Addiction Addictive Behaviors What Is the CRAFT Approach to Substance Abuse Intervention? By Brittany Loggins Brittany Loggins LinkedIn Twitter Brittany is a health and lifestyle writer and former staffer at TODAY on NBC and CBS News. She's also contributed to dozens of magazines. Learn about our editorial process Updated on September 20, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by John C. Umhau, MD, MPH, CPE Medically reviewed by John C. Umhau, MD, MPH, CPE John C. Umhau, MD, MPH, CPE is board-certified in addiction medicine and preventative medicine. He is the medical director at Alcohol Recovery Medicine. For over 20 years Dr. Umhau was a senior clinical investigator at the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health (NIH). Learn about our Medical Review Board Print FatCamera / Getty Images Table of Contents View All Table of Contents What Is the CRAFT Approach? History When Is CRAFT Used? How to Use CRAFT Impact of CRAFT Potential Pitfalls What Is the CRAFT Approach? Community Reinforcement and Family Training (CRAFT) is intended to help family members of people with a substance use disorder learn how to steer their loved one away from substance abuse. It is a great method for helping someone that's refusing treatment or refusing to admit they are no longer in control of how much they consume. Instead of an old-school intervention where the family and friends get together and confront the person in an attempt to enroll them in a rehabilitation program, the CRAFT method encourages close significant others (which the program calls CSOs) to reward their loved one when they choose sobriety or show control. Dr. 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. — Dr. 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. What Is Addiction? History of the CRAFT Method The CRAFT method was founded by Robert J. Meyers and William R. Miller in the late 1970s. It's an adapted version of another intervention method called the CRA, which stands for Community Reinforcement Approach. Since CRA therapy determined that a person's community and surroundings can have a lot to do with how often they engage in substance abuse, Meyers and Miller thought it would be helpful to get the person's community involved in helping them change. Meyers has since written multiple books on the topic and expanded on the approach by helping other therapists learn how to work with the loved ones of addicts. Today, there are training programs for therapists and many CRAFT-certified therapists across the country. 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 gathers to confront the person with a substance use disorder to compel them to get into treatment," says Umhau. "Well, what if they refuse, get angry, and as a result of the intervention become estranged from their loved ones? The CRAFT method is a much more respectful and humane approach," 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: 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. Communicate clearer with the user (and vice versa) in every aspect of their lives. Use positive reinforcement consistently to encourage non-using and pro-social behaviors. Take away positive reinforcement when the person is using and let them face the consequences on their own. 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. 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. Support the loved one through therapy, and be patient if the person addicted to substances drops out of therapy prematurely. DSM 5 Criteria for Substance Use Disorders 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 62 concerned family members signed up to take on the CRAFT method under clinical supervision to determine the program's effectiveness, 74% of the group ended up getting their loved ones to treatment. Another study by the Journal of Consulting and Clinical Psychology had similar results, with the CRAFT method helping 67% of people addicted to substances seek out treatment. This is compared to around 29% of users whose family members relied on Al-Anon or Nar-Anon, which are support groups for families supporting someone with a substance use disorder. 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 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. Online Addiction Counseling 3 Sources 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. Meyers RJ, Villanueva M, Smith JE. The Community Reinforcement Approach: History and New Directions. Journal of Cognitive Psychotherapy: An International Quarterly. 2005;19(3):257-259. Lee K. An underappreciated intervention. Monitor on Psychology. 2017;48(11). Miller WR, Meyers RJ, Tonigan JS. Engaging the unmotivated in treatment for alcohol problems: a comparison of three strategies for intervention through family members. J Consult Clin Psychol. 1999;67(5):688-697. Additional Reading Find a CRAFT certified therapist near you. 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 By Brittany Loggins Brittany is a health and lifestyle writer and former staffer at TODAY on NBC and CBS News. She's also contributed to dozens of magazines. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.