CRAFT Method, True Stories and Rewards Part I

How do we focus on the good, reward non-use and functional behavior…and how do we not?

I am happy to say I have come to learn a whole new way of dealing with the struggles of day to day life.  Whether it’s ordinary stress, conflicts that may arise, or issues with a Loved One struggling with mental health, alcoholism, addiction or SUD. I have found a bottom line method for managing those demanding life issues within the power of the CRAFT Method.

CRAFT, Community Reinforcement and Family Training Method is a set of scientifically proven, softer yet powerfully effective strategies for interactions with those we are involved with and are affected by.

I often refer to CRAFT in blogs, podcasts and regular conversation, what better time than now to explain it as applied to true life scenarios.

Taken from a recent discussion on the Coming up for Air podcast, this week’s article applies methods of CRAFT to true , real life examples (with details modified for the sake of anonymity), sent from families from all over the country, who are feeling the effects of a Loved One.

Each scenario is followed with suggested expert CRAFT responses from the Allies in Recovery team, beginning with the first two:

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Our 26-year-old daughter had an absolute wrecking ball heroin habit.  She got below 100 pounds, couldn’t be left alone with anyone’s purse or jewelry and caused turmoil and chaos everywhere she went.  It was a nightmare as much as it was devastating.  She went into treatment and has been off heroin for 16 months.  But things are still shaky.  She moved back home with us, doesn’t work, sleeps all day, lives to drink excessively with her friends, is miserable to be around.  She has become lazier and sloppier than ever, burning through her savings on clothes and shoes to wear to clubs.  She seems to think she’s a Kardashian!  However, we almost feel like this is better than when she was putting a needle in her arm and we didn’t know where she was or who she might be around.  Life is miserable for all of us.

While we understand the sorrow and terror everyone suffered when your daughter was in active IV heroin use, to an extent the disease of addiction and resulting at risk behavior are still calling the shots within the family. The acceptance of drinking would be the first issue to address.  Applying CRAFT to the alcohol issues would be the beginning.  Are we going to allow the behavior or remove rewards*?  When ready, you may have to swallow your fear that you are driving her back to “worse” behavior and let her know when she chooses to drink to excess, she can’t stay at home.   You will need a lot of support and comfort, be sure not to isolate yourselves within the home.

The starting place is for family members to decide they are no longer okay with the drinking. They can set a line that reinforces moderate drinking but that discourages serious drinking episodes. Or, the line can be set with abstinence on one side and any amount of drinking on the other.  The choice is informed by what the family feels is needed and what is possible, given how their loved one behaves with alcohol.

Abstinence or moderate drinking equals rewards; drinking or serious drinking equals removal of those rewards, disengagement, and allowing natural consequences.

As the family you change your behavior in the moment, in the day, so that it aligns with what you’re seeing.

Nothing changes over night, we want to get the family moving forward, but it’s a process.  Frequent conversations to open up communication are necessary.  Sometimes a 30 deadline for immediate change is more overwhelming for everyone, than it is helpful.  Think in terms of today, today we can begin with a conversation geared toward goals of changing some of these dysfunctional habits, setting boundaries and limits, making progress toward your daughter working and getting on her feet.  Perhaps suggest rewards* for every goal she meets, including attending meetings, working a program and possibly, revisiting the idea of treatment for the disease of addiction and alcoholism, even though IV heroin isn’t the immediate need she may still need a treatment program that fits the current situation.

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My 23 year old son is in currently active use, we believe heroin, meth and anything else he can get his hands on.  He is living on various friends couches and sometimes sleeps in his car, so…pretty much homeless.  We haven’t seen much of him in a year.

The pain of separation from a child, particularly one in a high risk lifestyle can be engulfing, it sometimes feels impossible to endure.  Yet peace is possible, one breath at a time.  Tending to our own needs is vital!  Therapy, support groups, helpful books and a support system are crucial.  No one should go through it alone.

As often as possible, extend a bridge of loving communication.  If you are in contact with your son or daughter, sending texts, calling or visiting (when they’re not high, just maintaining) to let them know that they are always loved, you are in their corner and will be there as soon as they decide to go for treatment.  Leave them with specific encouragement such as “You fought hard to make the honor roll freshman year, I know that fight and strong will is still there.  I can’t wait to see you fighting again!”  Or perhaps “You always have the ability to warm a room with your eyes when you smile, I just wanted to be in the presence of that again, even for five minutes.”  These statements are more powerful than we know.

An invitation to coffee, breakfast or for pizza is suggested.  If your Loved One appears high, cancel the plans – remove the reward: no pizza, no you.  If they seem lucid, reward them with pizza, you, and loving encouraging conversation that doesn’t approach their use or their current circumstances.  Keep the conversation light and loving.

Loved Ones in active use will have times (dips and wishes) with moments of clarity, even if brief.  Reminding them of happier days, vacations, holidays etc. will sometimes flood their memory and make them long for days before they were in the grip of this disease.  Their lucid moments may pass without our knowing or often don’t happen when we are present. If they happen in your presence, you’ll know them by statements that sound like a wish or a dip.

Planting seeds of love and hope will not go unnoticed.  Show up and reach out when they are not high, protect and care for yourself when there are signs that they are using.

Always have a researched list ready of suggested detox and treatment centers with their phone numbers.  This comes in handy when a Loved One has a moment of clarity and mentions wanting a different life.  It is then we can present the list, this is an effective, soft intervention. Don’t push your agenda.  Wait for these moments of motivation to open up and be ready.

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CRAFT has helped me maintain calm and sanity in the midst of great turmoil and trials as much as in my mundane daily life.  I hope these scenarios are relatable and helpful for you as well.

More on this topic can be found on Allies in Recovery and in our podcast conversation on Coming Up for Air!

Still learning,

Annie

Author of Unhooked

 

Expert Description of CRAFT: 

CRAFT was designed for Loved Ones struggling with addiction who are resistant to stopping or to getting treatment help.  CRAFT is based on the belief that family members can play a powerful role in helping to engage the Loved One who is in denial to submit to treatment. CRAFT is designed to teach families how to communicate effectively and how to behave around someone who is actively using drugs or alcohol. Learning these skills not only engages 70% of Loved Ones to enter treatment but helps a family member lower depression, anger and anxiety around the situation. It cleans up the mixed messages, the anger, and the frustration, by using positive reinforcement and steers clear of any confrontation. Family members know their Loved One best.  In addition to teaching families how to intervene, by applying the skills of CRAFT, families decrease the stress in the relationship and provide a way forward towards recovery.”  Dominique Simon-Levine, Ph.D.

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*Rewards don’t have to mean $500 in cash, cleaning up after anyone or buying them a new car.  Rewards can include family activities, outings, special dinners, praise and encouragement, a pat on the back, or a face that is lit up at seeing them (non-using) etc.  Additionally, buying a gym membership, signing up for a 5k together, or a canoeing adventure are great rewards if they like these things.  Other suggestions if you are rewarding them might be helping clean up the room or car, or looking into a reward debit card, such as Integrity Care Card which is geared toward rewarding family members working hard on recovery.

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