Coming Up For Air - Families Speak To Families About Addiction

The original CRAFT is outcome-driven and behavioral-based, aimed at getting people into treatment. Allies has made it more connection- and relationship-oriented, focused on listening and communication. The same skill set Allies focuses on -- validating, not arguing, not giving advice or challenging someone's reality or perception -- often works with someone dealing with mental health challenges. Creating that space helps that person feel calm and heard.

What happens to the 30 percent who, in the traditional, research-based CRAFT model, don't make it to treatment in 12 weeks? The Allies version -- "applied" CRAFT -- goes beyond the 12-week version and focuses on change, not just going to treatment. By making changes, starting with yourself, you are engaging in the same work as "treatment." CRAFT focuses on stepping back, listening, reframing, and communicating well, all starting points for long-term change.

What do these terms mean? Should we use them? And are they disparaging? "Dry drunk" comes from Alcoholics Anonymous, and refers to someone who's abstinent, but may not obviously be doing more than remaining abstinent. And "manipulation" is often in the eye of the beholder; CRAFT can help take the judgment out of it. The only fact you have is what is internal to you. CRAFT aims to help you get to know your process, and make choices on how you feel, what you need, and the boundaries you can live with.

How do you work with anxiety so it's of service to you? Sometimes, anxiety is information akin to intuition, a sign that maybe you need to set up a boundary. At the same time, the only completely accurate fact in moments of anxiety is that you don't know. Part of the work we need to do is getting comfortable with and coping with not-knowing.

Approach the question of capability with awareness and connection. Look at your own awareness of what they'e capable of or struggling with. You may be doing too much, leaving you unaware of what they can truly do. Do mini-experiments when they want to do things, and collect data. Help them have an opportunity to succeed or fail. Foster connection by not being critical or having huge expectations. Try to help them with their own awareness -- without expecting that they'll do the same, tell them what you're working on, and what you've learned gets in your way.

Our hosts speak with Dr. Julie McCarthy, Associate Psychologist at McLean Hospital and Assistant Professor of Psychology at Harvard Medical School. She completed her bachelor’s degree at Tufts University and clinical psychology doctoral training with a focus on schizophrenia research at the University of Maryland, College Park. She completed her pre-doctoral internship and post-doctoral fellowship in addiction research at McLean Hospital, and she is currently a principal investigator in the Division of Psychotic Disorders. Dr. McCarthy has received funding from the National Institute of Mental Health, National Institute on Drug Abuse, Harvard Medical School, and philanthropic support. Her research aims to identify biopsychosocial treatment targets and develop and evaluate interventions for individuals and families, such as Community Reinforcement and Family Training for Early Psychosis and substance use. She is a CRAFT-certified therapist, supervisor, and trainer. Dr. McCarthy uses a multimodal telehealth a

Celebrate the small victories, so they become bigger. Take yourself out of the story so your loved one can write their own. Trust that they can function on some level. They have the skills they use to navigate the difficult world of substance use, and those skills just need to be translated to a different lifestyle.

Taking a deliberate break to do nothing is about clearing a space, removing internal clutter and distraction. You can often gain new insight and power to make choices in that space. It's about taking care of yourself, replenishing and healing, and coming up with better ideas than your more anxious or panicked self can.

What does it mean to CRAFT? It means slowing things down to look at them in a more complex way, seeing behavior in light of abstinence versus use, using positive reinforcement for positive changes, not focusing on the negative. CRAFT asks you to look at yourself and your reactions, self-talk, and storytelling so that you can step back and make considered choices about how to interact. Bring compassion, not judgment to the situation. What looks like laziness or avoidance may be depression, anxiety, or low self-esteem.

When the stakes are low, CRAFT seems easier to use. What do you do when the stakes are high, when danger feels present? Assessing safety -- yours and theirs -- is first. But CRAFT, even in those moments, can help you communicate more effectively while still holding to the boundaries you need. It's tougher in high-stakes situations, so go easy on yourself. It may not be perfect, but just give it a try, one step at a time.

