Dr. Jeff Foote, Co-Founder and Clinical Director of the Center for Motivation and Change, and his inspiring colleagues, conducted a life changing training last August in New York.
I feel fortunate to have been in attendance.
Eleven parent volunteers gathered together to learn more about Community Reinforcement and Family Training (CRAFT).
The past few years the parent volunteers had communicated via conference calls and it was a thrill to finally meet in person.
We were there, however, to learn about CRAFT and how it could help families. It was an emotional weekend as we peeled back the layers to discover that this strategy could work for any family, including our own.
I’m thrilled to share this interview, because we know one size does not fit all. The more options that parents have, the better the chances that their child will find recovery.
Please meet Dr. Jeffrey Foote and learn more about CRAFT.
What inspired you to work with families struggling with substance abuse?
Through many years of working directly with people who were struggling with substances, a couple of things got clearer and clearer:
- the families of these folks (spouses, parents, kids) are really suffering through this whole process, at times for years, and they need help themselves
- those same families could be our greatest and most powerful allies in helping our clients.
As they say…almost everyone knows someone…So many families have been touched by substance abuse in some way.
Unfortunately, through this ordeal, families typically wind up feeling a lot of hard emotions:
- guilt (that they somehow could have prevented this or could be stopping it now)
- anger (that their child or loved one is doing some dangerous, hurtful and scary things)
- frustration (that they don’t know what to do to help, or that the treatment system doesn’t seem to help either)
- shame (maybe the worst and most isolating of all, dealing with such a stigmatized problem in our culture)
We hear story after story of families seeking treatment and finding themselves feeling judged in this process. If not judged, then told there is one path and one path only, and if they don’t follow it, they are doing it wrong and hurting their child.
At the same time, we know there are many specific things that DO help in this very complicated and often very scary process, and it is important to me to get the word out… to give families who are trying so hard some needed and reality-based hope.
Each time a parent tells me that they thought this was all their fault, and they were told that they were only enabling their child by trying to help, and that the only answer was to kick him out, I get angry and also inspired to keep spreading the more hopeful and more effective word and strategies we know work…and we know from controlled research studies, not just in our hearts.
Can you describe CRAFT for families who know nothing about it?
The CRAFT approach, developed by Bob Meyers at U of New Mexico, is one set of important tools that DO work, and it feels great to see families using these strategies and getting results, feeling hopeful again, feeling empowered, getting support, learning to trust themselves again, getting their lives and the lives of their children back. What could be better?
CRAFT is a set of very positive strategies to help you help your child, especially when they are not so sure they want to change. The approach teaches you new ways to interact with them (positive communication skills), and doesn’t implicate or blame the family, but instead supports them as a positive force that is trying to deal with a very difficult situation as best they can.
By using CRAFT, you learn helpful ways of talking to your child so they are more likely to listen (what we call recognizing green lights and red lights), learn ways of understanding what’s going on from their perspective (what’s “in it for them”), the importance of recognizing positive change when it happens, how to allow them to learn from the natural consequences of their negative behaviors, and importantly, how to take care of yourself in the process.
Kindness, collaboration, positive reinforcement, and good limit setting…these are all part of real change. What we now know is this: it works! You can stay involved, you can help, and you can take care of yourself as well, and this combination is powerful and effective in helping your child decide to make positive changes.
What are the Top 3 take aways for parents just learning about CRAFT who want to communicate better with their child?
First – as Bob Meyers likes to say, you catch more flies with honey than vinegar: in the middle of this storm you sometimes feel you are in, it can be a game changer to try to focus on pointing out positive things you notice in your child rather than the negative. Easier said than done, but it’s going to be much easier to talk about your concerns if you also give them attention for seeing things that you like… whether they say something funny, take out the garbage, come home on time, or watch TV with you.
Second – confrontation is not your friend, even if it feels like the right thing at the time. That doesn’t mean don’t be straight up and honest with your child; it just means that the shouting, the anger, the venting, the “that’s it mister, I’ve reached my limit” stuff is not so helpful. If you’re shouting or shutting down, you’re not helping. Again, all understandable, but you’re stepping backwards and away you’re your child hearing you in those moments.
Try to find ways to realize you’re pot is boiling over well before it does, and step away. Talk to a friend, remember something positive your kid did, act like they are the neighbors kid…these things matter in not exploding and creating a distance.
Third – try to collaborate. While it may seem that your child is trying to personally torture you, usually they’re not…they are lost in their own world and doing these things for their own reasons, which are important to them. Their decisions make sense to them, and if in your communication you can acknowledge that, give them that respect (which does not mean agree with them!), you have the basis for a discussion.
A big part of that is also learning how to listen to your child (even when you don’t like what he’s saying) with a set of strategies (e.g. using open-ended questions and affirmations) that we describe in depth in our “20 Minute Guide”, a set of tools from CRAFT that we have on our website.
