How does CRAFT in this book differ from traditional family confrontation approaches?

Smith contrasts CRAFT’s reinforcement-and-training logic with approaches that push the substance abuser to “see the light” first. In CRAFT, the clinician works through the CSO’s behavior changes, so the family stops accidentally reinforcing use patterns.

What does Smith mean by CSOs, and why are they central to the method?

CSOs are the concerned significant others—partners, parents, or close relatives—who are willing to engage in training. Smith’s point is blunt: you can’t control the abuser, but you can coach the CSO to respond in ways that change home incentives.

Is the domestic violence risk guidance worth reading even if you’re not focused on safety planning?

Yes, and it’s one of the most serious parts of the book. Smith builds safety awareness into practice rather than treating it as a separate checklist, which matters when families are already volatile.

How does Smith handle relapse moments during CRAFT sessions?

She treats relapse as predictable and uses it as a training trigger for the CSO’s response. The book emphasizes adjusting routines and consequences so the CSO isn’t pulled into reactive cycles that reward use.

What chapter should you read first if you only want the CRAFT implementation basics?

Start with the early overview chapter on CRAFT itself, because Smith’s later steps assume you understand the reinforcement and family-training premise. Without that foundation, the intervention sequence can feel like disconnected tactics.

Does Smith explain what to do when the CSO’s attempts at rewarding sobriety backfire?

She does, through troubleshooting and case examples that show how good intentions can become enabling. Smith pushes the clinician to help the CSO tighten boundaries and keep reinforcement behavior consistent.

How does this compare to Using Motivational Interviewing with families?

Motivational Interviewing often targets the individual’s readiness to change, while Smith’s CRAFT targets the family system’s behavior patterns. You can combine ideas, but the book’s engine is reinforcement training via CSO coaching.

What makes Smith’s “client materials” different from generic worksheet advice?

Smith’s materials are meant to be used in-session and repeated with structure, not just handed out as homework. If you’re implementing CRAFT, these resources reduce guesswork and keep the intervention consistent.

Motivating Substance Abusers to Enter Treatment by Jane Ellen Smith — book cover

Self-Help

Motivating Substance Abusers to Enter Treatment — Book Summary & Review

Name: Motivating Substance Abusers to Enter Treatment
Author: Jane Ellen Smith
ISBN: 9781593856465

by Jane Ellen Smith

Last updated: August 2026

4 min read 289 pages Published 2007-11-01 Guilford Press

Motivation Psychology Family Polytoxicomanie Réadaptation Substance abuse

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Motivating Substance Abusers to Enter Treatment Summary

Motivating Substance Abusers to Enter Treatment is built around CRAFT (Community Reinforcement and Family Training), and Jane Ellen Smith keeps circling back to one practical goal: help clinicians coach concerned family members to change their own behavior so sobriety gets rewarded and substance use gets discouraged. The book’s structure is clinician-forward, starting with a concise overview of CRAFT and then moving into step-by-step planning and delivery of motivational, behavioral, and cognitive interventions. One of Smith’s most concrete sections is the chapter-level walkthrough of how CSOs (concerned significant others) can use reinforcement strategies with clear, reproducible scripts and “client materials” rather than vague encouragement. She also threads in troubleshooting for the messiness of real life—what to do when a family member’s attempts at “rewarding sobriety” accidentally come off as enabling, or when the home dynamic spirals after setbacks. A standout part of the approach is how Smith frames CSO behavior as changeable: instead of demanding the substance abuser get motivated first, the clinician teaches the CSO to adjust communication, routines, and consequences. Smith even includes guidelines for handling domestic violence risk, which is the book’s reminder that “motivation” work can’t ignore safety. The honest limitation: this is not a narrative or memoir-style read, and it doesn’t offer a broad survey of addiction treatment philosophies; it’s tightly focused on implementing CRAFT, so readers hoping for a wider clinical worldview or research review beyond the evidence base summary may feel boxed in. Still, if you’re trying to run CRAFT sessions (or supervise someone who is), Smith’s repeated emphasis on family training mechanics, plus her copious case examples, makes the book feel like a working manual you can actually adapt.

Key Takeaways from Motivating Substance Abusers to Enter Treatment

1
CRAFT: A clinician coaches the CSO to shift reinforcement patterns so sobriety is rewarded and substance use loses its payoff at home.
2
CSOs (concerned significant others): Smith treats the family as the leverage point, teaching them skills for communication and consequences under pressure.
3
Motivational interventions: The book emphasizes concrete motivation work—goal setting and structured interaction—rather than persuasion speeches.
4
Behavioral and cognitive interventions: Smith layers thought and action changes so CSOs respond differently after relapses, not just during “good weeks.”
5
Domestic violence risk guidelines: Safety planning is integrated into practice so CRAFT doesn’t ignore coercion, escalation, or caregiver danger.

Who Should Read This

If you’re a therapist, counselor, or graduate student stuck trying to get a resistant loved one into treatment without relying on ultimatums, this is for you. Someone who has a household where substance use keeps escalating and you need a structured way to train the CSO will find Smith’s CRAFT steps immediately usable.

Who Shouldn't Read This

If you want a broad, comparative guide to addiction treatment models, Smith’s narrow focus on CRAFT will feel limiting. If you’re looking for emotional storytelling or a lighter self-help tone, this clinician-oriented book will likely read as procedural and demanding.

Editor's Verdict

Smith’s best move is operationalizing CRAFT through step-by-step clinician guidance and case examples, especially around teaching CSOs reinforcement strategies and troubleshooting common failures. The limitation is that it offers little beyond implementing CRAFT, so readers seeking a wider addiction-treatment map or richly written clinical narrative will be disappointed. Anyone early in their training—right before they start supervising family-focused work—will get the most traction from Smith’s specific planning and session logic.

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Motivating Substance Abusers to Enter Treatment — Frequently Asked Questions

About Jane Ellen Smith

Jane Ellen Smith is the author of Motivating Substance Abusers to Enter Treatment. She is credible on this topic through her professional work focused on substance-abuse treatment engagement and related behavioral interventions. Her writing addresses practical strategies for increasing entry into treatment among people with substance use problems. Other notable works by Smith are not specified in the available information.