Part II: “Train a Parent, Spare a Child” using CRAFT: Community Reinforcement and Family Training

January 22, 2013

This is part II of a response to the article “Train a Parent, Spare a Child” (NYTimes, 1/11/2013).  Part I outlined four points in thinking about behavior change.  In part II, we are applying those theories to helping make change regarding substance use.  To read Part I, click here.

And what if the problem isn’t that your 10 year-old won’t eat broccoli but rather that your 17 year old (or 35 year old!) keeps getting drunk??  Pretty different situation, but positive reinforcement strategies have the most promising hope for impacting change.  In fact, positive reinforcement is one of the most powerful and effective tools parents have in helping their adolescent or adult child change their substance use.

Often, when we are first suggesting this to parents, they look at us skeptically and ask, “So, you’re suggesting I bribe my kid?”  Well, sort of…but that oversimplifies and also puts a negative spin on something they can do to help shape their child into engaging in healthier, more positive behavior.

Basically, gold stars, both literal and metaphorical, are powerful motivational enhancers.  This is true whether we are 5 years old or 50 years old, whether we have a substance use problem or not.  These four points applied to this more difficult situation deserves a lot more discussion, but here are some examples of how these ideas are applied:

1. Break it Down!
Breaking down a larger problem into smaller steps allows you to reward/reinforce the smaller steps towards larger goal.  If your teenager is skipping school to smoke marijuana, you might break down that behavior so you can find ways of rewarding attendance at school, or coming home on time, or agreeing to getting drug tested.  And you might consider rewarding him/her for getting other things done (homework, chores, errands) after school which would be more difficult for your child to accomplish (or in CRAFT language, we would say that they “compete”) if they were smoking beforehand or instead.  Remember that rewards do not have to be money!!

“…research clearly suggests that praise is usually a sufficient reward, she said. Dr. Dweck suggests parents make their praise specific, and focus on the process the child went through to achieve the behavior, not merely the behavior itself.”

2. Intrinsic Motivation
Substances come along with very powerful reinforcing effects, and people often don’t have a lot to “compete” with these positives at first. By rewarding your child with things you know they experience as rewarding, you can help with shifting the balance to their experience of feeling rewarded by NOT using substances.  As the Times article explains, the essential element of a positive reinforcer is that you experience it as rewarding. We encourage parents to talk to their kids and brainstorm about what rewards they would find incentivizing (could be anything from praise, to later curfew, to car access, to guitar lessons, etc.).  Essentially, a lot of people do not start out the process of changing substance use with intrinsic motivation to change… providing positive reinforcement can serve to enhance that motivation to move in the direction toward NON-using behaviors.  We can all change our behavior when the positives of change outweigh the negatives of change.  By mindfully and deliberately applying positive rewards to behaviors you want to see more of, you will help your child add to his experience of the positives of abstinence.

3. Rewards and Consequences Are a Part of Life (and you are your child’s life!)
The first reaction most parents would have to discovering their child is abusing substance would naturally be to immediately set limits, which is appropriate and probably useful.  But if you’re talking about wanting to initiate and support a more sustaining change moving forward, the real key is balancing the limits/consequences with the positive rewards/reinforcements for what they do INSTEAD of the substance using behaviors.  It may be blatantly obvious to you that there are numerous risks and downsides to substance abuse, but for your child, they may need more than a rationale – a lot more.  And that “more” usually means feeling the benefits of abstinence in a variety of ways.  You can help create that environment in which an abstinent life is rewarded.

4. Notice The Good Stuff!
When you have a loved one who is struggling with substance use, it’s natural to become solely focused on all of the negative and scary behaviors you are seeing. Relationships suffer and the attention your kid is getting is likely to be almost exclusively negative attention. As crappy as this feels to everyone, it also can be inadvertently rewarding negative behaviors, and contributing to them sticking around. Attention is a very powerful reward, even if it is negative.  When you start training yourself to focus on things you want to see more or, things you are liking (and this might be a struggle at first to find these things), it help shift this balance to where your loved one is getting attention for things they are doing well. You are, as the saying goes, “catching them being good.”  Giving attention for positive behaviors also goes a long way toward putting good will back into relationships that have often become characterized by arguing, threatening, begging, nagging, and overall unpleasantness.

Using behavioral strategies like these can take some getting used to, especially when we are much more familiar/comfortable with strategies in our parenting which focus on conversation and teaching lessons.  We would submit to you, however, that the more effective lesson-learning strategies do NOT have a convincing argument as the cornerstone.  That might be helpful at times, but it is far from sufficient.  If that were the case, simply detailing the evidence for someone that smoking will eventually kill them, would be sufficient for change.  But it is not.

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