Beyond Addiction Explores Alternatives to Interventions

More than 22 million Americans struggle with substance abuse in any given year, with the problem affecting one in four families in the U.S. The impact this has on the individuals, their families and society as a whole is hard to overstate. Besides the users’ physical and psychological issues, the stress and strain they put on their families can drive people to their breaking point while they struggle to do the best they can to help their loved one.

The best approach to take when a loved one is struggling with addiction isn’t always clear. The authors of a new book—Beyond Addiction: How Science and Kindness Help People Change—are offering an alternative to the common-but-confrontational “intervention” approach.

The Book

Beyond Addiction was written by three PhD scientists, Jeff Foote, Carrie Wilkens and Nicole Kosanke; all three work with the Center for Motivation and Change. The philosophy behind the book is that of Community Reinforcement and Family Training (CRAFT), and the authors offer advice for helping family members get their loved ones who abused substances to make a change. It could be considered as a counterblast to the prevailing theories that the abuser needs to “hit rock bottom” before he or she is ready to get help or that the most restrictive approaches are the best because they feel the “safest.”

What Is CRAFT?

CRAFT can be most simply defined as an alternative to more confrontational methods of intervention, which effectively rely on conflict (telling the addict how his or her addiction is affecting loved ones) to convince the addict to seek treatment. The alternate idea is to encourage the individual to seek treatment, focusing on the use of healthy rewards rather than punishments. This method also teaches families how to determine the best times and approaches to use to help the individual make a change. According to research, over two thirds of families who use CRAFT successfully help their loved ones enter treatment, and people who are encouraged into treatment in this manner are less likely to relapse than those convinced to attend by more confrontational approaches.

The Advice in Beyond Addiction

The advice in the book largely revolves around conveying the core principles and methods of the CRAFT approach. One important point is that looking after yourself is the first step to helping your loved one. In short, if you feel better, you’re more capable of dealing with stress, more understanding of the individual’s issues, less likely to be affected by setbacks and generally more effective at helping somebody else.

Another core argument in the book is that confrontation begets defensiveness, and this is the enemy of motivation. In other words, it’s essential that you don’t approach your loved one confrontationally—it’s better to try to understand his or her behavior (including understanding the perceived benefits of their substance abuse) than to dismiss it as making no sense whatsoever. This helps to cement the idea that you’re an ally, and also gives you insight into their problem.

Rewards are suggested as a method to encourage change and reinforce positive behaviors. There is an inherent temptation to “focus on the bigger picture” and thereby still be upset with your loved one when he or she does something positive because the overall problem still persists. However, this “never happy” attitude may lead the individual to feel as though everybody is out to get him. The authors also suggest using rewards that can be given in response to positive behavior but withheld if that behavior isn’t shown. In the same vein, they encourage family members to allow “natural consequences” of the individual’s behavior to occur, rather than continuously protecting him or her.

Setbacks to the Approach

Despite some very positive advice throughout the book, the suggested approach is far from perfect. The authors, for example, fail to differentiate between approaches suitable for adults and those suitable for teenagers, and reject the idea that a goal of abstinence is best. Although they acknowledge the genetic elements at play in many cases of addiction, they don’t consider the effect of moderate use on somebody genetically pre-disposed to addiction—most likely a full relapse because of his or her difficulty exercising self-control.

The book’s advice isn’t perfect, but there are plenty of positive lessons within the pages of Beyond Addiction. The core take-away lesson is that positive communication—rather than confrontational conversations that can feel like “attacks” to the individual—is essential to help your loved one get help. The strategies they suggest are practical, backed by evidence and pay attention to key areas such as self-care for the loved ones of addicts. If you’re struggling to cope with your loved one’s addiction and are unsure how best to help, this book contains many useful tips and is well worth a read; just don’t take everything within its pages as gospel.