title: The community reinforcement approach: an update of the evidence.
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.
authors.affiliation: Psychology Department at the University of New Mexico,Albuquerque, New Mexico.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Meyers
authors.forename: Hendrik G
authors.initials: HG
authors.lastname: Roozen
authors.forename: Jane Ellen
authors.initials: JE
authors.lastname: Smith
mesh_terms: D000437:Alcoholism / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy*; D005196:Family Therapy / Q000379:methods / Q000639:trends; D006801:Humans; D012056:Reinforcement, Social; D012111:Residence Characteristics; D012944:Social Support