Robert J Meyers- Ph.D,
- Research Associate at University of New Mexico
Robert J Meyers
- Ph.D,
- Research Associate at University of New Mexico
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86
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Introduction
Skills and Expertise
Current institution
Publications
Publications (86)
Treatment retention and engagement of emerging adults with opioid use disorders can be particularly challenging. This study compares treatment outcomes of young adults with primary opioid use (OU) to those with primary marijuana or alcohol use (MAU), who received the Adolescent Community Reinforcement Approach (A-CRA), an evidence-based therapy for...
Community Reinforcement and Family Training (CRAFT) assists family members with a treatment-resistant loved one. The most consistent outcome of CRAFT is increased treatment entry of the identified treatment-resistant person (IP). This led us to question whether all 6 components of CRAFT are necessary. In a randomized clinical trial, 115 concerned s...
Background:
This paper compares adolescents with primary opioid problem use (OPU) to those with primary marijuana or alcohol problem use (MAPU) who received up to six months of Adolescent Community Reinforcement Approach (A-CRA), an empirically supported treatment.
Methods:
Intake clinical characteristics, treatment implementation measures, and...
Central to the debate over the implementation of empirically supported treatments is whether therapist skill has a measurable, positive relationship with client outcome. The fidelity and skill with which therapists deliver treatments have been studied under the constructs of adherence and competence. Evidence for a relationship between adherence an...
A unique collaboration with The Cadence Online Company, Treatment Research Institute & Dr. Robert J. Meyers has developed a unique program for family of adolescent substance users. Follow link below.
Parent CRAFT is a research-supported online course that teaches parents how to effectively interact with their children in order to change drug and al...
We describe a project focused on training parents to facilitate their treatment-resistant adolescent's treatment entry and to manage their child after entry into community-based treatment. Controlled studies show that Community Reinforcement and Family Training (CRAFT) is a unilateral treatment that fosters treatment entry of adults; however, there...
The Community Reinforcement Approach (CRA) is a behavioral treatment for substance abuse problems which is based on the belief that a nondrinking and nonusing lifestyle must be accessible and experienced as rewarding in order for individuals to choose it routinely over substance use. As part of CRA, the client’s “community” (e.g., family, friends,...
Diagnostiek door middel van een functieanalyse van het alcohol- en/of druggebruik van de IP is een belangrijk onderdeel van CRAFT. Dit omdat CSO’s vaak veel informatie hebben over het gebruik en de bijbehorende gedragspatronen van de IP. De CSO kan daarnaast informatie geven over emotionele en fysieke aspecten van het gebruiksgedrag, zoals hoe het...
Uit onderzoek blijkt dat vaak pas vele jaren na de eerste tekenen van problematisch alcohol- en druggebruik er een formele behandeling wordt gezocht.20, 21 Dit is zorgelijk, want gebruikers die in een vroeg stadium van een verslaving in behandeling gaan, hebben doorgaans meer kans op goede resultaten. Gelukkig groeit het bewustzijn dat familieleden...
Uit de literatuur blijkt dat er een sterke relatie is tussen de verschillende verslavende middelen (zoals alcohol) en agressie.15 Het blijkt dat individuen onder invloed van alcohol en/of drugs gemakkelijker impulsieve beslissingen nemen en sneller ongewenst gedrag laten zien dat normaal gesproken niet voorkomt. Alcohol speelt in veel gevallen een...
Een verslaving kan negatieve gevolgen hebben voor CSOs omdat zij zich vaak schamen voor het alcohol- en/of druggebruik van de IP, zich schuldig voelen, of kampen met angst- en depressie klachten. Ook kunnen CSOs zich afgewezen voelen of op onbegrip stuiten vanuit hun omgeving. Voorts kunnen CSOs – omdat zij bezorgd zijn – de noodzaak voelen om thui...
CSO’s kunnen aan de hand van deze procedure worden uitgenodigd om te werken aan vaardigheden waarmee ze hun communicatie met de IP kunnen verbeteren. Een belangrijke rationale is dat positieve en constructieve communicatie de kans vergroot om persoonlijke doelen te bereiken. Goed communiceren zorgt ervoor dat de boodschap, zoals de spreker die bedo...
