What is the Adolescent Community Reinforcement Approach (A-CRA)?
The treatment model known as A-CRA recognizes that, at least initially, alcohol and drug use is about reinforcing consequences — that make us more likely to repeat actions. This is true whether we are hanging out with friends, playing a favorite game, eating a good meal, or using alcohol or other drugs. People who use alcohol and drugs get something out of it — or they wouldn’t keep doing it.
The overall goal of A-CRA is to help youth reconnect with or discover new sources of positive reinforcement within their community to compete with alcohol or drug use. How do A-CRA clinicians do this? By listening to and learning from their clients what is important to them. They then help them connect to pro-recovery activities that have meaning and value to their client. In addition, A-CRA clinicians help their youth identify goals and learn how to achieve them. Adolescents also learn a variety of new skills, such as problem-solving and positive communication (with caregivers, friends, and others), which help them attain a better quality of life. Practicing new skills is a critical component of the skills training used in A-CRA. Every session ends with a mutually-agreed upon homework assignment to practice skills learned during sessions.
This intervention has been implemented in outpatient, intensive outpatient, and residential treatment settings. This research-tested intervention has been used in over 300 organizations across the United States and Canada.
How is A-CRA structured?
A-CRA is typically conducted in a Community Agency, Outpatient Clinic, Residential Care Facility, or in home, school or other settings.
The A-CRA sessions are positive, strength-based and focused on the individual’s needs. Clinicians have a variety of A-CRA procedures to choose from based upon the issues adolescents raise during sessions. Within a broad framework, the model includes guidelines for three types of sessions: individuals alone, parents/caregivers alone, and individuals and parents/caregivers together or individuals and their significant others together.
According to the individual’s needs and self-assessment of happiness in multiple life areas, clinicians choose from a variety of A-CRA procedures that address day-to-day stressors, communication skills, and active participation in positive social and recreational activities with the goal of improving life satisfaction and eliminating alcohol and substance use problems.
Goals of A-CRA
- Decrease the use of alcohol and drugs
- Improve communication with family and others
- Increase participation in non-using social activities
- Increase positive relationships with peers