COMMUNITY REINFORCEMENT
The community reinforcement approach (CRA) is based on the theory that environmental reinforcers for substance use perpetuate substance use disorders and that, at the same time, patients with substance use disorders lack positive environmental reinforcers for sober activities and pleasures. CRA aims to provide individuals with substance use disorders with natural alternative reinforcers by rewarding their involvement in the family and social community; thus, family members or peers play a role in reinforcing behaviors that demonstrate or facilitate abstinence. In CRA, emphasis is placed on improving environmental contingencies for
activities of a sober lifestyle to make that type of lifestyle preferable to a substance-dependent
lifestyle. In addition to individual behavioral treatment and contingency management, the multifaceted CRA treatment package typically includes conjoint marital therapy, training in finding a job, counseling on substance-free social and recreational activities, and a substance free social club. CRA is often applied with contingency management incentives (e.g., vouchers for recreation or food) that are used to reward evidence of sober behavior. CRA has been shown to be effective in treating alcohol dependence, with adjunctive disulfiram treatment increasing its effectiveness. CRA can be clinic or office based, but it is largely practiced in residential or partial hospitalization programs, therapeutic communities, and community residential facilities.
Substance use disorders and recovery are so widespread in Los Angeles and Orange County, more resources and activities are needed to provide for a growing need.
If you have questions whether you or a loved one has a problem with drug use or alcohol use or if you believe you or a loved one may be an addict please click here.
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