What is the CRAFT Model?
According to a recent MinnPost article, Hazelden is now promoting the CRAFT model to help families address SUD concerns in loved ones. CRAFT stands for Community Reinforcement and Family Training.
As noted in the article:
CRAFT helps family members build skills that move beyond terms like “enabling” and “tough love”, instead helping them learn to help their loved one without confrontation, detachment or having to choose between impossible extremes.1
By the way, this is the model many of us in the field advocate for our clients and friends to use as a much more successful and humane approach than Al-Anon
This is in contrast to, and a shift from, the Al-Anon model, which is considered:
…. a more confrontational model, where families are encouraged to ‘detach with love,’ so that the alcoholic can learn from their own mistakes.1
This is the approach advocated by the traditional treatment community and counselors.
Engage or Not Engage? Hazelden now says ENAGAE
CRAFT and Al-Anon are two completely different approaches that cause a huge amount of divisiveness in families, friends and advisors. In our work with families, we almost always have to start with the Al-Anon folks who want to do nothing and wait for their LO to “hit bottom”. We’ve learned the hard way that the do nothing approach comes with far too much risk.
Now that we have a recognized national leader advocating for use of the evidenced based CRAFT model, we should be able to end the debate about how to effectively engage families and addicts, which wastes a lot of time and energy and often subverts recovery.
Why the shift? CRAFT IS EVIDENCE BASED
The head of Hazelden, Dr. Joe Lee, said “…the CRAFT approach is evidence-based and backed by research studies that show a high rate of success in getting people to voluntarily enter addiction treatment while maintaining strong family ties.“ The science says that family members don’t have to stand on the sidelines,” Lee said. “Instead of just saying, ‘I didn’t cause it,’ dealing with the stigma or learning to say, ‘This is a medical condition,’ with CRAFT, family members learn actual skills that can influence a bunch of different outcomes for their loved ones.”1
In contrast, there is no credible evidence that Al-Anon is successful. In fact, Al-Anon is part of the predominate treatment approach with outcomes around 16%.2 It came into being over seventy years ago, heavily influenced by AA co-founder Bill Wilson’s desire to drink without consequences from his wife. Al-Anon has not changed since. (You still watching TV on a black and white with three channels?)
CRAFT Encourages Small Changes
A Hazelden Family Program CRAFT trained therapist says:
More traditional approaches can promote detachment or ultimatums,” she said. “CRAFT takes more of a, ‘Let’s lean into the relationship,’ approach. It encourages small, incremental growth and changes even if it is not fully what we’re hoping to see. How can we encourage our loved one to make small changes in a more healthy direction?”1
Hard to believe this change of heart after all these years of Hazelden telling family members they have no power to influence their loved one’s addiction and we had to recover on our own.
The Beginning of a New National Standard for Family Support and Education
Dr Lee “…hopes that this move will spur a collaborative evolution across the national addiction treatment community, one that creates a new standard for family support and education.” 1
Welcome to the Treatment Reform Movement!!
WHAT CAN WE DO TO SUPPORT THE REFORM MOVEMENT?
1. Spread the word that the “leader” in addiction treatment is promoting the CRAFT model – interactive support and encouragement for loved ones
2. Make Evidence based practices the topic of conversation.
Focus the discussion on science, when your Auntie Al-Anon starts promoting tough love and letting go (CRAFT is evidence-based, Al-Anon is not).
3. Use the Article Contents to Promote Dialogue
The quotes in the article are more than enough to support using the CRAFT or other similar models for helping families.
For all of us who know that Al-Anon is a recipe for failure and heart ache, let’s celebrate a new era for all of us facing SUD in our lives.
5. Take a minute; Bitter Wins – Hard Rains
For those of us who have lost loved ones or experienced unnecessary conflict and hardship due to advice from Hazelden, interventionists, self-appointed experts and counselors to practice the “Al-Anon principles”, this is a moment tinged with bitter memories of trying to fight this prevailing advice that we knew was wrong.
1“Hazelden Betty Ford ‘evolves,’ encouraging skills-based approach to a family support”. MinnPost. Andy Steiner. October 17, 2022. https://www.minnpost.com/mental-health-addiction/2022/10/hazelden-betty-ford-evolves-encouraging-skills-based-approach-to-family-support/
2 “Experts Say We Have the Tools to Fight Addiction. So Why Are More Americans Overdosing Than Ever?” New York Times Opinion. Jeneen Interlandi. June 24, 2022. https://www.nytimes.com/2022/06/24/opinion/addiction-overdose-mental-health.html