What is the Community Reinforcement Approach (CRA)?

Are you familiar with the Community Reinforcement Approach?

Various methods are used in the treatment of addiction disorders. Many studies on the effectiveness of these concepts have shown that community programs, social skills training, couples therapy, and motivational therapies are particularly effective. In 1973, Nathan Azrin and George Hunt developed the Community Reinforcement Approach (CRA) at the intersection of these interventions.

CRA combines many individual methods, with a particular focus on positive reinforcement from the client’s social environment. By analyzing behavior between consumption and abstinence, documented in an abstinence account, abstinence-promoting behaviors are stabilized during dry phases. Increasing and maintaining satisfaction in certain areas of life becomes more important than positive reinforcement from consumption.

In the German-speaking world, the Association for Community-Oriented Psychotherapy (VGP) in Bielefeld is mainly responsible for the implementation and dissemination of this psychotherapeutic treatment concept. The trainers at the association, who train CRA counselors and supervisors, are partly employees of the Department of Psychiatry and Psychotherapy at the Bethel Evangelical Hospital in Bielefeld (EVKB).

In 1995, Robert J. Meyers and Jane Ellen Smith published the Clinical Guide to Alcohol Treatment – The Community Reinforcement Approach, which describes its use in practice. Since then, it has been adopted worldwide, especially in English-speaking countries, and translated into several languages. The German version, CRA-Manual zur Behandlung von Alkoholabhängigkeit – Erfolgreicher behandeln durch positive Verstärkung im sozialen Bereich by Wolfgang Lange, Stephanie Kunz, and Martin Reker, was published by the Psychiatry Press.

Together with the VGP and the EVKB, the exact need for an internet-based therapy program based on the Community Reinforcement Approach for post-inpatient treatment was identified. After two years of development, RADIUS now meets this need and has been in use at the EVKB since autumn 2015.