This course presents an evidence-based treatment which provides guidance on how to prepare for and conduct the adolescent community reinforcement approach (ACRA) - intervention sessions with adolescents and caregivers. The manual includes examples of exchanges between therapists and adolescents to illustrate what happens in actual ACRA sessions.

A core curriculum in addiction studies for all practitioner levels. Appropriate course selection for those seeking to meet addiction certification education requirements.

Developed by: Karen Albig Smith, LMFT, LCAS, MAC, CAP, SAP, SAE

Revised 2024

Description:  This course presents an evidence-based treatment which provides guidance on how to prepare for and conduct the adolescent community reinforcement approach (ACRA) - intervention sessions with adolescents and caregivers. The manual includes examples of exchanges between therapists and adolescents to illustrate what happens in actual ACRA sessions. Much of the adolescent community reinforcement approach is based on previous work using a community reinforcement approach (CRA) (Meyers & Smith, 1995). The CRA intervention was adapted for use with adolescents who abuse or are dependent on marijuana. One modification is the inclusion of urine screening for drugs, a procedure commonly used in adolescent substance abuse treatment. Other modifications of CRA used in this manual include (1) the addition of specific sessions for a caregiver only and for a caregiver and an adolescent together, (2) changes in the Happiness Scale and Goals of Counseling forms so that the categories are relevant to adolescents, (3) inclusion of urine-screening feedback procedures, (4) inclusion of dialog representative of interchanges between adolescents and therapists, and (5) requirements that snacks be provided routinely for the adolescents receiving the intervention. Some CRA procedures were eliminated (e.g., use of disulfiram, marital therapy) because they were not relevant for adolescents.

Public Domain Notice:  All material appearing in this study guide except that taken directly from copyrighted sources is in the public domain and may be reproduced or copied without permission from SAMHSA or CSAT. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, DHHS.  The fee you are paying for this course is for the credits only the materials are provided at no charge.

Citation:  Godley SH, Meyers RJ, Smith JE, Karvinen T, Titus JC, Godley MD, Dent G, Passetti L, Kelberg P. The Adolescent Community Reinforcement Approach for Adolescent Cannabis Users, Cannabis Youth Treatment (CYT) Series, Volume 4. DHHS Pub. No. 01–3489. Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 2001.

1.   Participants will be able to describe the adolescent community reinforcement approach.
2.   Participants will be able to discuss the role of rapport building and motivation enhancement.
3.   Participants will be able to complete functional analysis for substance abuse and prosocial behaviors.
4.   Participants will be able to complete ACRA treatment planning utilizing the happiness scale and the goals of counseling.
5.   Participants will be able to increase prosocial recreation using sampling reinforcement and systematic encouragement.
6.   Participants will be able to implement relapse prevention including early warnings, functional analysis, behavioral chains, refusal training, and cognitive restructuring.
7.   Participants will be able to assess and teach communication skills, using techniques and role- play.
8.   Participants will be able to implement problem definition, solution brainstorming, and problem resolution.
9.   Participants will be able to implement and document urine testing.
10.  Participants will be able to involve caregivers in the ACRA approach including enhancing motivators, and service needs.
11.   Participants will be able to enhance the caregiver-adolescent relationship through utilization of communication, problem-solving, reminders and reinforcers, treatment closure, and so on.
12.   Participants will be able to intervene with dropout issues, motivation problems, job seeking, anger management, managing assignments, and treatment activities such as role plays.

CE Credits:  20 (NBCC Hours - 20)

Hour One - Two:  Overview of the treatment model and manual, Key concepts of ACRA.
Hour Three-Five:  Procedure 1: Functional analysis of substance use, Behavior procedure 2: Functional analysis of prosocial behaviors.
Hour Six – Ten:  Procedure 3: The Happiness Scale and the Goals of Counseling Procedure 4:  Increasing prosocial recreation.
Hour Eleven – Twelve:  Procedure 5: Relapse prevention skills, Procedure 6: Communication skills.
Hour Thirteen – Fourteen:  Procedure 7: Problem-solving skills training, Procedure 8: Urine testing, Procedure 9: Caregiver overview, Rapport building, and motivation.
Hour Fifteen – Sixteen:  Procedure 10: Caregiver communication skills training, Procedure 11: Caregiver–adolescent relationship skills, Procedure 12: Treatment closure.
Hour Seventeen – Eighteen:  Optional procedure 1: Dealing with failure to attend, Optional Procedure 2: Job-seeking skills, Optional Procedure 3: Anger management.
Hour Nineteen-Twenty:  Post-test and evaluation.

CE Broker #:   20-328797

Methods: Pre-test, study guide, posttest and evaluation, internet sources via URLs, Q&A by email.

Content Areas:  Adolescent issues, Addictions, Helping relationship, Treatment knowledge, Counseling, Classes in a series.

Purpose: This evidence-based course prepares practitioners to utilize the Community Reinforcement Model with substance abusing adolescents. It is useful for professionals providing clinical services and assessment for substance-involved populations.

Target Audience:  Social workers, marriage and family therapists, licensed professional counselors, mental health counselors, nurses, employee assistance professionals, addiction professionals, behavioral health technicians, and other allied professionals who may work with these populations.

Overview of the whole series:

Increasingly in substance abuse service delivery, assessment, intervention, and prevention supported by science are being required.  Evidence-based best practices permit increased efficacy, a better utilization of all resources and reduce recidivism.  This six-module series is provided to bring such science-based assessment, prevention, and intervention information to the substance abuse intervention specialist.  The text for this series is the Cannabis Youth Treatment Series:  Volume 1-6. (SAMHSA/CSAT:   Please note that while the title of the treatment manual series pertains to cannabis abuse and dependency problems we assert that the practices described in these manuals constitute valid best practices for early intervention (prevention), outpatient and intensive outpatient intervention with youth who are abusing alcohol, and other drugs.  Youth who meet dependency criteria for alcohol, opiates, other habit-forming drugs, and cocaine will require a more intense level of care than the models described in this manual.

Module One provides an overview of prevention, assessment, and intervention in adolescent substance abuse prevention, outpatient, and intensive outpatient services.  Module Two presents a five-session model of combined Motivational Enhancement Therapy and Cognitive Behavioral Therapy.  Module Three presents a supplemental seven-session CBT treatment focusing on coping skills.  Module Four presents the Family Support Network approach.  Module Five describes the Community Reinforcement Approach, and Module Six describes Multidimensional Family Therapy.  Module Six presents the Multidimensional Family Therapy model.  Module Seven is due for release in 2014 entitled Brief Strategic Family Therapy for Adolescent Drug Abuse. Each of these approaches represents the culmination of years of challenging theory and practice to articulate and test models for intervening with youth.  Learners using the entire series will be well equipped to provide early intervention, outpatient, and intensive outpatient services to the substance abusing youth population.

Allied profession approvals can be found at

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Online Course

CE Broker#:
CE Credits:
20 (NBCC Hours - 20)

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