Title of Program: The Adolescent Community Reinforcement Approach
Target Audience: Counselors, social workers, psychologists, nurses, addiction specialists, mental health workers.
Total Instructional Hours 13 hours
9:00 – 4:30 each day (allows for a 15 min. break each morning and afternoon, and a 1 hr. lunch break each day)
Methodology: Lecture, powerpoint presentation, case presentations, small group exercises, handouts, discussions.
Content Description: This 2-day workshop is designed to teach therapists to be able to use a scientifically-supported substance abuse 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. The adolescent version (ACRA) has recently proven effective with marijuana-abusing 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. 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. As such, 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.
Learning Objectives: At the conclusion of the 2-day workshop each participant should:
· Understand the theory and rationale for the Adolescent Community Reinforcement Approach (ACRA), which is based upon the adult version; CRA. Content includes overview of CRA’s research-base and meta-analysis standings, and its underlying cognitive-behavioral principles.
· Know methods for increasing the chance that an ambivalent substance abuser will commit to treatment and work toward behavior change. Content includes learning to identify and use a client’s reinforcers (reward system) in a way that motivates change; using basic CRA motivational techniques (e.g., involving the client in goal-setting, introducing sobriety sampling, praising small steps, avoiding confrontation).
· Know how and when to use the CRA assessment and treatment plan materials. Content includes CRA Functional Analyses (for both drinking and pro-social behaviors), a Happiness Scale, and a Goals of Counseling plan.
· Know how and when to use CRA behavioral skills training. Content includes problem-solving procedures, communication training, drink/drug refusal, social-recreational counseling, and relapse prevention procedures.
· Understand how and when to introduce specialized CRA techniques. Content includes CRA’s job-finding program, anger management, and Antabuse monitoring.
· Know how and when to involve the adolescents’ caregivers in treatment.
Selected Peer Reviewed References:
1. 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.
2. Brewer, C., Meyers, R. J., & Johnsen, J. (2001). Does disulfiram help to prevent relapse in alcohol
abuse? CNS Drugs Vol. 14, 329-341.
3. Smith, J.E. Meyers, R.J. & Miller, W.R. (2001). The community reinforcement approach to the treatment of substance use disorders. The American Journal of Addictions, 10, (Suppl.): 51-59.
4. Meyers, R.J. Miller, W.R. (2001). A Community Reinforcement approach to the treatment of addiction.
5. 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.
6. Meyers, R.J., Apodaca, T.R., Flicker, S.M., & Slesnick, N., (2002). Evidence-Based approaches for the Treatment of Substance Abusers by Involving Family Members. The Family Journal: Counseling and Therapy for Couples and Families, Vol.10, No. 3, July 2002, 281-288.
7. Meyers, R. J., Miller, W. R., Smith, J.E., & Tonigan, J.S., (2002). A randomized trial of two methods for engaging treatment-refusing drug users through concerned significant others. Journal of Consulting and Clinical Psychology Vol .70, No. 5, 1182-1185.
8. Meyers, R.J., Smith, J.E., & Lash, D. (2003).
The Community Reinforcement Approach. In (Eds.) M. Galanter.
Recent Developments in Alcoholism: Research on Alcoholism Vol. XVI.
9. Meyers, R. J. & Wolfe, B.L. (2004). Alternatives
to nagging, pleading and threatening: Help for you and your problem
drinker. Hazelden Publications,
10. Smith, J.E. & Meyers, R.J. (in press). Community
Reinforcement and Family Training: A Counselors Guide to Treatment Engagement.
11.
12. Smith, J.E.,
13.
Pinsky, D., Seppala, M.D., Meyers,
R.J., Gardin, J, White, W.L., & Brown, S. (2004).
When painkillers become dangerous: What everyone needs to know about oxycontin and other prescription drugs? Hazelden Publishing &
Educational Services,
14. Smith, J. E., Meyers, R. J., & Miller, W. R. (2004). Take the network into treatment. Drug and Alcohol Findings, 10, 4-7.
15. Wolfe, B.L., & Meyers, R.J. (2004) Community Reinforcement and Family Training: Getting Loved Ones Sober. The Counselor Publication of the National Association of Alcoholism and Drug Abuse Counselors, Vol. 5, No. 3, 57-60.
16. Smith, J. E., Meyers, R. J., & Miller, W. R. (2004). Take the network into treatment. Drug and Alcohol Findings, 10, 4-7.
