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The family intervention process: Confrontation or community?

Community Reinforcement and Family Training (CRAFT) is an efficient alternative to confrontational interventions. In fact, the process helps address family dynamics and addiction in a holistic and committed way, rather than a one-time event.  Here, we review the basics of the CRAFT model, and how it differs from traditional “intervention” models. Then, we invite your questions about best practices in family interventions or families and addiction therapy at the end.

Addiction is a family disease

Very often, people experiencing substance abuse problems are in denial; they deny that addiction occurs and often refuse to get treated. While addicted individuals experience physical and psychological consequences, their concerned family and friends go through emotional and interpersonal damage. Living with a person with substance use disorder isn’t easy and tends to leave many family bonds broken. That’s why CRAFT was designed to target individuals who refuse to get into substance abuse treatment, to address their problems as addicts, and as family members.

What is CRAFT (Community Reinforcement and Family Training)?

CRAFT is an intervention approach closer to the traditional type of addiction treatment than a one-time “all or nothing” approach. While the CRAFT model does engage patients who resist seeking formal treatment, it also helps improve the functioning of concerned significant others (CSOs) and helps families stay together and be supportive of one another. Family support for drug and alcohol addicts is important, but so is supporting the family itself.  is In fact, CRAFT works for all variety of relationship types, including spouse-spouse, parent-child and sibling-sibling.

As a family intervention, the CRAFT method does not pressure people who are dealing with substance abuse disorders to attend treatment. As an alternative, a concerned family member, called a Concerned Significant Other (CSO) is consulted and taught by therapists how to gently and indirectly approach the individual using drugs or alcohol. The CSO is shown how to change the living environment, reward behaviors that encourage the users’ sobriety, while withholding rewards whenever the individual is using substances.

The success record of CRAFT interventions

Medical studies have proven CRAFT to be more successful at engaging addicts in treatment than the Al-Anon model and the Johnson Intervention Method. In fact, CRAFT has specifically designed for people who refused to be treated for their substance abuse problem. CRAFT is considered to have 2-3 times better results than theses two more commonly used methods. And after only 4-6 CSO sessions, friends and family reported a significant reduction in physical symptoms, depression, anger and anxiety, even when the substance users didn’t engage in treatment. And approximately two-thirds of individuals that initially refused treatment were successfully lead into substance abuse treatment after their families engaged in CRAFT, whether they used drugs or alcohol problematically.

Support for the family unit

Addiction affects more than the addict. And families need support to cope. This is why the CRAFT method helps the family and friends improve their relationship with the person using alcohol or illicit drug. Through this approach, CSOs show encouragement for their loved one, help them through the treatment, and accompany them towards an addiction-free life.

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CRAFT also focuses on encouraging the happiness of the CSO by identifying the areas of their own lives that need to change. After recognizing those areas, strategies for improvement that fit the family’s needs are developed, which lead to accomplishing goals. Then, therapists can then check the CSOs progress regularly, and help family members modify their goals if needed. So, CRAFT is an approach that does not only get the family and friends to help a loved one with drug or alcohol abuse problems, but it also focuses on helping both the substance user and the family.

Why is CRAFT preferred to confrontational interventions?

CRAFT is a successful motivational method of reaching out to substance users, and according to therapists, what makes it successful is the non-confrontational nature of the approach. People who use CRAFT are more likely to see the process through to success than those who use confrontational methods. Also, the close observation that allows therapists to be directive, set clear expectations, and set limits as needed is an essential part of the treatment.

Questions about CRAFT

Is a family member or a friend a substance user? Research proves that you too can succeed with the CRAFT program. The methods are effective and easy to learn, and make you feel good about the efforts on behalf of your loved ones. Do you have any other questions or experiences to share? We welcome you to post them in the comments section at the end. All legitimate questions will be answered promptly and personally.

Reference Sources: NCBI: Community reinforcement and family training: an effective option to engage treatment-resistant substance-abusing individuals in treatment
NIAAA: COMMUNITY REINFORCEMENT APPROACH
Office of Veteran’s Affairs: CRAFT Training Manual
HBO: CRAFT Alternative Intervention

Photo credit: geralt

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6 Responses to “The family intervention process: Confrontation or community?
Estevan Torres
1:16 am June 5th, 2014

My female friend that live with me is a recovering addicts. Here lately we have problems disagreeing with just about everything. She was court mandate to a rehab center and attend N.A meeting. She was successful with that. She has a suspend driver licence, has back problems keeping her from working. I have been help her with her probation fees, court fee,and transportation with court dates. I myself feel that i don’t have to tell her about my financial or my personal business. She says that i need to keep her in the loop. We have only a short time of living with each other a short time. Now she says is saying she feel that she is going to drug relapse and its going to be my all fault. I strongly disagree with that . I know that bitch her because i every unhappy for everything she has put thru, she is woman enough just to say that she is moving on and let me be.
I really tried to help out in this stage of her life. I have anger thought and I am sick and tired.
I donot know how to deal with her. I do not drink or take any illegal drug. I am normal sober person. With all of my outreaching to some one to answer my question is will be my fault if she relapse?

10:52 am June 5th, 2014

Hello Estevan. Drug relapse is the responsibility of the person who is coping with addiction. While there are some ways that you can support an addict’s recovery, you are NEVER responsible for someone else’s decisions. For more help, seek out a family counselor with experience in treating addictions. This can really help you and your friend.

gracie
10:29 pm October 6th, 2014

My husband is cross addicted to alcohol and benzos. Was treated twice for alcohol prior to developing amn addiction to xanex. He was arrested for prescription fraud and he is waiting for his case to go to court. He was treated in Jan for xanex addiction and on finishing treatment has been purchasing Valium online to which he is now also addicted I suspect. I tackled him yesterday and today and he is in denial. Since earlier conversation I suspect he has taken as dose which has mellowed him out for now. I have kids and can’t have this happening in the house. Can’t have him in charge of the kids at all if he is taking something. Advice? They tell me I am a co_dependant_- I hate that phrase- but I can be strong. So what would you do…should I persist in casual intervention where I have mno hard evidence…I.e stash found? Help!!!

11:32 am October 13th, 2014

Hello Gracie. Have you tried family counselling? If he won’t listen to you at home, maybe he’ll listen and talk with a little professional help. He should understand he has responsibilities and that he needs to take care of your children. Maybe giving him responsibilities to take care of will motivate him to be more attentive and involved in his recovery.

Lisa
3:05 pm September 24th, 2015

I have a 30 year old son who is a heavy user of marijuana. Probably two to three times a day though I don’t know for sure. This has been going on since High School. He attended a mandated outpatient drug rehab program after High School that did not do anything for his addiction. The problem is that he lives out of state from me and I don’t get to see him often. He is living with his girlfriend and they have a baby daughter who is 18 months old. I’m going down for a visit in a month and want to make the most of my trip using the CRAFT principles. What do you suggest doing when I’m only with him for a week? What do you suggest for ongoing interactions with him via the phone? I only get to see him face to face about 3 times a year, the rest of our interactions are on the phone.

12:13 pm September 25th, 2015

Hi Lisa. I believe it’s best to direct your questions to a professional therapist who specializes in the CRAFT method, since your situation is quite unique with them living in a another State and the amount of time you’ll spend there. Thank you for being such a loving and caring parent and I hope your efforts bring success and a better life for your son.

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