Looking out three to five years, what would you like to see as some of the next big trends for substance abuse treatment and recovery?
There is a lot of talk about “evidence-based practices”, and of course a lot of in-fighting about what those are. But in it’s simplest version, all this means is having available some approaches for families and substance users that have been proven effective, apples to apples in clinical trials.
There is a lot that’s effective out there now… and a lot that people don’t know about or doesn’t get used. CRAFT is one approach like this, but there are lots of other effective ideas and strategies:
- one size doesn’t fit all…there are many paths to change. It’s not all about “interventions”, or “boot camp” or “rehab”. Those are necessary sometimes, other times not. Different things for different folks.
- emotional and psychiatric issues matter a lot…don’t just assume it’s all about drugs…people use substances for reasons, sometimes including anxiety, depression, ADHD etc.
- medication can help..not always, not everyone, but don’t rule it out just because someone is telling you “why would you give drugs to a drug addict”…bad reasoning. Medications can be critical tools to achieve abstinence, prevent relapse, and prevent overdose.
- words matter..stigma keeps people (and kids) from getting help…call it a disease, call it a biopsychosocial problem, but understand that whatever you call it, it’s a hard thing to accept in this culture…please have the popular discussion (on TV, movies, media) change enough that people (and their families) don’t feel the need to go underground with these struggles.
Truthfully, I have a longer list of things I’d like to see than we could possibly talk about here!
What tips do you have for parents when substance abuse is an issue during the upcoming holiday season?
“It’s the most wonderful time of the year.” Really?…Be aware of the pressure and expectations of the holidays and do your best to manage your own expectations. It’s a tough time of year under the best of circumstances, and having a loved one struggling with substances can make it that much harder. Letting go of the pressure to have it be “amazing” can actually go a long way to having the holidays go better than you might fear.
Keep it light. If you are spending time with your child this year, try to keep conversation focused on light topics…take a break from discussing problems if you can. Spend time talking about and doing things you may not have been able to pay much attention to recently: whether it’s cooking together, eating together, wrapping presents, watching movies, try to reconnect with light, “non-problem” activities and topics. Building goodwill not only helps everyone feel better, but also goes a long way to more effectively work on solving problems later.
Think about what you can do to help keep your anxiety in check this holiday season…Make time for exercise, to have down time, time with people you find supportive, time for relaxing activities. This struggle can be so isolating, especially at holidays when “all the other families look happy”!
What do you want to do about alcohol? Plan in advance if you want your home to be an alcohol free zone during the holidays. If this is important to you in helping yourself and your child, think about best ways to keep it out of your house and be direct with other people about your preferences.
We have a webcast done by our Director of Family Services, Dr. Nicole Kosanke, on exactly this topic: navigating the holidays. You can find that webcast at http://youtu.be/SvNj-vN8Dtw.
How can parents learn more about CRAFT?
There are some resources out there about CRAFT. One is our upcoming book for families called “Beyond Addiction”, getting published by Simon and Schuster this February, 2014. It’s our way of sharing our years of clinical experience with families about addiction, the treatment system, the culture, and how to help; as a roadmap for people just entering this strange and not so friendly land.
More specifically, we have our “20 Minute Guide” for parents, which is CRAFT ideas explained for parents in straightforward, practical terms, more like a workbook or a playbook.
Then there is the first book for families about CRAFT, “Get Your Loved One Sober”, by Bob Meyers, the creator of this approach at the University of New Mexico.
We have also been involved for several years with The Partnership at DrugFree.org, a wonderful collaboration where we are helping develop a parent coaching network of parents who have been trained in how to help other parents start to navigate these deep waters, based on their own experiences as well as their knowledge of CRAFT. These coaches are already doing an incredible job, and we hope to keep growing this network of parent-coaches.
How could CRAFT strategies help your family? Please let us know in comments.
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Co-Founder and Executive Director, Dr. Jeffrey Foote is a nationally recognized clinical research scientist who has received extensive federal grant funding for his work on motivational treatment approaches. Dr. Foote has worked in the addiction treatment field as a clinician and researcher since the late 1980′s, and has developed a unique motivational treatment approach that incorporates principles of group treatment as well as research-based principles of human behavior change. Previously, Dr. Foote was the Deputy Director of the Division of Alcohol Treatment and Research at Mt. Sinai Medical Center in NYC, as well as a Senior Research Associate at The National Center on Addiction and Substance Abuse at Columbia University (CASA) in NYC. Dr. Foote also served as Chief of the Smithers Addiction Treatment and Research Center as well as Director of Evaluation and Research between 1994 and 2001. Dr. Foote is also team Psychologist for the New York Mets.