Azrin was the founder of several research methodologies, including Token Economics, the Community Reinforcement Approach (CRA) on which the CRAFT model was based, Family Behavior Therapy, and habit reversal training.
[3][5] After he completed his PhD, Azrin did two postdoctoral years as a research psychologist, first at the Institute of Living, with Karl H. Pribram, and then with the US Army Ordinance studying human factors in fatigue.
He also spent one year in 1976–1977 on sabbatical as a fellow at the Center for Advanced Study in the Behavioral Sciences, in Palo Alto, California.
In order to do this, Azrin together with Teodoro Ayllon developed a bartering system he called "token economics", which gave incentives to patients to make behavioral changes, such as putting on their clothes each day.
[4] In the 1970s he worked with Mark Godley and George Hunt on the development of the Community Reinforcement Approach (CRA), applying behavioral therapy to the treatment of alcoholism.
Any indirect reinforcement is controlled by ensuring all members of a client's family are present for therapy sessions, so that there is a group effort towards behavioral change.
Therapy methods included contingency management, communication skills surrounding drug use, problem solving, and efforts to improve family relationships.
[16] He co-authored the book Treating Adolescent Substance Abuse Using Family Behavior Therapy: A Step-by-Step Approach with Brad Donohue, aimed at providing a model for clinicians to employ with clients, based on his research.
[18] In addition to academic works, in 1974 Azrin co-authored the parenting book Toilet Training in Less Than a Day with Richard M. Foxx, which sold more than three million copies and is available in several dozen languages.
[3][4][19][20] Azrin and Foxx's technique has drawn a considerable amount of controversy, with critics saying it is overly harsh,[21] and psychologist Dr Eda Leshan stating that “Although one is supposed to be kind and patient, it’s all done by forcing fluids (with things like salty potato chips and orange soda) and conditioned reflexes, leaving out such minor considerations as fears and fantasies, love-hate feelings, dependency and rebellion — the whole unconscious, which we have been struggling so hard to understand.
[24] His research also included lab animal tests, such as incentivizing experiments with pigeons that produced the result that they are more likely to form a behavior if there is some reward involved rather than punishment.
In the 1970s, Azrin was involved in the government review of BF Skinner's Special Treatment and Rehabilitative Training research program at the Federal Medical Center for Prisoners in Missouri.
[38] He is also the namesake of the Nathan H. Azrin Distinguished Contribution to Applied Behavior Analysis Award given annually by the American Psychological Association.