Community Reinforcement Approach (CRA)

Scientific Rating:
Promising Research Evidence
See scale of 1-5

Additional Implementation Resources

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

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Community Reinforcement Approach (CRA).

Formal Support for Implementation

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

CRA has a system to teach and certify qualified therapists. After a two-and-a-half day training, they have the option to send in audio tapes to an encrypted system and have their tapes coded by professionally trained coders which will lead to certification. There is a system in place to also certify CRA coders, supervisors, and trainers.

Fidelity Measures

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

Sessions are coded for fidelity purposes and then reviewed with the therapist. To be a coder, the professional must become certified as a therapist before beginning the coder, supervisor certification process. To move onto becoming a supervisor, one must pass all protocols so that they are able to properly code any type of treatment session that comes their way. The coder will listen to and rate at least one therapist tape per week, when possible, using the rating form and criteria provided and maintain 80% agreement with expert rater for a minimum of 5 tapes. Tapes will be rated by RJM & Associates staff as well for inter-rater reliability.

Implementation Guides or Manuals

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

These 2 books with step-by-step information on all protocols and examples are available on

  • Meyers, R. J. & Smith, J. E. (1995). Clinical guide to alcohol treatment: The Community Reinforcement Approach. New York: Guildford Press.
  • Meyers, R. J. & Miller, W. R. (2001). A Community Reinforcement Approach to the treatment of addiction. Cambridge, UK: University Press.

Research on How to Implement the Program

Research has not been conducted on how to implement Community Reinforcement Approach (CRA).