Chapter 14 Flashcards
What are the two striking facts about the community reinforcement approach (CRA)?
It has strong evidence of efficacy in clinical trials but was relatively unknown among addiction treatment professionals for a long time.
What is central to the principle of CRA?
Positive reinforcement—when a behavior leads to rewarding consequences, it is likely to be repeated.
Why does CRA focus on positive reinforcement rather than negative consequences?
Because suffering and punishment do not effectively cure addiction and may even backfire.
Why are psychoactive drugs reinforcing?
They access the brain’s central reinforcement systems that signal ‘Do that again!’ and can provide psychosocial reinforcers like relaxation and well-being.
Why doesn’t everyone who uses addictive drugs become addicted?
Many people discontinue use due to environmental changes, controlled use, or having alternative reinforcements.
What is the fundamental goal of CRA?
To increase drug-free positive reinforcement and undermine rewards associated with drug use.
How does CRA begin its treatment process?
With a functional analysis of drinking or drug use, examining antecedents and consequences of substance use.
What is the purpose of a functional analysis in CRA?
To identify triggers and consequences of drug use and develop alternative ways to achieve similar outcomes without substances.
What tool does CRA use to assess life satisfaction?
A happiness or life satisfaction survey that rates various life areas from 1 (unhappy) to 10 (happy).
What is sobriety sampling in CRA?
A method where clients agree to a trial period of abstinence to experience the benefits of sobriety.
How does CRA use monitored medication?
Clients may take medications like disulfiram or naltrexone with supportive monitoring from a loved one to reinforce abstinence.
Why is time management important in CRA?
Stopping drug use leaves people with extra time, so they need to find positive, reinforcing activities.
How does CRA address interpersonal relationships?
By strengthening positive communication, problem-solving skills, and engaging in substance-free activities with loved ones.
Why is stable employment important in CRA?
It is a strong predictor of sobriety, and CRA includes job-finding support for clients.
What is a key strategy for maintaining abstinence in CRA?
Developing coping skills to handle triggers and social pressures to use substances.
How is CRA tailored to individual clients?
It provides a flexible menu of procedures rather than a one-size-fits-all approach.
What is the role of the counselor in CRA?
To be encouraging, affirming, and responsive, reinforcing positive steps toward recovery.
What does research say about the effectiveness of CRA?
Every clinical trial of CRA has shown significant benefits over traditional addiction treatments.
What is A-CRA?
An adaptation of CRA for adolescents, effective in reducing substance-related problems.
What is CRAFT and how does it relate to CRA?
Community Reinforcement and Family Training (CRAFT) helps engage unmotivated substance users through family members and significant others.
