The Adolescent Community Reinforcement Approach (A-CRA) is a developmentally-appropriate behavioral treatment for youth and young adults ages 12 to 24 years old with substance use disorders.
A scientifically-supported substance use disorder (SUD) treatment called the Adolescent Community Reinforcement Approach (ACRA). The adult CRA program repeatedly ranks as one of the top five alcohol treatments across various reviews that examine 30-50 different treatments. This cognitive-behavioral treatment has proven successful with populations that are ethnically-diverse, and across a wide range of ages and SES groups. It has proven effective with both inpatients and outpatients, as well as with severely alcohol-dependent individuals and dually-diagnosed clients.
CRA is based on the belief that one’s environment plays a major role in determining whether an individual will use alcohol or illicit drugs. It teaches individuals how to examine the triggers and the consequences (positive and negative) for drug use, and to then re-arrange their lives so that clean, sober behavior is more rewarding than is using alcohol/drugs. Strategies that increase the likelihood that sober behavior will be supported are taught, and skills deficits are addressed in the process (e.g., problem-solving, drug-refusal, communication).
The important role of an adolescent’s caregiver is acknowledged, and special sessions are introduced to teach some of these same basic skills, as well as overall parenting strategies, to the caregivers.
The adolescent version (ACRA) has been proven effective with marijuana-using adolescents. A relative cost effectiveness of the CYT was examined by (Dennis et al., 2004). The findings showed that both across and within sites, ACRA economically dominated MET/CBT5 and MDFT.
Welsh JW, Passetti LL, FunkRR, Smith JE, Meyers RJ & Godley MD (2019).
Treatment retention andoutcomes with the adolescent community reinforcement approach in emergingadults with opioid use.
Journal of Psychoactive Drugs, 51(5), 431-440.
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Godley, M. D., Passetti, L.L., Subramaniam, G. A., Funk, R. R., Smith, J. E., & Meyers, R. J. (2017).
Adolescent Community Reinforcement Approach implementation and treatment outcomes for youth with opioid problem use.
Drug and alcohol dependence, 174,9–16.
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Slesnick, N., Prestopnik, J.L., Meyers, R.J. & Glassman, M. (2007)
Treatment Outcome for Street-living, Homeless Youth.
Addictive Behaviors,32, 1237-1251.
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Slesnick, N., Meyers, R.J., Meade, M. & Segelken, D. S. (2000).
Bleak and hopeless no more: Engagement of reluctant substance abusing runaway youth and their families.
Journal of Substance Abuse Treatment, 19, 215-222.
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Diamond, G., Godley, S.H., Liddle, H., Webb, C., Sampl, S., Tims, F.,Meyers, R. (2002).
Five outpatient models for adolescent marijuana use: A description of the Cannabis Youth Treatment interventions.
Addiction, 97, 69-82.
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Campos-Melady, M., Smith, J. E., Meyers, R. J.,Godley, S. H., & Godley, M. D. (2017/02//).
The effect of therapists’ adherence and competence in delivering the adolescent community reinforcement approach on client outcomes.
Psychology of Addictive Behaviors, 31(1),117-129.
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Garner BR, Hunter SB, Slaughter ME, Han B &Godley SH (2017).
Factors associated with an evidence-based measure of implementation for the adolescent community reinforcement approach.
Drug &Alcohol Dependence, 180, 144-150.
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Kirby, K. C., Versek, B., Kerwin, M. E., Meyers,K., Benishek, L. A., Bresani, E., . . . Meyers, R. J. (2015/05//).
Developing community reinforcement and family training (CRAFT) for parents of treatment-resistant adolescents.
Journal of Child & Adolescent Substance Abuse, 24(3), 155-165.
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Susan H. Godley, Jane Ellen Smith, Robert J. Meyers, and Mark D. Godley (2016).
The Adolescent Community Reinforcement Approach: A Clinical Guide for Treating Substance Use Disorders.
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The Community Reinforcement and Family Training (CRAFT) intervention is a research-supported treatment designed to help family members to engage treatment-refusing substance abusers into treatment.
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The Community Reinforcement Approach (CRA) is a comprehensive behavioral program for treating substance-abuse problems. It is based on the belief that environmental contingencies can play a powerful role in encouraging or discouraging drinking or drug use.
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