Your Double-Punch Strategy for Creating Change with a Child Struggling with Addiction & Mental Health

Brenda Zane: INTRO When both an interventionist and a therapist that I hired used MI with my son, I almost lost my mind. I thought they were going to say the magic thing that was going to enlighten him and get him to change and fix this huge problem that we had. And they just kept asking him questions, nodding with understanding and saying things like, I can see how that would make you mad or tell me more about that. And I was just completely dumbfounded. But guess what? My son talked to them. He didn’t get defensive and push back on them, and sometimes he just sat there and thought about something without talking at all. It was kind of magical and I could see that I was going to have to start doing something different if I wanted to get those results. Welcome to Hopestream, a podcast where you’ll hear interviews, conversations, and encouraging words for parents of teens and young adults who struggle with substance misuse and mental health. I’m Brenda Zane, your host and a fellow parent whose child struggled. I’m so glad you’re here. Take a deep breath and know you’re not doing this alone anymore. Hello, friend. Happy 2025. I haven’t had a chance to just chat one on one with you since we turned the page on a new year. So I hope things are going well. And thank you so much for being here for showing up. I want to quickly say hello to our friends and listeners outside of the US today. Did you know we have listeners from 37 different countries? Shout out to you if you are listening from Canada, Australia, the UK, Germany, New Zealand, or Ireland. You guys are right up there in the top of the charts, next to the US, of course. I’m so glad you’re here because as we know, no matter where you are parenting from, when your child struggles, it is scary and lonely. So I’m glad to know that you have found your Hopestream family here.

[00:02:19] Why add MI to CRAFT? — Today, I want to explore a question that I often hear, which is, Why would I add motivational interviewing or am I to the community reinforcement and family training approach craft? Now this may be a complete mystery to you. Like what is she even talking about? And if that’s the case, hang on because it’s going to make a lot of sense. But I think it is important to share information about the approaches we teach and why. Because none of this was created in a vacuum, we are not just winging it over here at HopeStream. You deserve to know why and how these tools and actions we recommend and teach work. So today we’re going to spend some time talking about motivational interviewing, which I will refer to as MI going forward since it’s kind of a mouthful.

[00:03:10] History of CRAFT and MI — So Very quickly, I’ll share the background on this topic. Basically, when Dr. Robert Myers created the CRAFT approach in the early 80s, he was working with families of people struggling with substance use, and he noticed something. He noticed that the traditional high confrontation approaches of that time weren’t working too well. He designed the CRAFT method specifically to work through concerned family members of loved ones who were refusing to seek help for their substance use. CRAFT teaches the family members skills, so not looking at the person who’s misusing substances, specifically teaching family members skills to reinforce sobriety or recovery, encourage recovery, rather than encouraging alcohol or drug use. and to also motivate their loved one to enter treatment or accept help. It’s still true, but especially 40 or 50 years ago, families were shut out of the process of helping their loved one get healthy. They basically were told, stand by, watch helplessly as your child, or whoever it is that you love, continues down this destructive, deadly path. And unfortunately, I know for sure that that message is still being relayed to parents today, which is heartbreaking since there has been so much development in understanding the brain and in the world of motivation and change in the past, I don’t know, 50, 70 years or so. So Dr. Meyers wanted to change that your helpless dynamic by giving families tools that would allow them to play a more active and supportive role in encouraging their loved one, be it a spouse, a partner, a sister, brother, or child, or someone else to accept help.

