Community Reinforcement Therapy

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Community reinforcement therapy is a cognitive-behavioral approach to treating substance use disorders for alcohol, cocaine, and opioids. This therapy enhances the positive aspects of a healthy, drug-free lifestyle so that patients can come to view abstinence as far more rewarding than alcohol and drug use. Community reinforcement therapy is based on the belief that the environment has a strong impact on substance abuse, and focuses on helping patients change their environments to achieve sobriety and lasting recovery.

What is Community Reinforcement Therapy?

Community reinforcement therapy motivates and teaches people how to make healthy lifestyle changes that support recovery from substance use disorders. This therapy uses a number of family, social, career, and recreational reinforcements and incentives to make sober living more rewarding than alcohol and drug use. Most addiction treatments offer a degree of positive reinforcement for abstinence, but community reinforcement therapy focuses solely on this one particular aspect.

The primary goal of community reinforcement therapy is to help patients maintain abstinence long enough to develop new life skills that help them sustain their abstinence. In addition to enhancing positive reinforcement for sobriety, this therapy also focuses on eliminating positive reinforcements for alcohol and drug use.

Those who receive community reinforcement therapy take part in some non-substance-related social activities, so they can learn to enjoy the benefits of sober living along with a sense of community surrounding their families, jobs, and environments. Sports clubs, church involvement, and 12-step meetings are just some activities that may be included as part of community reinforcement therapy.

The main components of community reinforcement therapy are:

  • Building motivation
  • Putting a trial period of sobriety in place
  • Analyzing one’s behaviors surrounding alcohol and drug use
  • Increasing positive reinforcement for sobriety
  • Rehearsing coping behaviors
  • Involving loved ones in treatment

What are the Benefits of Community Reinforcement Therapy?

A top benefit to receiving community reinforcement therapy is learning and implementing a series of healthy behaviors that promote a more fulfilling, rewarding lifestyle without drugs and alcohol. Community reinforcement teaches people skills that allow them to achieve abstinence, a greater sense of happiness and success, and continued good health and long-term sobriety.

Benefits of community reinforcement therapy:

  • Delivers positive reinforcement for maintaining abstinence from drugs and alcohol
  • Uses a non-confrontational approach to recovery from substance abuse
  • Encourages engagement and participation in treatment
  • Offers vocational and skills training
  • Involves family and loved ones in treatment
  • Can be easily integrated with other addiction treatments
  • Can take place in an inpatient or outpatient treatment setting
  • Addresses multiple aspects of a person’s lifestyle that may be contributing to addiction
  • Offers a healthy alternative to drug and alcohol use
  • Prepares people for life after rehab
  • Lowers the risk for relapse

Many of those who struggle with addiction end up losing interest in non-sober activities and hobbies throughout their addiction. But community reinforcement therapy helps these individuals foster a renewed interest in these activities without feeling as though they need drugs and alcohol.

How Does Community Reinforcement Therapy Work?

At the beginning of community reinforcement therapy, patients work with therapists to identify various triggers that may have led to substance abuse. In some cases, the patient’s significant other and family members are involved with identifying and discussing these triggers. Patients and therapists then work together to create and set goals for abstinence-based on triggers that may be reinforcing alcohol and drug use.

A trial period of abstinence begins, and patients start taking part in social and community activities that reinforce sobriety and recovery. Throughout this time, alternative behaviors and coping mechanisms are discussed, and therapists work with patients to explore their motivation for change and to find the best incentives for rewarding abstinence. Negative consequences associated with past drug use and potential future use are also discussed to foster a strong motivation for change.

Sobriety and abstinence may not be immediate, and relapses are acknowledged in a non-confrontational way as a normal part of overcoming substance abuse. Throughout treatment, therapists and patients continue working together to set a series of short-term goals for long-term sobriety.

In some instances, community reinforcement therapy may reward patients with incentives for reduced substance use and abstinence. Family therapy may also be integrated with community reinforcement therapy as a form of intervention for those who may be reluctant to start treatment.

Who Should Get Community Reinforcement Therapy?

Community reinforcement therapy is ideal for those who need help overcoming addiction to alcohol, cocaine, and opioids. However, this therapy may be effective for nearly anyone who wants to learn positive skills and behaviors that promote a healthy lifestyle with abstinence from drugs and alcohol. People who may have spent lots of time in environments with access to drugs and alcohol can benefit from community reinforcement therapy, as well as those who need help finding new hobbies, interests, and activities to consume their time after struggling with long-term addiction.

Where Can I Find Community Reinforcement Therapy?

Community reinforcement therapy is offered at many inpatient and outpatient addiction treatment centers and may be combined with other treatments including drug and alcohol detox, cognitive behavioral therapy, and group therapy. Those recovering from alcohol and opioid addiction may also be given medications that work to promote abstinence from these substances, or that manage post-acute withdrawal symptoms like depression and insomnia.