Community Reinforcement Approach (CRA) At Spring Hill
Among our many evidence-based approaches here at Spring Hill, CRA helps people facing addiction prioritize healthy behaviors and a healthy lifestyle over drug or alcohol use.

At Spring Hill, we help people with addiction live healthy, full lives in many ways. This includes by helping them rediscover the activities they once enjoyed, before substance abuse took over, and experience the thrill of finding new healthy hobbies. A behavioral approach called the community reinforcement approach (CRA) can help with this.
By helping people analyze their substance use, gain the motivation to change, discover healthy coping behaviors, and increase enjoyment in their everyday lives, CRA helps build a foundation for lasting recovery.
What Is The Community Reinforcement Approach?
Drug and alcohol use can be highly pleasurable at first, due to the feel-good dopamine rush they cause. However, when it comes to addiction, substance use eventually results in the opposite effect, with dopamine receptors reduced in the brain over time leading to anhedonia, or the inability to feel pleasure. In this case, drugs or alcohol may be the only thing that allows someone to feel “normal,” despite the many harms and risks it’s causing the person.
Considered one of the most effective forms of addiction treatment, CRA focuses on a shift in positive reinforcement. That is, it eliminates positive reinforcement for drinking or using drugs and builds positive reinforcement for recovery.
Like B.F. Skinner before him, Nate Azrin, who developed the community reinforcement approach for alcohol addiction in the early 1970s, agreed that punishment was ineffective for modifying human behavior. Azrin instead focused his approach on building positive reinforcement from within the person’s community and helping people discover, participate in, and enjoy activities that didn’t involve alcohol. CRA came to be used to help people with other addictions as well.
Key Elements Of CRA
There are several elements involved in CRA, a few of which are detailed below.
Motivation Building
Through CRA, clients may explore with their therapist any current positive reinforcements for their recovery, such as support from family. Building motivation for recovery may also involve reviewing the negative consequences of substance use in the past and how these may recur, or others may occur, in the future unless behaviors change.
Analysis Of Substance Use Patterns
Here, the therapist and client may look into where any positive reinforcement was happening with drug or alcohol use to better understand the perceived benefits. Situations in which use was more likely to occur will also be explored. This can help determine which recovery approaches will be most beneficial for the client.
Increasing Positive Reinforcement Of Recovery
Here, the focus is on increasing the sources of positive reinforcement in the client’s life for not drinking or using drugs. This can help combat the loneliness and anhedonia that tend to develop with addiction as people find themselves engaging in fewer and fewer activities that don’t involve substance use.
Activities may include engaging in hobbies the client once enjoyed or trying new hobbies. Clients also may be encouraged to participate in activities not centered around substance use, such as attending support group meetings, volunteering, or participating in common-interests clubs, like photography or hiking clubs.
In addition to leisure activities, clients may benefit from assistance with building reinforcement for recovery into their everyday lives, such as through obtaining a job. Family members and spouses can also become sources of positive reinforcement.
Behavior Rehearsal
Clients may benefit from practicing some behaviors, such as substance refusal, assertive communication, boundary setting, and problem-solving, with their therapist. The therapist may model a specific behavior, such as turning down a drink, and then have the client practice it.
Effectiveness Of CRA For Addiction Recovery
CRA has been proven to help a wide range of people achieve recovery from addictions involving a variety of substances, not just alcohol use disorder (AUD). This includes people with addictions involving opioids, alcohol, and illicit drugs; adolescents and adults; people with co-occurring mental health disorders; and people living in both rural and urban communities.
Start Your Recovery Journey At Spring Hill Today
If you would like more information about our programs or what we have to offer, please call our treatment specialists today. We can help you or your loved one find the support you need today.
- American Psychological Association – Community Reinforcement and Family Training https://www.apa.org/pi/about/publications/caregivers/practice-settings/intervention/community-reinforcement
- National Library of Medicine – The Community Reinforcement Approach https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3860533/