By Robert J. Meyers, William R. Miller
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Extra info for A Community Reinforcement Approach to Addiction Treatment
Use of the CRA treatment plan is similar to the functional analysis inasmuch as it is referred to and modiﬁed throughout treatment. Not only do clients’ goals change as therapy progresses, but the strategies available to them for achieving the goals diversify as clients acquire behavioral skills. Behavioral skills training An essential component of the CRA program involves identifying behavioral skill deﬁcits, and then providing training to improve those skills. The particular deﬁcits are uncovered in a variety of ways.
Although it was possible that these outpatient clients would be less severely aﬀected by alcohol problems, it was also a concern that implementing the procedures outside of the structured, contained hospital environment would lead to a 1982: Testing the importance of disulﬁram as a CRA component 21 lack of participation and treatment compliance. The clients would be expected to face the challenge of confronting their alcohol problems while continuing to live in an old environment that was probably conducive to alcohol abuse.
As far as identifying the long-term positive consequences for the nondrinking behavior, the same categories are presented as for the drinking chart. In this situation we take note of the client’s reinforcers, so that they can be incorporated in subsequent sessions and presented as reasons to pursue a healthier lifestyle. So assume the client reports that both interpersonal and emotional beneﬁts are associated with having dinner at his brother’s house. We do not shy away from suggesting other possible reinforcing aspects of the behavior, since activities that are seen as rewarding in many diﬀerent areas of the client’s life will probably be good candidates for behaviors that compete with drinking.