CRAFT, short for Community Reinforcement and Family Training, teaches family members practical skills to encourage a loved one toward treatment without confrontation. Instead of one big meeting, a family member works with a trained clinician over several sessions. It has the strongest randomized trial evidence of the family approaches, and it also helps the family member’s own wellbeing.
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Where CRAFT came from
CRAFT was developed by psychologist Robert Meyers and colleagues, building on the Community Reinforcement Approach, a behavioral treatment for people with alcohol problems. The insight was simple: the people who live with someone who drinks or uses drugs shape much of their daily environment. If family members learn to make sober time more rewarding and using less comfortable, without nagging or threats, the person’s choices can shift. SAMHSA’s guide to family therapy in substance use treatment, TIP 39, describes CRAFT as a structured, positive reinforcement approach for family members.
What families learn in CRAFT
- Understanding the pattern. When, where and with whom the person uses, what sets it off, and what they get out of it.
- Positive communication. Short, specific, non-blaming statements that are more likely to be heard than arguments.
- Rewarding sober time. Making time together noticeably better when the person is not using.
- Letting consequences land. Stepping back from rescuing, such as calling in sick for them or cleaning up after a binge, so the costs of use are felt by the person rather than absorbed by the family.
- Safety planning. Recognizing warning signs of violence and having a plan to stay safe.
- Self-care. Rebuilding the family member’s own life, sleep, friendships and interests.
- Inviting treatment at the right moment. Recognizing windows of opportunity, such as remorse after a bad night, and having a treatment option ready to offer.
What the research says
CRAFT has been tested in randomized trials, which is rare among family approaches.
- Problem drinking, 1999. Miller, Meyers and Tonigan randomly assigned 130 family members of people with drinking problems to CRAFT, Johnson-style preparation or Al-Anon facilitation, each with about 12 hours of counseling. CRAFT families saw their loved one enter treatment in 64 percent of cases, compared with 30 and 13 percent. Engagement usually came after four to six sessions, and family members in all three groups reported feeling better.
- Drug use, 2002. Meyers and colleagues reported in the Journal of Consulting and Clinical Psychology that CRAFT engaged about two thirds of treatment-refusing drug users, compared with about 29 percent for a twelve-step facilitation program for family members. The full record is available through the journal.
These are encouraging numbers, but they come from research programs with trained therapists and volunteer families. They measure whether the person entered treatment, not long-term recovery, and they cannot predict what will happen in any one family.
Strengths
- No ambush and no ultimatum delivered in front of an audience, so trust is easier to protect.
- Works with just one committed family member.
- The family benefits even if the person does not enter treatment right away.
- Skills carry forward into recovery, when the home environment still matters.
Limits and when to be careful
- It takes weeks. CRAFT is not designed for a crisis. If someone is in danger, call 911, and for thoughts of suicide or a mental health crisis call or text 988.
- Medical risk. Families of people who use opioids should keep naloxone at home and know how to use it. Heavy daily drinking and benzodiazepine use can cause dangerous withdrawal, so treatment should include medical detox when needed.
- It asks a lot of the family member. Changing long-held habits, such as rescuing or arguing, is hard, especially alone.
Learning CRAFT and combining it with an intervention
CRAFT is delivered by trained clinicians, and families can also learn its principles from books and online family programs, such as Get Your Loved One Sober by Meyers and Wolfe. Free family groups such as SMART Recovery Family and Friends teach related skills.
CRAFT also blends well with other approaches. Families often use CRAFT-style communication in the weeks before an invitational meeting and keep using it if the answer is no. Our intervention team tailors the approach to each family; when we draw on CRAFT principles, we say so and explain why. Families can work with our team by video, so coaching does not have to wait for anyone to travel. See all four approaches on our methods page, or read what to do if they say no.
Frequently asked questions
What is CRAFT in addiction?
CRAFT, or Community Reinforcement and Family Training, is a structured program that teaches family members how to encourage a loved one toward treatment using positive communication, rewards for sober time and safety planning, without confrontation.
How long does CRAFT take?
Research programs offered about 12 hours of counseling over several weeks, and loved ones who entered treatment often did so after four to six sessions. The pace depends on the family and the situation.
Is CRAFT better than an intervention?
In a 1999 trial, CRAFT engaged more loved ones in treatment than Johnson-style preparation. It is a different tool rather than a replacement, and it is not designed for emergencies. Many families combine it with other approaches.
Can CRAFT help if our loved one never agrees to treatment?
Yes, in a different way. Family members in CRAFT research reported improvements in their own wellbeing, whether or not their loved one entered treatment.
Talk with our intervention team
We can talk through whether a skills-based approach fits your family, and how it can work alongside other steps.