Meyers worked with Nathan Azrin in the early 1970s whilst he was developing his own community reinforcement approach (CRA), which uses operant conditioning (also called contingency management) techniques to assist those with addictions to live healthily.
CRA treatment is time-limited,[2] meaning that it typically involves a specified number of sessions, such as 16, or a time frame, like one year, which is determined early in the therapy process.
[3] This approach aims to increase the likelihood that substance users who are resistant to treatment will seek help, while also enhancing the well-being of their concerned family members.
Also, CSOs who attend the CRAFT program also benefit by becoming more independent and reducing their depression, anxiety and anger symptoms even if their loved one does not enter treatment.
[6] The following CRA procedures and descriptions are from Meyers, Roozen, and Smith for the substance user:[1]: 382–384 Interviewer: "So, if you can, explain [to] us a little bit about how the CRAFT technique works.
"So, it takes a little bit of time, but we've been very successful here, being funded by the National Institutes of Health through the University of New Mexico to run a couple of scientific studies, where we've actually proven that my CRAFT intervention is much more powerful than anything that is used out there currently.
"[8] In fact, the title of Robert J. Meyers' and Brenda L. Wolfe's book based on CRAFT is, Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening.
[12] Even the most extreme "disease model" programs that profess solely neurochemical origins of addiction ultimately rely upon the client's volitional abstinence (Milam & Ketcham, 1981).
[13] Studies in the 1960s clearly demonstrated that even chronically dependent drinkers with access to alcohol could regulate their drinking given sufficient incentives to do so, at least under controlled laboratory conditions (Heather & Robertson, 1983).
The CRAFT program has been demonstrated in Meyers' research to be more effective than the Vernon Johnson type intervention or Al-Anon, with less negative side-effects and better outcomes, whether or not the person using substances enters treatment.
Robert J. Meyers, the psychologist who developed the CRAFT approach to alcoholism, wrote in an introduction to one of his books that "although my mother was blessed by the support and comfort she found in Al-Anon meetings, she was never able to achieve her most cherished goals of getting my father into treatment and getting him to stay sober".
Robert J. Meyers and Jane Ellen Smith of the University of New Mexico developed the CRAFT program to teach families how to impact their loved one while avoiding both detachment and confrontation, the respective strategies of Al-Anon (a 12-Step based approach), and traditional (Johnson Institute-style) interventions in which the substance user is confronted by family members and friends during a surprise meeting.
While all three approaches have been found to improve family members' functioning and relationship satisfaction, CRAFT has proven to be significantly more effective in engaging loved ones in comparison to the Johnson Institute Intervention or Al-Anon/Nar-Anon facilitation therapy.”[20]Having worked with Nathan Azrin in the early 1970s whilst Azrin was developing the community reinforcement approach, Meyers started to look into using the process in other settings.
The community reinforcement approach was developed by Nathan Azrin in the early 1970s and has considerable research supporting its effectiveness in working with addicts.
Based on operant conditioning [a type of learning], CRA helps people rearrange their lifestyles so that healthy, drug-free living becomes rewarding and thereby competes with alcohol and drug use.
Nate Azrin already was convinced of this back in the early 1970s, when he designed an innovative treatment for alcohol problems: the Community Reinforcement Approach (CRA).
Azrin believed that it was necessary to alter the environment in which people with alcohol problems live so that they received strong reinforcement for sober behavior from their community, including family, work, and friends.
As part of this strategy, the program emphasizes helping clients discover new, enjoyable activities that do not revolve around alcohol, and teaching them the skills necessary for participating in those activities.”[1]Community reinforcement has both efficacy and effectiveness data.
The National Institute on Drug Abuse (NIDA), a federally funded organisation aiding scientific research into addiction, has supported CRAFT intervention techniques among others.
Meyers and the Treatment Research Institute (TRI) worked with Cadence Online to create a ParentCRAFT course where parents pay a one-off fee for a series of videos presenting the CRAFT process, aimed at teaching them skills to meet the risks of substance use in their adolescent children.
[31] Allies in Recovery provides a series of videos, eBook, blog, live calls and other services to families of people with addiction based on the CRAFT method.
[32] Based in Rhode Island, Resources Education Support Together (REST) is a peer-led mutual aid group that uses CRAFT and the Allies in Recovery service for its members.
We The Village's work is supported by funding from the National Institute on Drug Abuse (NIDA)[34], ensuring its programs are rigorously tested and accessible online.
[41] From an article on the American Psychological Association (APA) website about the success of CRAFT in substance use treatment and intervention,[42] these are the success outcomes for engaging drinkers into treatment: Elsewhere, Robert Meyers has clarified that Twelve-Step Facilitation used in the Miller et al’s comparative study of 130 caretakers of problem drinkers was a control group structured to “simulate the kind of care and guidance CSO’s would traditionally receive from attending Al-Anon meetings... treatments were delivered one-on-one and included up to 12 hours of therapy.”[19] Sisson and Azrin (1986) recruited 12 adult women with an alcoholic husband, brother, or father and randomly assigned them either to an early version of CRAFT or to a traditional intervention.
Results indicated that CRAFT was considerably more successful in getting the persons with substance abuse into treatment and reducing their alcohol consumption in comparison to the Al-Anon group.
Miller et al. (1999) conducted a controlled comparison of CRAFT, the Johnson Intervention, and Al-Anon facilitation (TSF) that randomized 130 caregivers of problem drinkers to receive 12 hours of contact in one of the three conditions.
However, the CRAFT approach was more effective in engaging initially unmotivated problem drinkers in treatment (64%) as compared with the facilitation therapy (13%) and Johnson interventions (30%).
Caregivers who were assigned to CRAFT attended more sessions than those in TSG and were more likely to complete a full course of counseling during which the persons abusing drugs were far more likely to enter treatment (64% vs 17%).