CRAFT for Families: What You Learn and What the Research Shows

When someone close to you keeps drinking or using drugs, advice to “set boundaries” can leave the practical questions unanswered. What should you say? Which responsibilities can you stop taking over? What support do you need yourself?

CRAFT, short for Community Reinforcement and Family Training, is a structured approach to working on those questions with family members or other concerned people. It includes their wellbeing as well as ways to encourage treatment.

What families work on

The following seven themes are an editorial overview, not a universal seven-session syllabus:

1. Look at situations. Describe what happens before and after use, including short-term consequences, without assuming you know the person’s private motives.
2. Notice helpful behavior. Acknowledge actions you genuinely appreciate when it feels safe and appropriate, such as keeping an agreement or spending time together without using.
3. Review taking over consequences. Consider which responsibilities you can stop carrying. Plan changes with attention to safety, dependents, and shared obligations.
4. Choose the timing of contact. Difficult conversations may be more manageable when the person is sober and the situation is calm. Medical emergencies still need a response.
5. Practice clear communication. Use specific requests and describe your own concerns. You do not have to accept blame for someone else’s behavior.
6. Prepare a treatment invitation. Know the available service, how to contact it, and what practical help you could offer if the person is willing.
7. Restore your own support. Make room for rest, care, relationships, and activities that belong to your life.

These changes should be adapted with a trained professional when possible. A family member who is frightened, exhausted, or hurt should not be pressed to offer warmth or physical affection.

What the 1999 trial found

A randomized trial by Miller, Meyers, and Tonigan included 130 concerned significant others of people with alcohol problems who were not seeking treatment. The reported rates of the person entering treatment were:

Approach offered to the concerned person	Treatment entry
CRAFT	64%
Johnson Institute intervention	30%
Al-Anon facilitation	13%

The outcome was treatment entry, not recovery or lasting abstinence. Al-Anon facilitation in this trial should not be relabeled as every family self-help group. Family functioning and wellbeing improved across the approaches, so that finding should not be claimed as unique to CRAFT.

The trial concerned alcohol problems. It does not establish the same percentage for gambling, other substances, or your family.

Finding an appropriate service

Ask a local addiction or family service whether a clinician has CRAFT training, what the program involves, and how it handles safety. A book can introduce the ideas, but cannot assess your household. For gambling concerns in the US, the National Council on Problem Gambling provides a route to local resources; services elsewhere differ.

Violence, threats, serious intoxication, or a child’s safety are reasons to get appropriate help promptly. Do not withhold food, housing, or urgent medical care to create “natural consequences.” You can seek support for yourself even if the other person declines treatment. Our article on family boundaries discusses everyday decisions in more detail.