The Science Behind Helping Families Help
CRAFT is an evidence-based and compassion-centered approach
CRAFT has been shown, through numerous clinical trials, to be an effective way for family members to approach a loved one who is drinking or using drugs too much.
Overview of CRAFT
CRAFT stands for Community Reinforcement Approach and Family Training. That’s a mouthful, and so we say CRAFT for short. CRAFT is an evidence-based approach for family members struggling with a loved one’s substance use.
Essentially, CRAFT teaches family members how to change the way that they interact with their loved one. Research shows us, time and time again, that loved ones whose family members learn CRAFT, are more likely to enter into treatment and reduce their substance use, and the family members themselves increase their overall wellbeing as well!
Family members can be very influential. They also tend to know a great deal about their loved one who is using substances (including alcohol). However, they often don’t know what to do with all that information to be helpful.
That’s where CRAFT comes in. CRAFT provides a comprehensive strategy for how to interact with their loved one in a way that has been shown to effectively encourage their loved one to start treatment and to get their life back from addiction. CRAFT also helps family members improve their own lives, whether their loved one ends up seeking treatment or not.
In the research protocols, CRAFT is often delivered over the course of a few months with a trained provider, who teaches the family member techniques that they can use at home with their loved one. Sessions focus on increasing the family member’s understanding of the loved one’s concerning behaviors, learning and practicing effective communication skills that tend to increase motivation for change, learning ways to respond to loved ones that decrease the chance of use over time, and investment in the family member’s own self-care.
CRAFT is different than family therapy. CRAFT doesn’t need the loved one to be interested in participating… in fact, the data collected on CRAFT was often from families where the loved one was described as being “resistant” to treatment at the start of the study! CRAFT is offered to the family members on their own, and the family members then bring the practice of their own skills into the family system.
Read more about CRAFT on our “What is CRAFT?” page.
Does CRAFT work?
CRAFT is what we call an “evidence-based therapy,” meaning that it has been proven to be effective in controlled clinical studies. The earliest research goes back about 40 years, so several decades of evidence has accumulated to show that CRAFT can teach family members how to engage their loved one in treatment in an effective, non-confrontative manner, and also improve their own life in the process.
“Randomized Controlled Trials” (RCTs) are the gold standard way of evaluating whether a treatment is effective. Participants are randomly assigned to receive either the treatment in question, no treatment, a comparison treatment, or in some cases a placebo (i.e., a false but convincing treatment). By comparing differences between groups we can confidently assess whether the real treatment really works, and confirm that any improvements are not due to chance or some other external factor such as the time of year or people simply expecting to get better.
CRAFT has been evaluated in a series of RCTs with hundreds of people and has repeatedly shown that about 70% of families are able to get their loved one into treatment after learning CRAFT. CRAFT has been shown to work across alcohol and many other substances, and the loved ones whose families learn CRAFT tend to reduce their use over time. Research shows it works for parents, for spouses, and other family members and in multiple cultural contexts. CRAFT has also been shown to improve family relationships and reduce conflict, even if the family member doesn’t get into treatment. CRAFT also has been shown to help the family member to be healthier, less stressed, and less depressed and anxious.
Links to the Research
What to check out the research yourself? Here’s some of my favorite links:
APA Intervention synopsis: Excellent brief summary of CRAFT related research https://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/community-reinforcement.aspx
Listing of Dr. Robert Meyers CRAFT related research from his website. robertjmeyersphd.com/publications.html
NCBI article on CRAFT, specifically with parents of treatment-resistant adolescents, with additional links to related studies on left hand side https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4394369/
For More information discussing the empirical base, check out chapter 10 of the clinical text “Motivating Substance Abusers to Enter Treatment” by Drs. Jane Smith & Robert J Meyers.
Why create HelpingFamiliesHelp.com?
This phenomenal research is useless if it’s simply kept in the lab! The providers behind Helping Families Help are inspired by the powerful positive changes that we have seen in working with families and want to do what we can in getting this information out there!! It is important for families to know that one size doesn’t fit all and that there are options available that are based in research, rooted in compassion, and offer an amazing potential for change for the entire family.
We are passionate about this work. We want you to be too! As you continue to read, learn, ponder, and practice let us know how it goes. Ask questions. Share your experiences. And if you are pulled to get more involved in this work, whether as a family member, a clinician, or someone who struggles with addictive behavior yourself, there are many different ways you can become a part of this greater movement. We would love to connect you with other passionate people. Let us know!