Deze CRAFT-sessie begint met een kennismaking en introductie. Vervolgens wordt er een overzicht gegeven van de training qua inhoud en doelstellingen. Naast de bespreking van de theorie en de uitgangspunten van CRAFT is het inventariseren van de prioriteiten van de Concerned Significant Other (CSO) een belangrijk onderdeel. Dit om het CRAFT-programm...
Deze optionele CRAFT-procedure Terugvalmanagement is tweeledig. Enerzijds richt deze procedure zich op de CSO om gedurende het proces te leren van de vergissingen en fouten, en ingezette veranderingen te verduurzamen. Anderzijds gaat deze procedure er vanuit dat de CSO op een constructieve en actieve manier de IP kan bijstaan om in behandeling te b...
Veel families raken verstrikt in het middelengebruik van de IP en de negatieve gevolgen ervan. Doordat in veel gevallen verantwoordelijkheden worden overgenomen, ontstaat er een situatie die wordt gekenmerkt door een negatieve, neerwaartse spiraal. Zo kan het effect hebben op tal van leefgebieden. Deze CRAFT-interventie beoogt om de eigen verantwoo...
This study examined the relationship between Adolescent Community Reinforcement Approach (A-CRA)
participation with treatment engagement, retention, and satisfaction, and with substance use and emotional
problem outcomes. Participants had substance use disorders (SUD) only or co-occurring substance use and
psychiatric problems. Those with co-occurr...
Many individuals with substance use disorders are resistant to entering formal treatment, despite the negative consequences that plague their own lives and the lives of concerned significant others (CSOs). Community Reinforcement and Family Training (CRAFT) has been developed as an effective strategy for helping family members who are concerned abo...
Background:
There is a growing awareness that the treatment of patients with substance use disorders (SUDs) should target increasing patients' involvement in alternative pleasant reinforcers that compete with the reinforcing effects of substance use. The present cross-sectional study sought to identify factors that promote or impede engaging in pl...
This study examined the relationship between Adolescent Community Reinforcement Approach (A-CRA) participation with treatment engagement, retention, and satisfaction, and with substance use and emotional problem outcomes. Participants had substance use disorders (SUD) only or co-occurring substance use and psychiatric problems. Those with co-occurr...
Substance use disorders (SUDs) have a serious impact on several life areas, including family functioning. This study examined problem areas that patients with SUDs and their family members experience in terms of quality of relations, psychological problems, physical distress, and quality of life. A sample of 32 dyads--persons with SUDs and a family...
In a randomized clinical pilot study, 40 concerned significant others (CSOs) of treatment-refusing alcohol- and drug-using individuals were randomized to either Community Reinforcement and Family Training (CRAFT) conducted in a group format (Group CRAFT) or a Self-Directed CRAFT condition. Although results indicated no significant between-group dif...
[Clin Psychol Sci Prac 18: 67–83, 2011]
Multiple evidence-based treatments for adolescents with substance use disorders are available; however, the diffusion of these treatments in practice remains minimal. A dissemination and implementation model incorporating research-based training components for simultaneous implementation across 33 dispersed s...
The Community Reinforcement Approach (CRA), originally developed for individuals with alcohol use disorders, has been successfully employed to treat a variety of substance use disorders for more than 35 years. Based on operant conditioning, CRA helps people rearrange their lifestyles so that healthy, drug-free living becomes rewarding and thereby c...
This paper describes the development of a new 139-item behavioral questionnaire (PAL) assessing the frequency and enjoyability of pleasant activities occurring in the natural environment of patients with substance use disorders. The sample consisted of 265 patients with mainly substance use disorders and 272 healthy controls. Group comparisons indi...
The Community Reinforcement Approach (CRA), originally developed for individuals with alcohol use disorders, has been successfully employed to treat a variety of substance use disorders for more than 35 years. Based on operant conditioning, CRA helps people rearrange their lifestyles so that healthy, drugfree living becomes rewarding and thereby co...
A hallmark of the Community Reinforcement Approach (CRA) is its emphasis on getting individuals to increase their engagement in healthy old and new rewarding activities that can compete with substance use. The personality dimension extraversion seems to be an important mechanism underlying activity engagement. A median split classified 265 patients...
The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are two empirically-supported behavioral substance abuse programs. Whereas CRA is a treatment for the substance abuser, CRAFT is an intervention for the concerned family members or friends of treatment-refusing individuals with alcohol or drug problem...