[00:05:06] CRAFT and its main goals — And the CRAFT approach is a set of nine procedures that family members or friends learn with three main goals in mind. Number one is to help your treatment resistant loved one, again, child, spouse, partner, whoever it is, who is misusing substances to reduce their use, preferably reducing it even before going into treatment. Number two, to influence your child or someone else to enter treatment, which could be a variety of things. So we have to keep an open mind on that. And the third thing is to prioritize your own happiness and wellbeing, regardless of whether your child enters treatment or accepts help. So that’s craft in a nutshell. And that all sounds great, right? And it is. The research, which started decades ago and is still ongoing, continues to show efficacy at rates up to 70%, even higher. I think it’s actually like 76 percent of parents and other concerned people being able to get their loved one, to reduce their use, and accept help over a 12 week period using the CRAFT approach, compared to someone going to Al Anon or using a traditional Johnson style intervention. And because I know you are like me, there are links to the research in the show notes if you want to see that data. And I do think that’s important. So it’s there. Okay. So why would we then add this thing called motivational interviewing? Am I to such a successful approach? Well, for that answer, You need to turn to Dr. Bill Miller, a clinical psychologist who is generally considered the founding father of MI. A lot of backstory there, but I’ll save you the detail. He retired from the University of New Mexico as Emeritus Distinguished Professor of Psychology and Psychiatry, and is a colleague of guess who? Dr. Myers. So here you have two people. Dr. Bill Miller. With a deep commitment to helping individuals and families who are affected by substance use, collaborating with their groundbreaking approaches, wouldn’t you have loved to Ben fly on the wall in some of their early meetings? I definitely would have. Both MI and CRAFT are grounded in the belief that compassion, collaboration, and respect are more effective than confrontation or coercion. As colleagues, they were at the University of New Mexico. These two, Dr. Miller and Dr. Meyer, saw how their approaches complemented each other. MI helps people explore their internal motivation for wanting to change. And CRAFT gives you, as the family member or a friend, the tools to encourage and support that change. And, what’s interesting though, at least I think it’s interesting, maybe I’m just A real nerd. I think it’s very interesting that MI is not one of those nine craft procedures, but there is so much synergy between the two. And I truly believe that craft is more effective if you have even a basic understanding of MI. Again, because MI helps people find their intrinsic motivation to change, because as you’re probably well aware, I don’t need to tell you this, you cannot inflict change or help. Okay, enough history lessons. Thanks for bearing with me on that. I do think it’s important. I want you to be grounded in this information because if you are getting that doubtful side eye from your family members or friends who don’t understand the approach you’re taking or that you’re considering taking, it is just nice to have some data to back it up. So in the show notes, I’m putting in a few book links. And I’ll probably throw some podcasts in there, too, that you can forward to anyone who may be interested in the strategic approach that you’re taking or considering. And if none of this makes any sense, and you just want to see something change quickly in your family system, you will want to go to HopeStreamCommunity. org. At the top menu, click on the stream. And that will give you lots of information about our private online community for moms, female caregivers, female co parents, of kids who struggle with mental health and substance misuse. That is where we go deep into these approaches, both in a live format, on video format. you can be anonymous there if you choose to. So that is where you can get intimately familiar with how to create. These conditions for change with your child or anyone who is resistant to treatment for their substance misuse

[00:10:08] The difference between CRAFT and the Invitation To Change approach — Now that you have a little bit of background on CRAFT and MI I have one more thing to clear up because I often get asked what is the difference between CRAFT and the invitation to change approach and It’s pretty simple. The invitation to change is the foundation of CRAFT those nine procedures plus Two more things Am I an acceptance and commitment therapy or ACT? See this should all be wrapping up and making sense now. The brilliant team at the Center for Motivation and Change, who are by the way, the authors of the book, Beyond Addiction. They recognized how vital it is for parents and concerned significant others to have a base knowledge of and the ability to use MI because it enhances and strengthens the relationship between the person who wants to see the change and the person who doesn’t necessarily want to change. Probably a pretty familiar situation that you find yourself in. So I’ll cover the basics of MI and then in part two of this episode we will cover ACT. So then you’ll have the full picture and in the show notes, I’m linking to some additional MI resources for you. Uh, one is one of the top 10 HopeStream episodes of all time. Dr. Emily Klein was on episode 160. She’s a clinical psychologist and the author of the book, The School of Hard Talks, how to have real conversations with your almost grown kids. Cannot recommend it enough. There’s even little scripts in there for you, which I so appreciate. So that’s great. There’s a link to her episode. Also, she has a free e course that you can take. So that’ll all be in the show notes for you.

[00:11:56] A story that illustrated MI — Let me share a story now that I think will resonate with you as much as it does with me when it comes to motivation and change. It’s the old fable about the sun and the wind. Both were trying to get a person to take off their coat. The wind thought it could just blow with all of its strength and force to get the person to take their coat off. But the harder it blew, the more tightly the person wrapped the coat around themselves. Then it was the sun’s turn. Instead of force, the sun simply shone warmly and gently, and eventually the person felt comfortable enough to take off their coat. This story captures the essence of motivational interviewing so beautifully. When we are trying to help someone, especially if it’s someone we love deeply, when we’re trying to help them change a difficult behavior, our first instinct might be to act like the wind. We try to push, we try to pull. We work really hard at educating and convincing them. We might use logic, guilt, even anger or bribing. But, like the wind, this often just causes the person to hold on tighter to the very thing that we’re hoping they’ll let go of. MI encourages us to be like the sun. Instead of forcing change, we create a safe, non judgmental space where the person can reflect on their own reasons for change. We shine a light on their strengths, we gently explore why they’re ambivalent, and then we let them discover in their own time what might be possible. When we lead with warmth and empathy, we respect the fact that change has to come from an intrinsic source if it’s going to last. this approach, while it might look like it, does not mean you’re passive. It’s actually a skillful, intentional way to guide someone toward their own reasons and motivation for change. which are so much more powerful than any external pressure that we can apply. Now I know what you might be thinking. You’re saying, yeah, Brenda, that is great, but my child is in danger. I am worried sick about them and their health and safety every minute of every day. I don’t think I have time to be the sun and warm them up so they can find their motivation to change from within. Thank you very much. I hear you, I really do, because I was there at one point, , and when both an interventionist and a therapist that I hired used MI with my son, I almost lost my mind. I thought they were going to say the magic thing that was going to enlighten him and get him to change and fix this huge problem that we had. And they just kept asking him questions, nodding with understanding and saying things like, I can see how that would make you mad or tell me more about that. And I was just completely dumbfounded. But guess what? My son talked to them. He didn’t get defensive and push back on them, and sometimes he just sat there and thought about something without talking at all. But I could see that his brain was working. It was kind of magical and I could see that I was going to have to start doing something different if I wanted to get those results. And yes, he was in great danger and I wanted things to change immediately. And, I realized that using this approach consistently was the faster way to get through to him because the other options that I was trying, a. k. a. the shouting, shaming, blaming, and bribing approaches were actually getting us further apart, not closer together.

