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Community Reinforcement and Family Training (CRAFT)

Community Reinforcement and Family Training (CRAFT). Science and Management of Addiction Frank Couch, MA, LMFT, CDP, NCACI Beth Meyer, MA, LMFT, CDPT. CRAFT.

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Community Reinforcement and Family Training (CRAFT)

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  1. Community Reinforcement and Family Training (CRAFT) Science and Management of Addiction Frank Couch, MA, LMFT, CDP, NCACI Beth Meyer, MA, LMFT, CDPT

  2. CRAFT • This presentation is given with the permission of Dr. Robert J. Meyers, PhD, co-creator of Community Reinforcement and Family Training (CRAFT) • For more information visit: • http://robertjmeyersphd.com/

  3. Upcoming CRAFT training! • Dr. Meyers is conducting a full 2.5 day CRAFT training in Houston Texas on June 23rd, 24th, & 25th, 2014. For further information please contact: Tammy Samour, MS, LPC, LCDC Direct: 281-407-0777 ts@aodresource.com

  4. Role of the Family • Why do families need support? • How do you or your agency currently support families? • What are challenges in working with families? • Resources working with families

  5. Community Reinforcement and Family Training • Terms • CSO – concerned significant other • IP – Identified patient (substance user) • History • Not many options for family support • Al-Anon, Johnson Institute Intervention, Changes support group, mental health counseling, nothing

  6. 12 Step Programs (Al-Anon, Nar-Anon) • Loving detachment • Acceptance of CSO’s inability to control IP’s behavior • Group support for CSO

  7. Johnson Institute Intervention • Only 29% of CSO’s complete the training • Of that 29% only 24% engage in treatment (Lipman et al 1989)

  8. Changes Parent Support Network • Peer support • “Tough Love” model • Action steps

  9. Why use CRAFT? • Because It works… • HBO Addictions series video

  10. CRAFT: 3 Goals • Reduce loved one’s harmful substance use • Engage loved one into treatment • Improve the functioning of CSO • Emotional • Physical • Relationships

  11. CRAFT Program Description for the CSO • Problem focused • Skills based • Active during sessions (role play) • Active between sessions (assignments)

  12. Rapport Building Across Sessions • Always remember to: • Use empathy • Reinforce attendance • Stop the blaming • Re-label negative behavior • Emphasize family & adolescent strengths; aspects of the family life that are going well

  13. CRAFT’s Principles • Eliminate positive reinforcement for drinking and/or using behavior • Enhance positive reinforcement for non-drinking (sober) and non-using (clean) behavior

  14. Positive Reinforcement vs Enabling • Enabling: something the CSO does that increases drinking/drug using behavior or allows it to continue • CRAFT’s Positive Reinforcement: something the CSO does that increases non-drinking/non-drug using (pro-social) behavior

  15. Daily Reminder To Be Nice • Did you express appreciation to your adolescent today? • Did you compliment your adolescent today? • Did you give your adolescent any pleasant surprises today? • Did you express affection to your adolescent today? • Did you initiate a pleasant conversation today? • Did you offer to help your adolescent today?

  16. Benefits of Group Therapy: Support • CSOs can discuss their difficulty in trying to carryout certain CRAFT procedures • CSOs can congratulate each other for making important changes • CSOs can share resentment about having to work so hard in CRAFT

  17. Benefits of Group Therapy: Skills Practice Arena • Opportunities for sharing of ideas/ brainstorming • Chance to practice with “real world” cases • Opportunities for feedback from others in similar situations

  18. Benefits of Group Therapy: Modeling • Learn from successes and failures of CSOs • Hear how others manage strong reactions from their adolescents • Observe how others manage their own strong emotions • Witness examples of others continuing to try despite setbacks

  19. Group # 1: Communication Skills(Overview) (1) Offer rationale (2) Describe positive communication components (3) Generate adolescent examples (4) Role Play (5) Do a reverse role play (6) Assign homework

  20. (1) Communication SkillsRationale Why bother working on communication? • More likely to get what you want • Positive communication is “contagious” • Will open door to more satisfaction in other life areas as well (social support) • Positive communication is the foundation for other CRAFT procedures

  21. (2) Positive Communication Components: PIUS • P = say it in a positive way and say what you want as opposed to what you don’t want. • I = start with an “I” statement and express a feeling. • U = offer an understanding statement • S = share the responsibility or offer to help

  22. (3) Negative to Positive Examples: Words Matter * When you’re high, the I really have fun with you; time we spend together we all do, when you’re as a family seems like clean and sober. a waste. * Don’t you know I’m a I appreciate it when complete wreck when it’s you let me know in after midnight and you’re advance that you’re not home? going to be late. * You never lift a ^@#%*! I know you’re busy, but it finger around here! would mean a lot to me if you could help clean out the garage Saturday.

  23. (4) Role-Playing Guidelines • Acknowledge discomfort • Use less difficult scenes first • Get adequate description of the scene • Start it for them • Keep it brief (2-3 minutes) • Reinforce any effort • Get CSO’s reactions • Offer supportive, specific feedback • Repeat, repeat, repeat

  24. (5) Reverse Role-Play • Advantages: • Serves as a good starting point for a CSO who is reluctant to do a role-play • Allows therapist to model good positive communication • Helps CSO develop empathy for adolescent

  25. (6) Assign Homework • Practice Communication Skills in a conversation with adolescent over _________ issue on ____ (day/time) • Use Daily Reminder To Be Nice

  26. Remaining Sessions (2) Proven ways to help your child stay sober (3) Goal setting guidelines (4) Functional analysis part 1 (5) Functional analysis part 2 (6) Problem solving task

  27. Remaining Sessions cont’d (7) Happiness scale and personal goal setting (8) Components of supporting sober/clean behavior (9) Natural Consequences (10) Relapse prevention

  28. CRAFT: 3 Goals • Reduce loved one’s harmful substance use • Engage loved one into treatment • Improve the functioning of CSO • Emotional • Physical • Relationships

  29. Thank you!

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