Community Reinforcement and Family Training (CRAFT) is a cognitive-behavioral program designed to get treatment-refusing substance-abusing individuals to enter treatment by teaching family members how to support a clean/sober lifestyle. Additionally, CRAFT teaches family members how to improve their own lives, regardless of whether their loved one...
Substance use disorders are associated with life-threatening behaviours and substance use is found to strongly trigger criminal behaviour, including intimate partner violence (IPV). Although intimate partners are often subject to aggression and injury, most substance-using offenders refuse to enter formal treatments. Community reinforcement and fam...
Community Reinforcement and Family Training (CRAFT) is an empirically-supported program based on behavioral reinforcement that engages treatment-refusing alcohol-other drug abusers into treatment by working with their concerned family members. These concerned significant others (CSOs) are taught how to rearrange contingencies in the drinker's envir...
In de meeste behandelprogramma’s voor verslaving aan alcohol of drugs is tegenwoordig een training gedragsvaardigheden opgenomen.
Voorbeelden hiervan zijn te vinden bij alcoholverslaving (Monti, Abrams, Kadden & Cooney, 1989), cannabisverslaving (Hawkins,
Catalano, Gillmore & Wells, 1989), en cocaïneverslaving (Childress et al., 1993). Bij de behan...
CRA is veel meer dan een verzameling therapeutische interventies. Het is vooral ook een attitude en een filosofie over het
bijstaan van cliënten bij het verwezenlijken van blijvende gedragsveranderingen. Veel hulpverleners worden in het begin echter
nog al eens afgeleid door de vele mogelijkheden en geïntegreerde gedragstechnieken die CRA biedt. Al...
De relatie met de partner is vaak aangetast door het excessief gebruik van alcohol, en als gevolg daarvan disfunctioneel.
Meestal is er sprake van één van de volgende twee scenario’s. De partner maakt ruzie met de alcoholgebruiker over het excessieve
alcoholgebruik, óf de partner begint zich terug te trekken waarbij hij/zij steeds minder gaat commu...
CRA leert cliënten hun leefomgeving beter in te richten, zodat een gezonde en minder door alcohol gedomineerde levensstijl
tot stand kan komen. Voor sommige cliënten betekent dit dat er disulfiram wordt toegevoegd aan de behandeling. Disulfiram1 is een medicament dat het gebruik van alcohol tegengaat. Als de medicatie wordt ingenomen zoals voorgesc...
Tegenwoordig bevatten vrijwel alle behandelprogramma’s die gericht zijn op de behandeling van alcohol- en drugsmisbruik een
onderdeel dat specifiek gericht is op het voorkomen van terugval.1 De terugvalpreventie binnen CRA begint al bij de eerste sessie en is een continu proces. De functieanalyse is reeds geïntroduceerd
als een instrument dat trigg...
Op het moment dat u een behandelplan gaat samenstellen, moet u reeds bekend zijn met de informatie uit het assessment van
de cliënt, de functieanalyse hebben afgerond, de Sobriety Sampling-procedure hebben uitgevoerd en, indien van toepassing, de disulfiramoptie hebben gepresenteerd. Door deze voorbereiding kunt
u een behandelplan opstellen, waarbi...
Sobriety Sampling is een procedure die CRA onderscheidt van de meeste andere alcoholbehandelingen. Het gaat uit van de veronderstelling dat
een cliënt langer in behandeling blijft wanneer hij niet wordt overladen met strenge regels en te hoge verwachtingen. Meer
specifiek motiveert Sobriety Sampling de cliënt om abstinent te blijven tijdens een voo...
CRA beoogt het ongewenste drinkgedrag van de cliënt te vervangen door alternatief gedrag en meer aangepaste copingstrategieën.
Dit hoofdstuk geeft een overzicht van een aantal technieken dat door CRA-hulpverleners gebruikt wordt om dit doel te bereiken.
Meestal worden deze technieken gebruikt in combinatie met reeds eerder besproken procedures, zoa...
Een belangrijk onderdeel van CRA is het assisteren van de cliënt bij het ontwikkelen van een bevredigend scala aan sociale
en recreatieve activiteiten, die meer bekrachtigend zijn dan het gebruik van alcohol. Als cliënten voor het eerst om hulp
vragen zijn ze vaak verstrikt geraakt in een ‘drinkcultuur’ waarbij vriendschappen en recreatieve activit...
