Adolescent Community Reinforcement Approach (A-CRA)

Scientific Rating:
Supported by Research Evidence
See scale of 1-5

Additional Implementation Resources

Since this program Adolescent Community Reinforcement Approach (A-CRA) was highly rated on the Scientific Rating Scale, program representatives were asked to provide additional implementation information.

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Adolescent Community Reinforcement Approach (A-CRA) as listed below:

Chestnut Health Systems has EBT Coordinators available to discuss possible implementation of A-CRA with interested organizations and individuals. After an organization or individual expresses interest in learning the intervention, the EBT Coordinator will make contact and learn more about the organization or individual so that they can make recommendations regarding training. Once an organization makes a decision to proceed with training, orientation calls may be conducted with each site to review certification requirements for clinicians and supervisors. To contact an EBT Coordinator, an organization or individual can e-mail

Formal Support for Implementation

There is formal support available for implementation of Adolescent Community Reinforcement Approach (A-CRA) as listed below:

An EBT Coordinator is designated to work with each agency and is available by phone and email to address any questions from clinicians, supervisors, or management regarding the certification process, coaching, or the website. In addition to follow-up email communication, the EBT Coordinator makes post-training site implementation calls 4- 6 weeks after initial A-CRA training to review early implementation decisions and paperwork and answer site questions.

Implementing staff will participate in bimonthly telephone coaching calls for clinicians and supervisors who are working towards certification. The calls are led by an A-CRA expert. These coaching calls focus on addressing any questions clinicians, supervisors, or management have regarding the use of A-CRA and helping them learn how to implement the interventions with high fidelity; the calls can also involve a special topic or sharing of ideas with other sites implementing A-CRA. Individual coaching calls are available to trainees in need of extra assistance throughout the certification process. A-CRA Progress Reports are sent every month to the site's Project Director or assigned A-CRA specialist. These reports are based on the site's progress with A-CRA.

Fidelity Measures

There are fidelity measures for Adolescent Community Reinforcement Approach (A-CRA) as listed below:

There is an A-CRA checklist and a rating manual. Currently, the rating manual is only provided to individuals who have been trained as expert raters and/or certified A-CRA clinical supervisors.

  • The citation for the checklist is: Smith, J. E., & Meyers, R. J. (2006). The Adolescent Community Reinforcement Approach (A-CRA) procedures checklist. Albuquerque, NM: University of New Mexico.
  • The citation for the manual is: Smith, J. E., Lundy, S. L., & Gianini, L. (2007). Community Reinforcement Approach (CRA) and Adolescent Community Reinforcement Approach (A-CRA) therapist coding manual. Bloomington, IL: Chestnut Health Systems. Contact if interested in purchasing the rating manual.

The following article describes the training for A-CRA raters: Garner, B. R., Barnes, B. N., & Godley, S. H. (2009). Monitoring fidelity in the Adolescent Community Reinforcement Approach (A-CRA): The training process for A-CRA raters. Journal of Behavior Analysis in Health, Sports, Fitness, and Medicine, 2(1), 43-54.

Implementation Guides or Manuals

There are implementation guides or manuals for Adolescent Community Reinforcement Approach (A-CRA) as listed below:

Sites implement by participating in a well-defined training and certification process, which is described on the A-CRA website ( and in the following manuscript: Godley, S. H., Garner, B. R., Smith, J. E., Meyers, R. J., & Godley, M. D. (2011). A large‐scale dissemination and implementation model for evidence‐based treatment and continuing care. Clinical Psychology: Science and Practice, 18(1), 67-83.

Research on How to Implement the Program

Research has been conducted on how to implement Adolescent Community Reinforcement Approach (A-CRA) as listed below:

  • Garner, B. R., Godley, S. H., Funk, R. R., Dennis, M. L., Smith, J. E., & Godley, M. D. (2009). Exposure to Adolescent Community Reinforcement Approach treatment procedures as a mediator of the relationship between adolescent substance abuse treatment retention and outcome. Journal of Substance Abuse Treatment, 36, 252-264. doi:10.1016/j.jsat.2008.06.007
  • Godley, S. H., Garner, B. R., Smith, J. E., Meyers, R. J., & Godley, M. D. (2011). A large-scale dissemination and implementation model. Clinical Psychology: Science and Practice, 18, 67-83. doi:10.1111/j.1468-2850.2011.01236.x
  • Hunter, B. D., Godley, M. G., & Godley, S. H. (2014). Feasibility of implementing the Adolescent Community Reinforcement Approach in school setting for adolescents with substance use disorders. Advances in School Mental Health Promotion, 7(2), 105-122.
  • Campos-Melady, M., Smith, J.E., Meyers, R. J., Godley, S. H., & Godley, M. D. (2017). The effect of therapists’ adherence and competence in delivering the Adolescent Community Reinforcement Approach on client outcomes. Psychology of Addictive Behaviors, 31(1), 117-129.
  • Godley, M. D., Passetti, L. L., Subramaniam, G. A., Funk, R. R., Smith, J. E., & Meyers, R. J. (2017). Adolescent Community Reinforcement Approach implementation and treatment outcomes for youth with opioid problem use. Drug and Alcohol Dependence, 174, 9-16. doi:10.1016/j.drugalcdep.2016.12.029