A Community Reinforcement Plus Vouchers Approach: Treating Cocaine Addiction Module 1 (4 hours)

Robert Shearer


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Course Summary and Description

This course is based on a NIDA therapy manual for drug addiction series.
CRA+Vouchers is the focus of this course. This treatment integrates a community
reinforcement approach (CRA), originally developed as an effective treatment for
alcohol dependence, with an incentive program(Vouchers) wherein patients can earn
points exchangeable for retail items by remaining in treatment and cocaine abstinent.

This course(Module) is the first of three Modules that provide the necessary guidance
for therapists to implement CRA+Vouchers as a whole as well as the individual
components that are effective as adjuncts to other treatments.

Course Goals and Objectives

The goals/objectives for this course are for the student to understand:

• The research on CRA+Vouchers;
• Lifestyle changes needed;
• Treatment parameters;
• The counseling style;
• Counseling techniques;
• Counseling structure;
• Special issues;
• Documentation of patient contact;
• Clinical supervision;
• The vouchers program;
• Intake;
• Early counseling sessions.

Course Update

The Community Reinforcement Approach (CRA) has been used in the treatment of
opioid-dependent patients since the early 1980s. The effectiveness of the approach
is supported by many research studies and investigations. The current course materials were produced in 1998, but the approach remains very current. For example,
patients treated with CRA in combination with various other approaches have shown
improvement in the following areas:

• Reduction of opioid use;
• Reduction of use of other drugs;
• Improved legal status;
• Less psychiatric symptoms;
• Improved vocational and social functioning;
• Treatment retention;
• Sustained abstinence.

Consequently, the student can remain confident in the efficacy of the treatment in
treating cocaine addiction. Note the following studies:

Abbot, P.J.(2009). A review of the community reinforcement approach in the treatment
of opioid dependence. Journal of Psychoactive Drugs, Vol. 41(4), pp. 379-385.

Secades-Villa, R., Garcia-Rodrigues, O., Higgins, S.T., Fernandez-Hermida, J.R., &
Carballo, J.L.(2008). Community reinforcement approach plus vouchers for cocaine
dependence in a community setting in Spain: Six month outcomes. Journal of
Substance Abuse Treatment. Vol. 34(2), pp. 202-207.

Garner, B.R., Godley, S.H., Funk, R.R., 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. Vol. 36(3). pp. 252-264.

About the Instructor:

Dr. Robert A. Shearer is a retired professor of Criminal Justice, Sam Houston State University. He received his Ph.D. in Counseling and Psychology from Texas A & M University, Commerce. Prior to teaching Criminal Justice, he taught Educational Psychology at Mississippi State University on campus and in the extension program across rural Mississippi during the civil rights era.

He has been teaching, training, consulting and conducting research in the fields of Criminal Justice, human behavior, and addictions for over thirty-six years. He is the author of over sixty professional and refereed articles in Criminal Justice and behavior. He is also the author of Interviewing: Theories, techniques, and practices, 5th edition published by Prentice Hall. Dr. Shearer has also created over a dozen measurement, research, and assessment instruments in Criminal Justice and addictions.

He has been a psychotherapist in private practice and served as a consultant to dozens of local, state, and national agencies. His interests continue to be substance abuse program assessment and evaluation. He has taught courses in interviewing, human behavior, substance abuse counseling, drugs-crime-social policy, assessment and treatment planning, and educational psychology. He has also taught several university level psychology courses in the Texas Department of Criminal Justice Institutional Division, led group therapy in prison, trained group therapists, and served as an expert witness in various courts of law.

He has been the president of the International Association of Addictions and Offender Counseling and the editor of the Journal of Addictions and Offender Counseling as well as a member of many Criminal Justice, criminology, and counseling professional organizations prior to retirement.

Additional information


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