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Getting CRAFTy with Addiction

I think most of us have seen our fair share of Intervention episodes. We are familiar with the topics: compulsive substance use, addictions to gambling, sex, video games, and a myriad of eating disorders. Any significant mental health issue has been explored (and maybe a little exploited) by reality television.

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We become enthralled with the depths of the disorder. We are shocked, dismayed, and oddly entertained when we see the lengths that people will go to in order to obtain their drug of choice. We love seeing the confrontation between individuals who need help and their loved ones. The powerful emotions. The fights. The breakdowns. The happily-ever-afters. The relapses. The cycles of guilt and shame.

Relapse rates for substance use are pretty high, somewhere in the vicinity of 40% to 60%. Relapse rates for other chronic illnesses are also high: up to 50% for Type I Diabetes and up to 70% for Asthma and Hypertension. As addiction is commonly conceptualized as a disease state, its relapse rates are comparable to other chronic diseases.

Such high relapse statistics highlight the need for improved treatment modalities for those struggling with addiction. Those who enter treatment of any kind should recognize that relapse is usually a part of recovery. Guilt and shame are reduced, while clarity to the nature of addiction is introduced.

Do interventions really work in getting the treatment process started?

The definition of an addiction intervention differs for each person. Many people conceptualize interventions as confrontational and dramatic situations, which they very well can be. Not all interventions have to be this way, however.

Common thought in the field is that people with addiction issues usually only seek help when they feel it is the right time. Friends and family members, however, can facilitate this process for the individuals. Sometimes, through confrontational interventions. Sometimes, successfully.

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The literature, however, shows that as an alternative to confrontational interventions, positive reinforcement models have a higher efficacy rate of getting people into treatment. The CRAFT (Community Reinforcement and Family Training) system, in particular, boasts a high success rate with families motivating their loved ones to get treatment and sustaining healthy change. The CRAFT method was developed by Robert J. Meyers, Ph.D., who has 37 years in the addiction field. He is currently the Research Associate Professor Emeritus in Psychology at the University of New Mexico’s Center on Alcoholism, Substance Abuse and Addiction.

Using the CRAFT system, family members and loved ones make time spent sober more rewarding and fun. When individuals are not sober, time becomes way less fun. Positive behavior gets positively reinforced and negative behavior gets negatively reinforced. No judgment, no passive aggressive behavior. Family members clearly communicate that they support the user, but they will not support their addictive actions. Addictive behaviors are not enabled; users are held accountable for the responsibility of their actions.

The goals of the system are to ultimately encourage individuals to reduce their substance use, enter treatment, and to increase the quality of life for everyone involved. CRAFT implements strategies that foster conflict reduction and meaningful changes.

According to several studies, almost 70% of families who have used the CRAFT method were able to successfully motivate users into treatment. In the addiction world, 70% is staggeringly high. The system seems to work.

Whatever strategy or system is used, motivating people to seek treatment for their substance use (or any other addiction) can be very difficult and challenging. The reward, however, of seeing your loved one in a better place – physically, psychologically, and spiritually – is well worth that challenge.

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