Contingency Management

Treating Substance Use and Addiction

Contingency management is a standard treatment for substance use disorders and addiction.

It is a type of behavioral therapy where an individual is reinforced or rewarded for evidence of positive behavioral change. It may often involve the provision of monetary-based reinforcers, submitting negative drug tests, or an opportunity to win prizes.

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Contingency Management Therapy

The principles of this form of behavioral therapy involve reinforcing positive behaviors. For example, abstinence from drugs is reinforced with every negative urine test. Monetary reinforcement is done with vouchers and access to a clinic-managed bank account or a prize draw.

The level of reinforcement provided to each client increases as the sustained periods of abstinence increase.

It has been proven effective at reducing opioid use, alcohol, marijuana, and benzodiazepine use. It is common to use contingency management to reduce recidivism rates among individuals with addiction and criminal justice offenses.

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Why It is Used

The following reasons are why this form of behavioral therapy is applied to treating drug and alcohol addiction: 

  • CM is based on operant conditioning, an approach that shapes behaviors based on consequences. The individual’s behavior changes based on pleasant or unpleasant experiences.
  • It helps the person by removing the rewarding aspects of addiction and replacing it with something else.
  • The behavioral changes are targeted and accomplished through immediate rewards and consequences. 
  • Individuals begin to initiate and sustain abstinence as long as the rewards become greater and the consequences become more severe.

The Objectives of this Therapy are Specific for Each Person

Incentive-based interventions like contingency management increase treatment retention and promote long-lasting abstinence.

The objectives are specific and accomplish some of the following:

  • It targets specific behaviors to achieve positive and specific outcomes; the targets are negative drug tests or changes in behavior.
  • Each individual receives specific reinforcement, and not everyone works towards the same goals.
  • The incentives are specific to create the desired outcome. It is chosen based on the individual, and a schedule is established whereby the person can achieve specific goals.
  • A specific level of reward is given to achieve the targeted behavior.
  • The frequency of reinforcement differs for each person, depending on targeted behavior, resources, and the amount of contact the client has with the clinical provider.
  • The duration of reinforcement is predetermined to achieve the desired behavior.

Contingency Management and Other Therapies

Contingency management is not the best approach for every individual. Moreover, it is often combined with other behavioral therapies. Integrated approaches often include cognitive behavioral therapy, holistic therapies, and individual or group counseling.

A well-rounded rehabilitation approach is critical because it offers more opportunities to address every aspect of addiction.

Contingency management is often provided through outpatient and residential drug rehab centers, whether this involves short-term or long-term care.

However, suppose you or your family are considering contingency management. In that case, it is important to speak with one of our Addiction Referral and Consultation Services experts

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