Community Reinforcement Approach (CRA) At Bedrock

If you are living with addiction, you know how strong the pull to use drugs or alcohol can be. The community reinforcement approach (CRA), one of the evidence-based treatments available at BRC, can help counteract that pull.

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Your addiction treatment plan at Bedrock Recovery Center will be developed with your unique care needs and recovery goals in mind. One highly effective science-backed treatment option that we offer clients facing addiction is the community reinforcement approach (CRA).

CRA was developed almost 50 years ago to help people recover from alcohol addiction. Its creator, Nate Azrin, understood that punishment, or anything resembling punishment, was the wrong approach to recovery and instead wanted to create a pathway that inspired interest in adopting a healthy lifestyle. His approach involved introducing clients to enjoyable social activities that didn’t involve alcohol use and teaching them the skills to participate fully in these activities.

Today, scientific evidence shows that CRA works, not only for alcohol use disorder but for other substance use disorders as well. At BRC, you and your care team may discuss whether this option is right for you.

CRA Methods

There are eight basic CRA procedures that therapists employ to help clients take steps away from a lifestyle involving drug or alcohol use and toward healthy living. Below are some of the key methods.

Functional Analysis Of Substance Use

During this step, your therapist at BRC will ask you about your substance use, looking for patterns related to when you use, why you use, how you use, etc. You will discuss the short-term positive consequences of substance use as well as the long-term negative consequences. You will also begin discussing other, healthy options for stress-relief, anger management, or other coping skills.

CRA Treatment Plan

This method can help you get a wider perspective on your life overall based on how happy you are with the way things are currently going for you. Your therapist may use a happiness scale to determine how happy you are in key areas of your life, which may include your addiction, your relationships, your work, your spiritual life, your emotional life, etc.

Then, you’ll select areas to work on using specific methods to attain specific goals.

Behavioral Skills Training

Through instruction and role-playing with your therapist, you will learn and strengthen three basic behavioral skills: problem-solving skills, communication skills, and alcohol/drug-refusal skills.

Social And Recreational Counseling

This approach reflects back to what you and your therapist learned together during an analysis of your substance use. For example, if you discover that you drink alcohol every day after work with friends to de-stress, this method then identifies new social activities to try. The focus will be on providing the same socially reinforcing benefit rather than on simply finding an alternative activity.

In the same example, the behavioral skills you are learning can also help you deal with stress at work in a healthy way, such as by communicating your needs with your team.

Relapse Prevention

This plan of action gives you another opportunity to practice behavioral skills you are learning, such as problem-solving, this time solely through a relapse prevention focus. You will also learn specific relapse prevention techniques. This may include identifying high-risk situations and developing a plan for coping with “slips” so that they don’t turn into a full-blown relapse.

Applications For CRA

Although it began as a treatment approach for people with alcohol use disorder (AUD), CRA has also been shown to be effective for people with drug addiction, especially when combined with motivational interviewing (MI) and family therapy, both of which are also offered at Bedrock Recovery Center. Studies discussed in Alcohol Research & Health showed that CRA could also help people with antisocial personality disorder or other co-occurring disorders, for which Bedrock provides dual diagnosis treatment options.

Our residential programs provide a great opportunity to develop the skills taught in CRA, put them into practice, and begin engaging in new, healthy activities, such as game nights, basketball, yoga, fitness classes, movie nights, and more.

Evidence For The Efficacy Of CRA

Studies support CRA itself as well as the premise behind it. That is, people with substance use disorder (SUD) often report being less engaged in enjoyable activities than people without SUD are.

Specific studies have shown that CRA is just as effective as, if not more effective than, than 12-step programs, while also helping people achieve better outcomes in their work and family relationships.

Learn More About Bedrock’s Recovery Programs

If you are ready to take the first step toward recovery from drug or alcohol addiction, call Bedrock Recovery Center today. A freer, happier life is possible.

  1. American Psychological Association (APA) https://psycnet.apa.org/record/2009-17932-003/
  2. Cambridge University Press https://www.cambridge.org/core/books/abs/community-reinforcement-approach-to-addiction-treatment/treatment/710801A9487B0512B2F8FB56529F1586/
  3. Canadian Centre on Substance Use and Addiction https://www.ccsa.ca/sites/default/files/2019-04/CCSA-Community-Reinforcement-Approach-Summary-2017-en.pdf/
  4. Canadian Centre on Substance Use and Addiction https://www.ccsa.ca/sites/default/files/2019-04/CCSA-Community-Reinforcement-Family-Training-Summary-2017-en.pdf/
  5. Columbia University Irving Medical Center https://www.columbiadoctors.org/treatments-conditions/motivational-enhancement-therapy#:~:text=Motivational%20Enhancement%20Therapy%20(MET)%20is,increasing%20motivation%20and%20setting%20goals./
  6. Health Research Board National Drugs Library https://www.drugsandalcohol.ie/17279/
  7. National Drugs Library https://www.drugsandalcohol.ie/13609/1/NTA_Community_reinforcement_approach.pdf/
  8. National Library of Medicine: PubMed https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6760430/
  9. National Library of Medicine: PubMed https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860533/
  10. Rashid Latif Medical College https://rlmc.edu.pk/themes/images/gallery/library/books/Community%20Medinine/A%20COMMUNITY%20REINFORCEMENT%20APPROACH.pdf/
  11. Victoria State Government https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cognitive-behaviour-therapy/
  12. William R. Miller https://williamrmiller.net/the-community-reinforcement-approach-to-addiction-treatment/

Written by Bedrock Recovery Center Editorial Team

Updated on: July 12, 2024

© 2025 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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