Contingency management, or CM, is a form of behavioral treatment that focuses on reinforcing, or rewarding, desirable or positive behavior. This treatment approach is also known as positive reinforcement, where a patient is given a reward for doing the desired action.
Unlike how they are portrayed in popular media, CM interventions are often long-term, ongoing parts of treatment programs. A behavioral intervention may start with an introduction of the treatment plan, but may not stop until the entire program has been completed.
Contingency management is an effective treatment for substance use disorders and for abstinence (stopping drug use). The treatment goal of CM is usually to change a person’s behavior so they do not have to rely on substance abuse.
Types Of Contingency Management
CM comes in slightly different forms. These forms have been applied over a variety of substance abuse and addiction treatment programs.
Voucher-Based Reinforcement (VBR)
Voucher-based reinforcement can be an effective part of inpatient drug treatment programs. Patients in these programs often take regular drug tests, to make sure their levels are acceptable and that the treatment is going as planned.
If a patient has a urine test and returns a drug-free urine sample, they get a voucher. This voucher can be exchanged for drug-free rewards, such as restaurant coupons or entertainment items. Vouchers may get more valuable the longer the patient stays drug-free.
The voucher is the reinforcer of positive behavior, which is staying drug-free. VBR has been effective in promoting positive behavior changes in patients struggling with opioid or cocaine use, especially when combined with methadone maintenance treatment (MMT).
Prize Incentives Contingency Management (CM)
Prize incentives contingency management uses raffles or drawings instead of vouchers to reinforce positive behavior. Raffle tickets may be given out for negative urine tests, similar to VBR. These tickets are entered into a drawing to win a prize, which often includes cash.
Other positive behaviors that can earn raffle tickets may include showing up to appointments, attending counseling, and working on assignments given out by psychiatrists or clinicians. A star chart may also be used to track each patients’ progress in a public setting.
Prize incentive CM and VBR have been shown to increase treatment retention (amount of time a patient stays on a treatment program).
Outside The Treatment Setting
Contingency management can be helpful even after substance abuse treatment has ended. The behaviors learned during CM, such as building a support network and skills to increase productivity, can be applied to the workplace, social life, and other areas.
CM can help with many forms of substance use. Along with opioids and stimulants, CM has shown promise in reducing cannabis, methamphetamine, and benzodiazepine use. It may also reduce nicotine use in people who smoke cigarettes.
Why Contingency Management Works
Contingency management comes from behavioral psychology, which states that reinforcing positive behavior will lead to more of that positive behavior. People who are rewarded for doing an action will usually do more of that action.
Informal forms of CM may be seen in everyday life. You may “reward” yourself for working hard with taking extra time off, or a child may be “rewarded” for doing chores with a boost to their allowance.
Behavioral psychology usually revolves around the idea that a person’s thought processes can be studied from their behavior, or how they act. This observational, behavioral approach to life helped form the general treatment plan for CM.
Find Contingency Management Treatment Today
If you struggle with chronic drug use, addiction, or another form of a substance use disorder, you may benefit from contingency management.
A treatment provider may combine CM with other methods depending on your needs. Treatments that can be combined with CM include other forms of cognitive-behavioral therapy (CBT), drug tapering, and others.
Inpatient or outpatient programs that help both your physical and mental health can increase your chances of recovery. To find out if contingency management would be an effective treatment for you, please contact us today or speak with your healthcare provider.
National Institute on Drug Abuse - Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine)
PubMed Central - Contingency management: what it is and why psychiatrists should want to use it
TCU Institute of Behavioral Research - Contingency Management Strategies and Ideas
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