[00:15:56] On getting to a nonjudgemental mindset — And before I go any further, there are two little things that I have said so far that I want to go back and highlight because I know you might be getting tripped up on them. The first is when I said, instead of forcing change, we create a safe, nonjudgmental space where the person can reflect on their own reasons for change. Hmm, a safe, nonjudgmental space. To stop being the wind and use more of a sun strategy with someone who’s actively harming themselves and potentially causing havoc in your life, you may have to modify your mindset and make some changes to your own lifestyle. I say this and truly believe it’s important to mention because if you were in a place where being the sun was easy, you would likely already be beaming warm rays all over your kiddo. And to get to the place of being able to be sunny and warm, I believe it takes a willingness to have empathy and compassion for what your child’s going through. Even though it may look like they are defiant, oppositional, risky, short sighted, and determined to hurt you and themselves through their dangerous substance use and lifestyle choices. So, to get to the empathetic, compassionate place that’s required to use MI in particular, I recommend educating yourself about substances, addiction, trauma, and the root causes of substance use disorders. In the show notes, I have resources for you to gain that education. It is imperative to properly use MI. Without a foundation of non judgment, curiosity, and a spirit of willingness to set aside your agenda, MI cannot work as intended. So, that was one little thing I wanted to go back to.

[00:17:53] A highly strategic approach that requires more — The second thing I want to highlight quickly is that even though I said this isn’t a passive approach, it can come across that way if you don’t also remember that none of this work happens in a vacuum. While you are using MI, which is highly strategic and also pretty stealthy if you’re good at it, You are focusing on your own self preservation, your own wellness, and having healthy boundaries. I know, the B word. This tapestry of skills and actions and mindsets is what we focus on, is what we do in a deep way in the stream, because it’s a lot to wrap your head around at first, and it is so much easier to do with other people who are working at the same goal. So now that you know that there’s potentially some education that you can arm yourself with to get to the point where you can be more sunny, and you’re layering on lots of self preservation measures, and you have your boundaries clear and communicated, we can talk about motivational interviewing.

[00:19:03] When MI will be helpful for you — Okay, when would it be helpful to use MI? Here are a few scenarios. I like scenarios. I think it makes it easier to understand these crazy things. So here are a few scenarios that indicate that MI is going to be very helpful for you. If you find yourself talking more of the time than your child is, if you are passionately advocating for why change would benefit them, to them, to them, If you repeatedly try to educate them on the consequences of their unhealthy behavior. If you are trying to figure out why your child doesn’t follow through on things like going to therapy or treatment or doing healthy activities. If you’re thinking, my child isn’t ready to change, so there is nothing I can do. And if you understand the stages of change, this would be the pre contemplative stage. Or, If you just feel like, realistically, there is nothing I can do at this point. Those are all scenarios that indicate MI is going to be very helpful for you. So, that’s good news, right? What I love about MI is that it is respectful. In a world where our kids, and when I say our kids, I mean our kids, are beautiful, crazy, lovely, very complicated, brilliant. Substance using kids, our kids can get a lot thrown at them and not get a lot of respect from adults. MI gives you a framework for having effective conversations in a way that respects the agency that your child has over their choices and their life. I think that is so important and probably most importantly. MI addresses the problem of ambivalence about change, which drives us bananas as parents, right? That’s when somebody wants something to change and they want it to stay the same at the same time. It’s crazy making.

