Category Archives: Pre-Treatment

Community Reinforcement & Family Training (CRAFT)

Hands that help!

CRAFT is a cognitive behavior model for dealing with alcoholism and drug use that aims to achieve abstinence by eliminating the positive benefits of substance abuse and increasing the positive benefits of sobriety. CRAFT has several parts and is designed to build up motivation to quit using:

  • Helping the addict initiate sobriety.
  • Analyzing the addict’s using patterns.
  • Increasing positive benefits through reinforcement.
  • Learning new coping behaviors.
  • Involving significant others in the recovery process by teaching them skills.
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Pre-Treatment: Part Two

Intervention

An intervention is a method for family and friends to give caring and supportive confrontation to the addict in their lives. In this collective group, the possibility of increased defensiveness, avoidance, manipulation, and hostility is reduced. The goal of an intervention is to awaken the addict to their need for help, and get them committed to recovery immediately. Traditionally, this involves an addict consenting to treatment in a residential program. For many, this isn’t the right fit. The person may be motivated to participate in a less intense option, it would be financially difficult, job restraints or there are no residential programs for his or her specific addiction.

The theme in an intervention is concern, and the approach is carefronting the addict with facts about how their behaviors have affected those participating in the intervention. If the addict is able to relax his or her defenses, and accept the truth, they may be rescued from hitting a lower bottom.

A well-done intervention is a loving, yet manipulative process. The motivation for an addict to recover comes partly from their relationship with the carefronters; the possibility of loss of support, family, or a job can be very persuasive. Often, once an addict has realized their need to change, recovery will take hold.

The phases of an intervention are:

  1. Family, friends, employer, etc. who are concerned about, and important to, the addict need to agree to participate. A group of eight people is about right. Ideally, get a professional interventionist, who will hold one or more pre-intervention meetings.
  2. At pre-intervention meetings, the following issues will need to be discussed and a plan finalized:
    • Each participant needs to understand the intervention process. They need to vent their negative feelings towards the addict and decide on a personal experience they will share with the addict as an example of why they are concerned.
    • It’s vital to break through any denial the participants may have about the confronted person’s addiction. Usually the addict’s addiction has been enabled by well intending family members. This must be addressed and an agreement has to be made to stop rescuing, fixing and saving the addict from the consequences of his or her behavior. Furthermore, the participants must get past their negative feelings about the addict, their using, and the intervention process itself.
    • A decision must be made to determine whether an intervention is going to happen, who is going to participate, and what the group will expect the confronted addict to do. Anything less than a strong, clear, and solid group agreement is likely to sabotage the intervention.
    • A plan must be agreed upon as to how to get the addict to the intervention location and other details that need to be arranged.
  3. The intervention experience:
    • One or more participants will bring the confronted addict to a home, doctor’s office, treatment center, or any desirable location. This may need to be done under false pretenses.
    • The designated facilitator will briefly share the reason for the meeting and ask the addict to agree to listen until everyone has shared. Hopefully, the addict agrees to listen. If not, a prearranged response needs to be initiated.
    • Each participant, in pre-agreed order, will share for up to five minutes one specific using-related incident that was difficult, embarrassing, hurtful, or scary and their feelings regarding the incident.
    • The participants can share their feelings and hopes for the addict to accept help and live a healthy life. This is not a debate about whether the addict has a problem; it’s a monologue of why the addict needs help.
    • The facilitator shares the group’s decision and expectations for the addict and attempts to get an agreement with the addict.
    • If no agreement is obtained, a second, less intense option can be offered with a consequence rider. That is, if the second option doesn’t work, the first option will be carried out. For example, if the addict refuses residential treatment but agrees to out patient care, if the latter is unsuccessful, then residential treatment becomes the only option.
    • If neither option is accepted, then it’s time for the participants to share their response to that decision. Until recovery is started, participants will break off their relationship, separate from marriage, be severed from work, etc. If the confronted still doesn’t respond, end the intervention and put tough love into action.
    • If the addict returns to using, a second intervention may be necessary. This last and final intervention sets up what the addict must do to continue having any contact with family and friends.

Intervention is a very hard experience, and not everyone agrees that it’s the best approach.

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Pre-Treatment: Part One

Hitting Rock Bottom

Hitting Bottom

Major motivation for recovery occurs when you have hit your bottom, which is the point in time when you experience the reality that you have an addiction and that it is hurting your life and the lives of your loved ones. When you hit a bottom, the negatives of your behavior become real, your defenses break down, and denial is gone. You are left with the consequences that your addiction has caused in your life. Connecting as fully as you can to this awareness will motivate your need for change. Everyone has their own enough level, which is their bottom. You can raise your bottom by looking at your illusions, and reconsidering the mythical value that using has in your life. Let the reality of your using sink in. Connect with your healthy self and with those who care about you.

If you are fortunate, you will have hit your bottom early in your using career. If you say, “I’m not that bad, yet,” good! Why would you want to get worse or get that bad? Hitting bottom is not completely negative. It’s a crisis, but like any crisis, it’s an opportunity to experience change and growth and become better. Choosing to continue your addiction can lead to many problems, such as jail, illness, loss of a job, loss of money, damaged relationships, and ultimately death.

Brain Scan

Brain Scan

A brain scan is a powerful reality check. It’s very hard to deny that there’s a problem while looking at an image of the physical damage that has resulted from your behavior. This can be expensive, unless you can get medical insurance to help with the cost.

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