Overview of Contingency Management
- Contingency management uses rewards to reinforce certain behaviors, such as abstaining from drugs.
- It's often used in programs that are 3 months or longer.
- It has shown to be an effective intervention for both alcohol and drug addictions.
What Is Contingency Management?
Contingency management is a behavioral strategy commonly used in substance abuse treatment . This strategy focuses on promoting positive behavior change, such as abstinence, by introducing reinforcement when you meet your goals in treatment and withholding reinforcements or introducing a punishment when you participate in an undesired behavior.
In most instances, contingency management may be employed in addiction treatment programs that are 3 months or longer. This gives you a sufficient amount of time to experience some success in earning positive reinforcement.
The underlying principle of contingency management is that behaviors that are reinforced or rewarded will be more likely to occur in the future, and behaviors that are punished are less likely to occur in the future.1
How Contingency Management Is Used to Treat Addiction
- Voucher-based programs use vouchers that you can earn with every drug- or alcohol-free urine sample or breath test. Typically, the voucher is assigned a monetary value, which you can exchange for different items, such as food or passes for a movie. The value of the vouchers starts out low and increases as the number of consecutive positive behaviors increases.
- Prize incentive programs use similar principles; however, rather than vouchers, you can earn chances to win prizes.
Along with being reinforced for abstinence, individuals participating in either the voucher-based or the prize incentives interventions may also be reinforced for:
- Attending individual and group counseling sessions.
- Completing other goal activities.
- Taking medication as prescribed.
Length of Treatment
In general, contingency management is used in programs that are 3 months or longer. This allows time for you to experience some success in earning a prize from good behavior.
Some people may participate in contingency management longer due to mishaps along the way.
Contingency Management With Other Treatments
Due to its structured approach and ease of implementation, contingency management is an intervention that can be included in a wide variety of other treatment programs for substance abuse and addiction. In fact, contingency management strategies can be used to reward you for your participation in other kinds of treatments.
A large body of research has examined the effectiveness of using contingency management plans for treating individuals with substance abuse. Overall, contingency management appears to be an effective intervention for both alcohol and drug addictions .2
This intervention helps:
- Reduce the use of substances.
- Improves an individual's motivation to comply with medication recommendations.
- Promotes active participation in other treatment-related goals, such as finding and keeping a job.
Drawbacks of This Approach
One of the biggest drawbacks to implementing contingency management into substance abuse treatment programs is the cost.
For the reinforcer to continue to work over time, the value must increase with each successfully achieved treatment goal. Some of the most successful voucher programs offer the opportunity to earn over $1,000 during an individual's enrollment in a traditional, 12-week treatment program.
On average, however, individuals in these voucher-based contingency management programs earn around$600 during their 12 weeks of treatment.
Find a Program
If you need help finding a treatment program that uses contingency management or another type of therapy to treat substance abuse, call 1-888-319-2606Who Answers? to speak with a treatment support specialist.
For more information on programs that may offer contingency management, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) office of the U.S. Department of Health and Human Services. This agency offers an extensive list of certified drug and alcohol treatment facilities .
- Zlomke L. Token Economies. The Behavior Analyst Today 2003;4:177-184.
- Lussier JP et al. A meta-analysis of voucher-based reinforcement therapy for substance use disorders. Addiction 2006; 101:192-203.