Our hosts address a post from someone whose boyfriend just went to detox. So how does CRAFT come into play now? The reasons someone drank or used drugs before haven't gone away, and they come bubbling to the surface. CRAFT--and the CRAFT community--help you with the process that's begun with this first step of going to treatment.

People around you may want to be helpful, but not know quite how to truly help. They may offer pat answers or tell you to calm down because things aren't so bad. The temptation is to play the short game, to get caught up in the moment and solve the immediate crisis. Instead, learn how to calm your system CRAFT-style, so that you can process and not be as reactive. Think longer-term -- if you do the CRAFT work over time, join groups, find community, and learn new ways of thinking, it changes the process. Use the Allies in Recovery site to ask questions and connect to others in the community you, as an Allies podcast listener, are part of.

Your situation is uniquely your own. But as with any illness, it’s not entirely unique—others are also dealing with the illness. Trying strategies to manage your condition is the same thing as using CRAFT for coping with addiction. An important part of CRAFT is the C, which stands for “community.” Don’t be hopeless. Step out and bring the things you’re struggling with to the site, possibly to a group. Meet the people dealing with similar issues, and break the isolation to find out what the experts—other families—are doing.

We sometimes hitch our well-being to another person's behavior and emotional state. Strong negative emotions can get in the way of connection. When they happen, notice and respond, but don't derail with the other person. You can see your thoughts as stories -- what story are you telling yourself that produces your emotions? The idea is to turn your attention to yourself and what the emotion is doing to you. Try to slow down so you can be most effective, and work on your own sense of well-being, which will positively affect your loved one. Take time to work on your emotions separately, not dumping them on others. Ask "How do I manage and express this emotion in a productive way?" This is the beginning of stronger connection.

How do you make good decisions when the fear of your loved one’s death colors everything? If you’re stuck in a bad dynamic, your only option is to do things differently. CRAFT tools can help you change the dynamic over time, and help your loved one stay alive. It involves facing the fear, and implementing CRAFT on your own terms, in your own time.

It can be easy to dismiss things that don't work immediately, to give up and say, "Now what?" That's usually the wrong strategy. Instead, see every day as a new one, and remember that CRAFT takes practice and time. See CRAFT methods as tools for life, for all relationships. Stepping back, listening effectively, giving people respect and power, self-care, focusing on the positive -- all of it adds up to create change over time.

Our hosts discuss examples of "the craft of CRAFT" and the art of changing our messaging with subtlety and compassion to communicate better with our loved ones. It's about finding thoughtful ways to express boundaries and explain your needs and requests without criticizing. And keep in mind that the conversation will continue.

Christina Dent discusses her new book, Curious: A Foster Mom's Discovery of an Unexpected Solution to Drugs and Addiction. Christina grew up in a conservative Christian home. Her views of addiction changed dramatically when she and her husband became foster parents. Christina founded the non-profit End It For Good to invite others to listen to the voices directly impacted by our drug laws.

Laurie asks co-host Kayla questions about the role of a therapist in addressing substance use disorder. Kayla Solomon is a social worker in private practice in Northampton, Mass. Her specialty in addiction began right after college when she was hired as a methadone counselor in Brooklyn. She has worked in Intensive Outpatient Programs, clinics, residential and private practice. She is certified in Imago Relationship therapy, Cognitive Behavioral therapy, and Brainspotting.

Our hosts have a conversation with Bill Carruthers, who describes himself as "a person in long-term recovery." He is also a Certified Psychiatric Rehabilitation Practitioner; a Certified Peer Specialist for Mental Health, Addictive Disease, and Whole Health; and a Forensic Peer Mentor. He has done hundreds of presentations and workshops, and works to bring a voice gained through recovery experience to the transformation of current systems and programs. He is a new partner with Allies in Recovery.