Community Reinforcement Approach (CRA) (EN)

Ever heard of the Community Reinforcement Approach?

A broad variety of methods and interventions may be applied in the treatment of addiction disorders. As early as 1973 Nathan Azrin and George Hunt developed one specific method called Community Reinforcement Approach (CRA). It is a combination of community programs, social skill training, couples therapy and motivational therapy and many more. CRA aims to positively reinforce from within the social life of the client. The client’s behavior between consumption and sobriety is documented and analyzed to stabilize non-drinking behavior during dry periods. Growing and keeping the happiness in different life categories becomes more important than the positive reinforcement through consumption.

In Germany it is primarily the Verein für gemeindeorientierte Psychotherapie e.V. (VGP) in Bielefeld that tries to promote the CRA manual. The VGP’s CRA trainers, educating other professionals to become CRA counselors and supervisors, are mainly employees of the Klinik für Psychiatrie und Psychotherapie Bethel in the Evangelisches Krankenhaus Bielefeld (EVKB).

Internationally and originally Robert J. Meyers und Jane Ellen Smith wrote the Clinical Guide to Alcohol Treatment – The Community Reinforcement Approach in 1995, explaining the CRA application in practice. Since then their work has found great acceptance around the globe, especially in English speaking countries. Their body of knowledge has also been translated into many other languages. The German version called CRA-Maual zur Behandlung von Alkoholabhängigkeit – Erfolgreicher behandeln durch positive Verstärkung im sozialen Bereich was translated by Wolfgang Lange, Stephanie Kunz and Martin Reker.

In cooperation with the VGP and the EVKB we were abled to identify the requirements for an internet based therapy tool supporting the Community Reinforcement Approach in an out patient setting. After two years of development RADIUS closes this very gap and has been being used within the EVKB since autumn 2015.