17.
Meyers, R.J., & Gardin,
J. (2004). Empirically supported substance abuse treatment:
The community reinforcement approach. (Available
through
18.
Scruggs, S.M., Meyers, R.J., & Kayo,
R. (2005): "Community Reinforcement and Family Training, Support and
Prevention (CRAFT-SP),"
19. Meyers, R.J., Smith, J.E., & Lash, D.N. (2005): "A Program for Engaging Treatment-Refusing Substance Abuser into Treatment: CRAFT", International Journal of Behavioral and Consultation Therapy, Volume 1, No. 2, Spring.
20. Meyers, R.J., Villanueva, M., & Smith, J.E. (2005). The Community Reinforcement Approach: History and Empirical Justification. Journal of Cognitive Psychotherapy: An International Quarterly, Volume 19, Number 3, Fall
21. Meyers, R. J., Austin, J. L., & Smith, J. E. (2006): "Enlisting Family Members to Address Treatment Refusal in Substance Abusers," Psychiatric Times, 23, 31-34.
22.
Meyers, R.J. & Wolfe, B.L. (2006):
"Rakkaasta Raitis: Vaihtoehtoja nalkuttamiselle, anelulle ja
uhkailulle [Get Your Loved One Sober: Alternatives to
nagging, pleading, and threatening]'" Kustantaja
Suomessa Myllyhoitoyhdistys
ry. (
23. Slesnick, N., Prestopnik, J.L., Meyers, R.J. & Glassman, M. (2007): "Treatment Outcome for Street-living, Homeless Youth," Addictive Behaviors, 32, 1237-1251.
24.
Meyers, R.J. & Smith, J.E.
(2007): "CRA-Manual zur Behandlung von Alkoholabhangigkeit
[Clinical Guide to Alcohol Treatment: The Community Reinforcement
Approach]." Psychiatrie-Verlag,
25. Meyers, R.J. & Gardin, J. (2007): "How to Engage the Treatment Resistant Substance Abuser," Spotlight on Recovery Spring Issue, Part 1, Issue 12.
The Presenter:
Robert J. Meyers, Ph.D., is a Research Associate Professor at the
Other presenters may include Dr. Jane Ellen Smith, Dr. John Gardin, Brian Serna, MA, Karen Mertig, MA, Vicki McGinley, MA, Dr, Hendrik Roozen, and Greg Purvis, MA.
See www.robertjmeyersphd.com for further information of these presenters.
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An additional ½ day can be
added to train supervisors on how to use the A-CRA checklist system and how to
supervise therapist using ACRA.
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Testimonials regarding ACRA
I am a true believer in this
approach and not only live the ACRA lifestyle, but “preach” it all the time,
even when I’m not at work. It has so many practical applications in everyday
life. I’m using the problem solving skills and communication skills, the daily
reminder to be nice…functional analysis in all my sessions, including those
that are not ACRA related. This is the best training I have received in my
years in mental health and its not a methodology that you put on a shelf and
pull out when you need
it. I even use problem solving skills with my family and my son’s sports teams;
the brainstorming ideas are fun, especially when you’re in the 10, 11, 12 age
group.
Master's Level Therapist
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The substance of the ACRA
training has added value to the clinical structure of my agency as a whole, by
providing a way to define and organize clinical interventions and facilitating
clinical communication.
There is an added benefit to
the ACRA model in its time-limited curriculum-oriented format which I think can
do much to lower the barrier of treatment acceptance by non-Western
populations. This is a problem that has
troubled the addiction treatment field for a long time.
Brandon Nguyen, LCSW
Asian American Recovery
Services Inc.
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Since ACRA was adapted from
the CRA model that Bob had spent so many years developing, refining, and
documenting, it was very important for us to work with him and Jane Ellen Smith
on the manual and in its implementation during the Cannabis Youth Treatment
(CYT) study. Bob brings to the training situation a wealth of experience and
knowledge as a therapist, supervisor, researcher, and trainer. We highly
recommend Bob as an ACRA trainer and regularly refer others to him for this
training. ACRA, CRA and CRAFT are interventions that are well supported in the
literature and Bob Meyers is the top trainer in these models.
Susan Harrington Godley, Rh.D.
Senior Research Scientist
Chestnut Health Systems
West Chestnut