CRAFT — Community Reinforcement and Family Training — is an approach that helps family members respond to a loved one's drinking or drug use in ways that look after their own wellbeing and make positive change more likely, without confrontation. It works with you, the family member. The person who is drinking or using doesn't have to take part.
What CRAFT involves
- Looking after yourself — your wellbeing matters in its own right.
- Communicating differently — expressing concern without lecturing, in ways that are more likely to be heard.
- Making sober time more rewarding — noticing and responding warmly to the times they're not drinking or using.
- Letting natural consequences happen — stepping back from rescuing, safely.
- Spotting moments of openness — when someone might be more willing to consider help.
What the research says
In a randomised trial, 130 people concerned about someone's drinking were offered one of three counselling approaches: Al-Anon facilitation, which encourages involvement in Al-Anon's 12-step programme; a Johnson Institute intervention, which prepares for a confrontational family meeting; or CRAFT. With CRAFT, 64% of their loved ones engaged in treatment, compared with 13% with Al-Anon facilitation and 30% with the Johnson intervention. The people taking part improved in their own wellbeing and relationships to a similar degree with all three (Miller, Meyers and Tonigan, 1999).
A second trial, with 90 people concerned about someone who was using illicit drugs and refusing treatment, found that CRAFT alone engaged 58.6% of their loved ones in treatment, compared with 29.0% for Al-Anon and Nar-Anon facilitation (Meyers, Miller, Smith and Tonigan, 2002).
A review of four trials, with 264 people taking part, found that CRAFT encouraged about two-thirds of people who had refused treatment to attend it, typically after four to six CRAFT sessions — three times as often as Al-Anon/Nar-Anon and twice as often as the Johnson Institute intervention. The people taking part improved in their own wellbeing whichever approach they had (Roozen, de Waart and van der Kroft, 2010).
What CRAFT can't do
It can't promise that someone will stop, or start treatment. It isn't a confrontation or an ultimatum. And it isn't a replacement for medical help when someone needs it.
How I use it
I draw on CRAFT alongside systemic family therapy. That means we look at your whole family's patterns, not only at what you say to the person using. See family therapy for addiction, and, for particular situations, when your partner is drinking or using or when your child or young adult is using. If you're unsure where helping ends, helping vs enabling may be useful.
Frequently Asked Questions
Is CRAFT the same as an "intervention"?
No. A confrontational intervention prepares a family meeting to confront the person. CRAFT avoids confrontation.
Does my loved one need to know I'm having sessions?
That's your choice, and something we can think about together.
Can I do CRAFT-informed sessions online?
Yes — online, or in person at The Blossom Tree Clinic, Suite 2, 6A Love Lane, Pinner HA5 3EF.
Sources
- Miller WR, Meyers RJ, Tonigan JS (1999). Engaging the unmotivated in treatment for alcohol problems: a comparison of three strategies for intervention through family members. Journal of Consulting and Clinical Psychology 67(5):688–697
- Meyers RJ, Miller WR, Smith JE, Tonigan JS (2002). A randomized trial of two methods for engaging treatment-refusing drug users through concerned significant others. Journal of Consulting and Clinical Psychology 70(5):1182–1185
- Roozen HG, de Waart R, van der Kroft P (2010). Community reinforcement and family training: an effective option to engage treatment-resistant substance-abusing individuals in treatment. Addiction 105(10):1729–1738