De assessment die verricht wordt in het kader van CRA bestaat uit drie onderdelen: het identificeren en versterken van de motivatie voor verandering, het verzamelen van achtergrondinformatie en informatie over middelengebruik, en het uitvoeren van de CRA-functieanalyse. De informatie die in dit beginstadium verkregen wordt, zal in vervolgsessies wo...
De Community Reinforcement Approach (CRA) is een in de Verenigde Staten ontwikkelde gedragstherapeutische methode voor de behandeling van verslaving. Deze behandeling gaat uit van het gegeven dat mensen afhankelijk van middelen blijven doordat zij worden omgeven door een overmaat aan factoren die hun alcohol– of drugsgebruik bekrachtigen en hierbij...
Comprehensive intervention for homeless, street living youth that addresses substance use, social stability, physical and mental health issues has received very little attention. In this study, street living youth aged 14-22 were recruited from a drop-in center and randomly assigned to the Community Reinforcement Approach (CRA) or treatment as usua...
Discussion of CRAFT
This article provides an overview of 2 closely linked treatment approaches for the substance abusing client: The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT). In 1973, Hunt and Azrin created CRA in an attempt to restructure an individual's "community" so that a sober lifestyle was more rewarding tha...
Community Reinforcement and Family Training (CRAFT) is a scientifically-supported program for family members who are desperate to get a treatment-refusing substance abuser to enter treatment (Meyers & Wolfe, 2004; Sisson & Azrin, 1986; Smith & Meyers, 2004). CRAFT teaches these family members how to apply behavioral principles at home so that clean...
Whereas the model of Jellinek [Q. J. Stud. Alcohol 7 (1952) 673] of a predictable progression of alcoholism is generally supported, there have been few published studies regarding the natural history of illicit drug disorders. Identification of the development of drug abuse and/or dependence can inform clinicians and researchers on issues, such as...
The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT) are behavioral treatments for substance abuse problems that have received widespread empirical support. CRA, a treatment intended for the drinker him- or herself, was introduced 30 years ago (Hunt & Azrin, 1973). It is based onthe belief that a drinke...
Exploration of the danger of prescription opiate abuse
This chapter reviews two behavioral substance abuse treatments: The Community Reinforcement Approach (CRA) and Community Reinforcement and Family Training (CRAFT). Both of these programs were built on the concept that an individual's recovery is greatly affected by his or her unique environment. This environment, or reinforcing "community," is comp...
The five manual-guided treatment models tested in the Cannabis Youth Treatment study funded by the Center for Substance Abuse Treatment are described. The five models include (a) a 6-week intervention consisting of two sessions of individual motivational enhancement therapy plus three sessions of group cognitive behavioral therapy (MET/CBT5); (b) a...
In a randomized clinical trial, 90 concerned significant others (CSOs) of treatment-refusing illicit drug users were assigned to either (a) community reinforcement and family training (CRAFT), which teaches behavior change skills, (b) CRAFT with additional group aftercare sessions after the completion of the individual sessions; or (c) Al-Anon and...
In a randomized clinical trial, 90 concerned significant others (CSOs) of treatment-refusing illicit drug users were assigned to either (a) community reinforcement and family training (CRAFT), which teaches behavior change skills; (b) CRAFT with additional group aftercare sessions after the completion of the individual sessions; or (c) Al-Anon and...
There is now a variety of replicable, empirically supported family-based treatments for substance use disorders. Unfortunately, the gap between evidence-based substance abuse treatment methods and treatment as usual remains wide. Disseminating evidence-based treatments into practice is of obvious importance as the overall effectiveness of health ca...
Over the past 40 years, an abundance of research has focused on which alcohol treatment approaches are most effective. Adult alcoholism treatment research clearly indicates that even brief treatment is generally better than no treatment at all, that certain treatments are more consistently effective than other methods, and also that there is no sin...
Empirical support is presented for the Community Reinforcement Approach (CRA), a broad-spectrum cognitive-behavioral treatment for substance use disorders. At the core of CRA is the belief that an individual's environment can play a powerful role in encouraging or discouraging drinking and drug use. Consequently, it attempts to rearrange contingenc...
Empirical support is presented for the Community Reinforcement Approach (CRA), a broad-spectrum cognitive-behavioral treatment for substance use disorders. At the core of CRA is the belief that an individual's environment can play a powerful role in encouraging or discouraging drinking and drug use. Consequently, it attempts to rearrange contingenc...
