The community reinforcement approach: an update of the evidence

Robert J Meyers, Hendrik G Roozen, Jane Ellen Smith, Robert J Meyers, Hendrik G Roozen, Jane Ellen Smith

Abstract

The Community Reinforcement Approach (CRA), originally developed for individuals with alcohol use disorders, has been successfully employed to treat a variety of substance use disorders for more than 35 years. Based on operant conditioning, CRA helps people rearrange their lifestyles so that healthy, drug-free living becomes rewarding and thereby competes with alcohol and drug use. Consequently, practitioners encourage clients to become progressively involved in alternative non-substance-related pleasant social activities, and to work on enhancing the enjoyment they receive within the "community" of their family and job. Additionally, in the past 10-15 years, researchers have obtained scientific evidence for two off-shoots of CRA that are based on the same operant mechanism. The first variant is Adolescent Community Reinforcement Approach (A-CRA), which targets adolescents with substance use problems and their caregivers. The second approach, Community Reinforcement and Family Training (CRAFT), works through family members to engage treatment-refusing individuals into treatment. An overview of these treatments and their scientific backing is presented.

Figures

Figure 1
Figure 1
Functional Analysis for Using Behaviors SOURCE: Meyers, R.J., and Smith, J.E. Clinical Guide to Alcohol Treatment: The Community Reinforcement Approach, New York: Guilford Press, 1995, pp. 34–35. Adapted with permission.
Figure 2
Figure 2
Happiness Scale. SOURCE: Meyers, R.J., and Smith, J.E. Clinical Guide to Alcohol Treatment: The Community Reinforcement Approach. New York: Guilfor Press, p.95. Adapted with permission.

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Source: PubMed

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