CRA & CRAFT Flashcards
(32 cards)
What are the two effective behavior treatments that help people build rewarding lives without substances?
Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT). Both recognize that for someone to choose a substance-free life, life needs to feel satisfying and offer rewards that outweigh those from substance use.
What are the differences between CRA and CRAFT?
CRA focuses on the individual struggling with substance abuse and is designed to work even if they are not initially motivated for change. CRAFT, on the other hand, is for concerned significant others (CSOs) who are supporting individuals refusing substance abuse treatment.
What is a functional analysis (FA) in CRA?
Functional analysis (FA) is a foundational component in CRA. It aims to understand both external and internal triggers that lead to substance use. Looks at the short-term positive consequences of using (that help sustain the behavior) as well as triggers and reinforcements for healthy behaviors. It is used to identify alternative, rewarding activities to replace substance use.
What is sobriety sampling in CRA?
Sobriety sampling is a technique used to gently introduce the idea of change by encouraging individuals to try a limited period of abstinence. Helps reduce resistance, allows for experimentation with new coping strategies, and builds self-confidence. The length of the trial is collaboratively decided based on the individual’s motivations, and during this time, clients work with their therapist to develop coping strategies and alternative activities for high-risk situations.
What is the Happiness Scale procedure in CRA?
The Happiness Scale is a 10-item questionnaire used to assess an individual’s satisfaction across various life areas. It is used in therapy to identify areas for goal setting and track progress throughout treatment.
What is the purpose of the Goals of Counseling form in CRA?
The Goals of Counseling form mirrors the 10 areas on the Happiness Scale. It helps set specific, measurable, realistic, and personally meaningful goals that are under the individual’s control. Each goal is broken down into actionable steps that serve as homework between sessions. This process enhances the satisfaction gained from a substance-free lifestyle.
How does CRA use communication skills training?
CRA emphasizes teaching positive communication skills to reduce relapse triggers like arguments or misunderstandings. Clients learn three key strategies for difficult conversations: offer an understanding statement, take some responsibility, and propose a solution. These skills are practiced through role-playing.
What is the problem-solving approach in CRA?
CRA includes training in a 7-step problem-solving process: 1) Clearly define the problem, 2) Brainstorm possible solutions, 3) Eliminate unrealistic or undesirable options, 4) Choose the best solution, 5) Anticipate obstacles, 6) Plan for dealing with obstacles, and 7) Assign the task. The solution is attempted between sessions and reviewed in therapy for refinement or alternative strategies.
How does CRA prepare people for relapse risk?
CRA teaches drink and drug refusal skills, focusing on seeking social support, identifying high-risk situations, and practicing assertive refusal. Clients role-play scenarios, build support networks, and use FA to anticipate challenges.
How does CRA incorporate employment support into treatment?
CRA recognizes employment as a powerful source of positive reinforcement. It enhances self-esteem, provides financial stability, and supports sober social connections. CRA uses a structured job-finding method which includes identifying relapse-safe job options that match the client’s skills, setting up systems to track job applications, providing resume and interview preparation, and anticipating workplace challenges to manage them proactively.
How does CRA help clients rebuild a sober social life?
By helping clients rediscover old interests or try new activities that are genuinely appealing. Includes identifying high-risk time slots for substance use and planning sober activities during those periods. Systematic encouragement and in-session planning help clients overcome hesitations and follow through.
How does CRA handle relapse when it happens?
It uses a new FA focused on the relapse episode to understand triggers and consequences, and a chain analysis to examine the sequence of decisions leading up to it. Turns relapse into a learning opportunity. Clients also create early warning plans to identify and respond to relapse risk, including notifying a trusted support person.
What is medication monitoring in CRA?
Medication monitoring is a support technique used for clients prescribed disulfiram or other meds. A designated support person is trained to remind and encourage medication adherence. This person may attend a therapy session to learn the process, and there is a plan in place for what happens if the client refuses medication. It also acts as a relapse warning system.
What does CRA relationship therapy involve?
CRA relationship therapy focuses on improving romantic relationships as a source of reinforcement and stability. Relationship Happiness Scale assesses satisfaction in key areas, teaches partners to make specific, positive requests, and uses structured exercises. It also emphasizes joint problem-solving and collaborative goal-setting.
What does the adolescent version of CRA (A-CRA) include?
A-CRA includes adapted questionnaires and interventions for teens. It involves separate sessions for caregivers and joint sessions with also the adolescent. The approach includes teaching communication skills, effective parenting strategies, and goal negotiation. These sessions parallel adult CRA.
How effective is CRA according to research?
Alcohol: Studies consistently show it outperforms traditional treatments like hospital-based AA groups in reducing drinking days, increasing employment, and improving treatment retention. CRA combined with disulfiram monitoring showed higher abstinence rates.
It has also shown effectiveness with other substances like cocaine, tobacco, and opioids. Computerized CRA versions and combinations with contingency management (e.g., voucher rewards) further improve outcomes.
What does the research say about A-CRA’s effectiveness?
Effective. The Cannabis Youth Treatment study showed significant improvements in abstinence and recovery days. A-CRA was also found to be cost-effective. Other studies with homeless youth showed better outcomes in substance use, depression, and social stability compared to standard services. Has also demonstrated effectiveness across different ethnic groups.
What is the purpose of chain analysis in CRA?
Chain analysis is used to understand the sequence of seemingly minor decisions that led to a relapse. Rather than focusing on the relapse as a single event, it helps clients see earlier ‘choice points’ where alternative actions could have changed the outcome. This gives clients more insight into their behavior patterns and highlights that opportunities for change often arise well before the moment of use.
What is the early warning system in CRA?
The early warning system is a proactive relapse prevention strategy. It involves identifying signs that a relapse may be coming and developing a plan in advance for how to respond. This includes selecting a trusted support person and defining what they should do if the client signals risk or stops following through with their plan. It helps catch a potential relapse before it escalates.
How does CRA differ from purely abstinence-based programs?
CRA is flexible and non-confrontational. It doesn’t require immediate commitment to total abstinence. Techniques like sobriety sampling help clients try short-term sobriety, which can lead to longer-term change through increased self-efficacy and improved quality of life.
It is designed to work even if clients are not ready to commit. It uses motivational strategies, focuses on enhancing rewards in everyday life, and introduces change gradually through low-pressure techniques like sobriety sampling and FA. So it is highly accessible and client-centered.
It has been adapted internationally with success. It’s used in Spain’s public health system, the Netherlands, Mexico, Ireland, and Germany, among others. Studies have shown its effectiveness across cultural groups, especially in adolescents.
What is the purpose of CRAFT and who is it designed for?
CRAFT is designed for Concerned Significant Others (CSOs) when the identified person (IP) struggling with substance use refuses treatment. Its goal is to empower CSOs to influence the IP’s environment and behavior in subtle but effective ways.
What are the three main goals of CRAFT?
1) Decrease the IP’s substance use. 2) Get the IP into treatment. 3) Improve the CSO’s happiness and wellbeing regardless of the IP’s actions.
How does CRAFT use Functional Analysis (FA)?
CRAFT uses FA to gather information from the CSO about the IP’s substance use, including triggers, and positive and negative consequences. This helps tailor strategies to influence the IP’s environment and behavior.
How does CRAFT assess and address safety risks, particularly domestic violence?
CRAFT includes an assessment for domestic violence before any behavior change is recommended. If significant risk is found, CSOs are referred to specialized safety programs. FA can also help identify aggression triggers and develop safety plans.
