All service users are offered key working and case managment using The Community Reinforcement Approach (CRA).
All clients receiving key working have care plans put in place, are assigned a case manager with regular care plan reviews
What is it?
The Community Reinforcement Approach (CRA) is a comprehensive behavioural
treatment model for working with people with substance use disorders. Fundamental to
CRA is the belief that environmental contingencies—behaviours the environment will
reinforce or punish—play a key role in encouraging or discouraging alcohol or drug
misuse. CRA employs familial, social, recreational and vocational behavioural
reinforcement contingencies to support the individual in the recovery process. The goal
of CRA is to assist the individual in developing a life style and environment where the
reduction of or abstinence from use of alcohol or drugs is rewarded, and substance
abuse or dependence is discouraged.
How does it work?
The philosophy of CRA is to rearrange an individual’s life so that non-using behaviour
becomes more rewarding than using behaviour. The use of alcohol and other drugs can
be highly rewarding. Therefore, CRA uses several treatment strategies to achieve its
goal of re-arranging rewards in a client’s life. These strategies include
increasing/exploring a client’s motivation, carrying out a functional analysis of the client’s
alcohol or other substance use, supporting a trial period of abstinence, increasing
positive reinforcers, and developing or enhancing basic social skills. A more detailed
description of CRA and the strategies it uses can be found in Clinical Guide to Alcohol
Treatment (Meyers, & Smith, 1995).