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Recently, I had the pleasure of participating in FHE Health’s First Responder Families Podcast. The conversation was about self-care for families affected by substance abuse and how to improve communication with a loved one diagnosed with a substance use disorder.
Much of this discussion about healthy communication involved an acronym that may be unfamiliar to many: “CRAFT,” or “Community Reinforcement and Family Training.” CRAFT is a model for effective communication and intervention. You can find out more about the approach, how it works, and why it is helpful for families, in the sections that follow.
The CRAFT Model: What It Is and Supporting Research
CRAFT is a purposeful, action-based approach to interactions in families affected by substance abuse. Key features of this approach are:
- Conscious vs. blaming/reactive communication – Rather than blaming the other or focusing on their issues, this model empowers family members to make conscious rather than reactive choices when responding to a loved one’s behavior.
- An emphasis on coping skills and managing feelings – By encouraging family members to focus on managing their feelings and using their coping skills, it equips them with the ability to respond intentionally to their addicted loved one.
- Positive support beyond the “intervention” stage – This method also teaches communication skills that go beyond the “intervention” stage. It reinforces positive support and communication throughout a relationship.
The End of “Rock Bottom” in Communication Approaches
Years of research and experience have led to a shift in communication approaches to addiction in families. “They need to hit bottom” is no longer the primary message to families whose loved ones have substance use struggles. We now know that the willingness to change is on a continuum, and a person can engage in the change process anywhere along that continuum. Waiting for them to “hit bottom” can have fatal consequences, especially in today’s context where drugs are often much deadlier.
This method teaches family members that they can be a force for positive change in their loved one’s life. CRAFT does not focus on why individuals use a substance and demonstrate the unhealthy behaviors that accompany it, but instead on families’ responses to these behaviors. Peer family coaches teach people that being supportive, communicating with intent, setting boundaries, and maintaining support of pro-recovery behaviors is key to helping their loved one.
10 Key Components of the CRAFT Model
Let’s explore the key components of the CRAFT model.
1. Focus on Loved Ones and Families – By prioritizing the empowerment of family members, partners, and close friends in this training process, CRAFT encourages them to inspire positive changes in their loved ones. It addresses the emotional toll on the family and equips them with tools to support themselves while helping their loved one. One of the central goals of the training is to improve the quality of life and functioning of family members, regardless of the outcome of the intervention. This requires prioritizing self-care and developing the tools and awareness that can help family members take care of themselves.
2. A Non-Confrontational Approach – Unlike interventions that rely on confrontation, CRAFT teaches gentle, respectful communication strategies to encourage openness and connection. It teaches participants how to communicate positively and effectively even when things are not going well. This method avoids blame, shame, and defensiveness, creating a safer space in which change can occur.
3. Reinforcement of Positive Behavior – Family members learn to identify and reinforce positive behaviors in their loved ones, such as small steps toward sobriety or healthier choices. For instance, recognizing and rewarding positive actions increases the likelihood that those actions will be repeated. In addition to praise, these can be tangible rewards such as a gift card to a favorite restaurant or increased privileges, if it is a child who is at home.
4. Decreasing Behaviors That Support Continued Substance Use — The CRAFT method helps families recognize behaviors that unintentionally sustain substance use, such as providing money or covering up for consequences. Shifting these patterns helps the loved one face the natural consequences of their choices.
5. Improving Communication Skills – Family members are taught effective communication strategies, like using “I” statements, reflective listening, avoiding blame or criticism, and choosing the right times to discuss a difficult subject. Participants also learn how to ask open-ended questions and provide affirmations that encourage continued dialogue. Improved communication fosters trust and understanding, making it easier to discuss difficult topics.
6. Encouraging Entry Into Treatment ¬ A core goal of CRAFT is to guide the loved one into treatment without coercion or pressure. Studies show that CRAFT is highly effective, with approximately 70 percent of participants achieving success with this goal.
7. Emotional Self-Care for Family Members – The program emphasizes the importance of family members taking care of their mental and physical well-being. Stress management, setting boundaries, and seeking support are crucial for maintaining resilience and effectiveness. They are encouraged to regularly engage in activities they enjoy, seek support, and learn to say no.
8. Understanding Triggers and Patterns – Family members and other loved ones learn to identify triggers and patterns that contribute to substance use in their loved one. This understanding allows them to create environments that reduce triggers and support healthier choices.
9. Building Problem-Solving Skills – CRAFT teaches families how to handle setbacks and challenges constructively, keeping the focus on long-term goals. Effective problem-solving reduces frustration and increases motivation for change. Family members are taught steps to identify the problem, brainstorm solutions, choose a plan of action, act, and then review and adjust if needed. They also learn to collaborate with each other instead of blaming and defending.
10. Celebrating Progress — Small victories, such as a loved one reducing substance use or taking a step toward treatment are acknowledged and celebrated. Celebrating progress builds confidence and reinforces positive momentum for everyone involved. This does not have to be a grand gesture; nor should it be a disingenuous response, but rather a heartfelt response to a small win or change. Acknowledging the small victories can mean something noticeably big to a person amidst their struggles.
These principles make CRAFT a compassionate and evidence-based approach for addressing substance use, while focusing on hope, collaboration, and sustainable change. Also, note that these communication skills, concepts, and action steps can be applicable when responding to a loved one’s mental health issues or behaviors as well.
Finally, I recall the old saying about “putting your oxygen mask on first,” as a reminder that compassion is a core value of the CRAFT Model, ever reminding loved ones to be kind and compassionate with themselves first.
Want to hear more? Take a few moments to listen to our First Responder Families Podcast with Kathleen Strain. Kathleen is a Certified Family Recovery Specialist with the organization, Partnership to End Addiction. She is also a parent with family members who have struggled with use disorders and can share about how this approach helped her and her family.
Joi Honer B.A, C.A.C, C.A.D.C
Director of Alumni Services and Resources
Resources and Reading
- The First Responder Families Podcast: https://fhehealth.podbean.com/e/the-first-responder-families-podcast-finding-the-words-how-to-act-when-it-feels-like-theres-nothing-you-can-say-or-do/
- Partnership to End Addiction: https://drugfree.org/
- Beyond Addiction: How Science and Kindness help People Change
- The Beyond Addiction Workbook for Family and Friends: Evidence-Based Skills to Help a Loved One Make Positive Change