[00:21:09] The four core principles of MI — So the four core principles of MI are, and this is in my own language, this is not in the textbook, so just so you know, Number one, show empathy. This kind of goes back to the education piece. You got to get to the empathy place first. And this is really about trying to understand your child’s perspective, even if you don’t agree with it, which you probably don’t. Instead of jumping in with a solution or a judgment, it’s saying, I get that this is hard for you, or I can see why you would feel that way. Empathy builds connection and when your child feels understood, they will be more likely to open up. Number two, help them see the gap. This is about gently helping your child recognize that there’s a disconnect between where they are right now and where they probably want to be. And we often only focus on where they are now and often we forget. That they’re probably have dreams and goals and things that they want to be doing that are not what they’re doing now. So it’s not pointing out what’s wrong, but asking questions like, what do you wish was different? Or what would different look like to you? Number three is don’t fight their resistance because you know you’re going to get it right. When your child gets defensive or they shut down, don’t push harder. Instead, roll with it. Acknowledge their feelings and just keep the conversation going without escalating the tension. So that could sound like, Hmm, that sounds really important to you. I would love to know more about it. Or it sounds like you’re not interested in my thoughts on that. Okay, let’s just move on. Roll with it. Number four, build their confidence. With MI, we put the focus on helping your child believe in their ability to make changes. You can remind them of the times that they have faced challenges in the past because they probably have and come out stronger. That could sound something like, I know you’ve handled tough things before. I believe you. I know you can figure this out. Our kids are some of the most resourceful humans on the planet. Remind them of that. You are so resourceful. I can’t wait to see how you’re going to solve this problem. And then put your lip clip on and let them respond. And don’t give them 11 potential solutions. So as you can see with those four points, MI is not about controlling the conversation. It’s about creating a space where your child feels safe enough to start exploring change on their own terms.

[00:23:56] MI conversations sound different — Conversations, when you’re using MI, sound different. And it takes a little bit of getting used to. I know it’s helpful sometimes to hear what I mean when I say things like that. So for example, instead of saying, you need to stop using drugs, you might say, I understand that weed helps you cope with your anxiety. Can we talk about some other ways to manage that? Or use open ended questions that can’t be answered with a one word response like, I know weed’s really important to you. What do you like about it? And what are some things that you don’t like? This is where you can see how important it is to have a non judgmental attitude and voice because you gotta say this with zero judgment. You can recognize and acknowledge their strengths and efforts no matter how seemingly small they might be. You could say, I appreciate how open you’ve been in talking about this with me. Even though you might be having a heart attack on the inside, you can let them know how you appreciate it. You can also mirror their thoughts to show understanding. So if they say, I don’t think I have a problem, you could respond with, you feel okay about your current choices. Again, zero judginess in the voice and keep it to that. Just reflect back what they’ve said. Then it’s important to recap conversations to make sure you understood what they said. That could be something like, so you’re saying that using helps you relax. and at the same time it might also be causing a few issues at school. Did I get that right? The net of it is that combining MI with craft is super powerful. It gives you a way to support your child through compassionate and effective communication instead of, let’s just say, less effective tactics like shame, blame, threatening, all those. And when you can be the son. I put that in air quotes for you. You create an environment where your child feels safe to consider and make positive changes without all that force. If you want to dive deeper into either craft or MI, Check out our previous episodes and resources. HopeStreamCommunity. org is our website. We’ve got a playlist there of all the craft related episodes, and we are also working on an MI one as well. That’s also where you can find the show notes for this episode.

[00:26:29] Free e-book: Worried Sick — And if you’re looking for some additional guidance on the craft approach, you can go to HopeStreamCommunity. org forward slash worried W O R R I E D to download a free ebook I wrote. It’s called Worried Sick, a compassionate guide for parents of teens and young adults who misuse substances. It’ll give you some peace of mind and ways that you can start using a more compassionate, less confrontational approach like we’ve talked about today with your child. That’s hopestreamcommunity. org forward slash worried. Thanks for hanging out with me today. I know there are 3 billion other podcasts and things that you could be doing with your time. So it tells me a lot about you that you’re here. And I hope if you’re a mama listening, you will come hang out with me and Kathy and lots of other moms in the stream. That’s where we do the deeper work, where you have a full badass tribe around you for this journey. And it’s actually really beautiful. So if having some extra scaffolding around you right now feels good, I hope that you will give yourself the gift of our love, our support, and importantly, the education that you will gain. Just go to HopeStreamCommunity. org and tap on the stream in the main menu. You are the most amazing, amazing Elite Parent ever. Keep your head high. You have nothing to be ashamed of, nothing to be quiet about, and absolutely everything to gain from the work you’re doing. And I will meet you right back here next week.