Runaway/homeless shelters document high levels of substance abuse among runaway youth, at least double that of school youth. These youth present a constellation of problems and research suggests that this population may be unique in the range and intensity of associated problems. Most studies to date have collected self-report data on these youth;...
When taken in an adequate dose, disulfiram usually deters the drinking of alcohol by the threat or experience of an unpleasant reaction. However, unless its consumption is carefully supervised by a third party as part of the formal or im-plied therapeutic contract, it is usually discontinued and the deterrent effect is therefore lost. In most studi...
Runaway/homeless shelters document high levels of substance abuse among runaway youth, at least double that of school youth. These youth present a constellation of problems and research suggests that this population may be unique in the range and intensity of associated problems. Most studies to date have collected self-report data on these youth;...
In a randomized clinical trial, 130 concerned significant others (CSOs) were offered 1 of 3 different counseling approaches: (a) an Al-Anon facilitation therapy designed to encourage involvement in the 12-step program, (b) a Johnson Institute intervention to prepare for a confrontational family meeting, or (c) a community reinforcement and family t...
In a randomized clinical trial, 130 concerned significant others (CSOs) were offered 1 of 3 different counseling approaches: (a) an Al-Anon facilitation therapy designed to encourage involvement in the 12-step program, (b) a Johnson Institute intervention to prepare for a confrontational family meeting, or (c) a community reinforcement and family t...
Recent meta-analyses of the alcohol treatment outcome literature have pointed to a number of therapeutic modalities that consistently surface as generally more effective than others. Yet the gap between science and practice remains largely unaffected by these findings. Among the many possible reasons for this gap, a critical one is the difficulty o...
The community-reinforcement approach (CRA) is an alcoholism treatment approach that aims to achieve abstinence by eliminating positive reinforcement for drinking and enhancing positive reinforcement for sobriety. CRA integrates several treatment components, including building the client's motivation to quit drinking, helping the client initiate sob...
Homeless alcohol-dependent individuals were randomly assigned to receive either a behavioral intervention (i.e., the Community Reinforcement Approach [CRA]) or the standard treatment (STD) at a large day shelter. Ninety-one men and 15 women participated. The majority of participants were White (64%), but both Hispanic (19%) and Native American (13%...
Although motivation for drug abuse treatment is a substantial problem, unilateral intervention through concerned significant others (CSOs) represents a promising method for engaging unmotivated individuals. The Community Reinforcement and Family Training (CRAFT) program, based on principles of reinforcement, was developed for this specific purpose....
Historically there have been few options for individuals seeking help for treatment-resistant loved ones with substance abuse problems. This article describes a program with empirical backing called Community Reinforcement and Family Training (CRAFT). This cognitive-behavioral treatment teaches the concerned significant other how to use behavioral...
Historically there have been few options for individuals seeking help for treatment-resistant loved ones with substance abuse problems. This article describes a program with empirical backing called Community Reinforcement and Family Training (CRAFT). This cognitive-behavioral treatment teaches the concerned significant other how to use behavioral...
When follow-up interviews are missed, researchers sometimes try to reconstruct the data that would have been obtained by asking clients to recall the missed interval when they are interviewed at a later point. Are such data reliable? The reliability of remote reconstruction was estimated by asking 57 participants in a clinical trial to recall their...
It is widely acknowledged that problems related to alcohol misuse can seriously affect the lives of family members, friends, and close associates of the drinker (Collins, Leonard, & Searles, 1990; Orford & Harwin, 1982; Paolino & McCrady, 1977). Very often those individuals closest to the drinker are the first to feel the negative effects of proble...
the Community Reinforcement Approach (CRA) is a broad spectrum behavioral treatment approach for substance-abuse problems / it was developed to utilize social, recreational, familial, and vocational reinforcers to aid clients in the recovery process / CRA acknowledges the powerful role of environmental contingencies in encouraging or discouraging d...
Traditional disulfiram treatment has often been ineffective because of a failure to maintain usage. The present study with 43 alcoholics compared: (1) a traditional disulfiram treatment, (2) a socially motivated Disulfiram Assurance program and (3) a Disulfiram Assurance program combined with reinforcement therapy. About five sessions were given fo...
