates at 77% and 86%, respectively.
It’s also worth noting that it may take some time. In the studies above, the family members were monitored for six months before moving onto phase two, when the person who is abusing substances actually starts to get help. This is important to keep in mind so that you don’t get discouraged, but know that it can be effective with consistency.
Potential Pitfalls of the CRAFT Method
One of the hardest parts about the CRAFT method is that family members must learn to let their loved one fail. This could mean that the person feels really sick, misses days of work, or misses out on important family moments. They may also feel anger or resentment toward the family as a result.
The CRAFT program wants family members to let the person struggling with addiction see the harm they’re causing themselves and others. This can impact families, especially if the family counts on the person to work and follow through with their responsibilities.
Training with CRAFT-certified therapists can be more expensive, and some of them focus entirely on this one method of treatment. When looking for a therapist for your loved one or the impacted family members, search through their website to see what training and methodologies they’ve studied.
It may even be helpful to know if they’re aware of the CRAFT method and other treatment plans like the Sinclair Method, which Dr. Umhau practices.
Keep in Mind
There is no single treatment option that is right for everyone. If you have a family member with a substance use problem, research your options and consider talking to a therapist to help determine which method might be right for your family and situation. CRAFT can be a great choice for many people, but you may find that support groups like Al-Anon and Nar-Anon can also be beneficial.
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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American Psychological Association. Community Reinforcement and Family Training (CRAFT).
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Nayoski N, Hodgins DC. The efficacy of individual community reinforcement and family training (Craft) for concerned significant others of problem gamblers. JGI. 2016;(33):189. doi:10.4309/jgi.2016.33.11
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Kirby KC, Versek B, Kerwin ME, et al. Developing Community Reinforcement and Family Training (CRAFT) for parents of treatment-resistant adolescents. J Child Adolesc Subst Abuse. 2015;24(3):155-165. doi:10.1080/1067828X.2013.777379
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Kirby KC, Benishek LA, Kerwin ME, et al. Analyzing components of Community Reinforcement and Family Training (CRAFT): Is treatment entry training sufficient? Psychol Addict Behav. 2017;31(7):818-827. doi:10.1037/adb0000306
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Archer M, Harwood H, Stevelink S, Rafferty L, Greenberg N. Community reinforcement and family training and rates of treatment entry: a systematic review. Addiction. 2020;115(6):1024-1037. doi:10.1111/add.14901
Additional Reading
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Find a CRAFT certified therapist near you.
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Meyers, R. J., Miller, W. R., Hill, D. E., & Tonigan, J. S. (1998). Community reinforcement and family training (CRAFT): engaging unmotivated drug users in treatment. Journal of Substance Abuse, 10(3), 291–308. https://doi.org/10.1016/s0899-3289(99)00003-6
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