The Community Reinforcement Approach to the Treatment of Substance Use Disorders

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Abstract
Empirical support is presented for the Community Reinforcement Approach (CRA), a broad‐spectrum cognitive‐behavioral treatment for substance use disorders. At the core of CRA is the belief that an individual's environment can play a powerful role in encouraging or discouraging drinking and drug use. Consequently, it attempts to rearrange contingencies so that sober behavior is more rewarding than substance‐abusing behavior. Originally tested in the early 1970s with a small sample of alcohol‐dependent inpatients, it has repeatedly proven to be successful over the years with larger, diverse populations. Empirical backing is also presented for a new variant of CRA that works through family members to engage treatment‐resistant individuals into substance abuse treatment.