What Is Community Reinforcement Approach (CRA) Therapy For Addiction?

Dr. Manish Mishra, MBBS

Medically Reviewed By: Manish Mishra, MBBS

on October 13, 2022

Behavioral therapies, like cognitive behavioral therapy (CBT), are one of the most effective treatments for drug and alcohol dependence, alongside other treatments, like medication.

Lesser known, however, is community reinforcement approach (CRA) therapy, which focuses on reducing addictive behaviors and reinforcing a positive, fulfilling life in recovery.

At Bedrock Recovery Center, we offer a number of evidence-based therapies, including CRA, as part of our holistic approach toward promoting lifelong addiction recovery.

The Goal Of Community Reinforcement Approach Therapy

The primary goal of community reinforcement approach therapy, like other addiction treatment services, is to deter and prevent harmful substance use behaviors. 

With CRA therapy, this is achieved by rearranging aspects of an adult or adolescent’s environment to make life in recovery more rewarding than the use of drugs or alcohol.

Basic goals of CRA therapy include:

  • enhancing positive reinforcement for non-drug/drinking behaviors
  • improving social relationships
  • improving job/work relations
  • preventing relapse
  • equipping you with skills for success in recovery
  • motivational enhancement

The premise of this is based on studies that show environmental factors, like home life, work, and social life can be influential on mental health and substance use behaviors.

What Are Common Strategies Of Community Reinforcement Approach Therapy?

A number of strategies, or procedures, are utilized by treatment providers who use CRA therapy to help treat drug and alcohol problems in adolescents and adults.

Examples of CRA therapy strategies include:

Community Engagement

One of the goals, or strategies, associated with CRA therapy is promoting participation in social and recreational activities, like sports, art, and other community-based activities.

Specifically, the goal is to participate in activities that can help you build positive relationships with peers, strengthen your social support network, and support a healthy lifestyle.

Identifying Negative Consequences Of Your Substance Use

Another therapeutic component of this approach involves identifying consequences of your drug or alcohol abuse with a counselor. This is known as a functional analysis.

With this, the goal is to also identify healthier behaviors that can reinforce your sobriety and replace the role that alcohol or drugs played in your life.

Job And Behavioral Skills Training

Another goal with CRA is to help you develop your personal skills, and provide training to help improve job/work relations, particularly for adults with chronic or severe addiction.

Key targets of CRA training include:

  • improving communication skills
  • improving problem-solving skills
  • emotional regulation
  • drink/drug refusal training
  • relapse prevention training
  • help with finding/maintaining a job
  • social and recreational counseling

Sobriety Sampling

Sobriety sampling is described by addiction researchers as a “gentle movement” toward long-term abstinence by beginning with a commitment to a time-limited abstinence period.

For instance, committing to sobriety for one month, two months, six months. Sampling sobriety, so to speak, as a way to work toward long-term drug or alcohol abstinence.

How Community Reinforcement Approach Therapy Began

The community reinforcement approach (CRA) was first developed in the 1970s by Nate Azrin, a behavioral modification researcher, psychologist, and university professor.

This is similar but not the same as community reinforcement and family training (CRAFT), which is an approach designed specifically for concerned significant others/family members.

Originally developed as a treatment for alcohol use disorder, today CRA treatment is used to effectively treat various substance use disorders.

What Addictions Can CRA Treat?

Community reinforcement approach therapy has been studied for its use as an effective treatment for a variety of substance use disorders, including:

CRA therapy is commonly offered as just one component of a full treatment plan sought through an inpatient or outpatient treatment center. 

A full treatment plan for addiction, depending on the drug of abuse and personal factors, may also include detox, medication (e.g. disulfiram), contingency management, and other treatments.

How Effective Is A Community Reinforcement Approach For Addiction?

Research shows this approach can be effective for both adults and adolescents with substance abuse problems, particularly issues with cocaine, alcohol, and opioids. 

This holistic approach to drug abuse and recovery can teach skills useful not only for staying sober, but also building a healthy lifestyle with one’s work, social life, and relationships.

Community Reinforcement At Bedrock Recovery Center

At Bedrock Recovery Center, our treatment programs at multiple levels of care integrate elements of CRA therapy to help promote lifelong addiction recovery and wellness.

Our substance abuse treatment programs include:

Call To Learn More About Our Addiction Recovery Programs Today

Addiction recovery is a lifelong journey, not a race. Here at Bedrock, our clinicians know: It’s never too late or too soon to enter treatment and begin your recovery process.

If you’re looking for treatment for yourself or a loved one with addiction in Massachusetts, call us today to learn if Bedrock Recovery Center is the right treatment center for you.

  1. Canadian Centre on Substance Use And Addiction — Community Reinforcement Approach https://www.ccsa.ca/sites/default/files/2019-04/CCSA-Community-Reinforcement-Approach-Summary-2017-en.pdf
  2. Humboldt County Department of Health and Human Services — Adolescent Community Reinforcement Approach (A-CRA) https://humboldtgov.org/333/Adolescent-Community-Reinforcement-Appro
  3. Journal of Consulting and Clinical Psychology — The community reinforcement approach with homeless alcohol-dependent individuals https://psycnet.apa.org/record/1998-02631-011
  4. U.S. National Institute on Drug Abuse (NIDA) — Community Reinforcement Approach Plus Vouchers (Alcohol, Cocaine, Opioids) https://nida.nih.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-therapies/community-reinforcement-approach-vouchers
  5. U.S. National Library of Medicine: PubMedCentral — The Community Reinforcement Approach https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860533/

Written by Bedrock Recovery Center Editorial Team

© 2024 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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