Spotlight on treatment: Contingency management

Spotlight on treatment: Contingency management

People receive incentives for good behavior and performance throughout their lives. Children get toys or ice cream from parents for cleaning their rooms or getting good grades, and professionals get bonuses or promotions for doing well at their jobs. Addiction recovery should be no different. Contingency management helps addicts stick with their recovery by providing tangible incentives for achieving goals. By rewarding positive change, the therapy helps addicts become accustomed to healthy behavior and less beholden to their drug cravings (National Institute on Drug Abuse).

The name “contingency management” refers to the fact that the rewards are “contingent” on a certain behavior, such as attending meetings or delivering clean drug tests. “Management” indicates that the therapist oversees these behaviors and judging whether they have met the criteria for success.

Rewarded behaviors

Contingency management rewards positive behaviors that will keep the recovering addict from relapsing (Texas Christian University, “Contingency management strategies and ideas”). These behaviors include:

  • Drug abstinence – The most critical aspect of addiction recovery is keeping the patient off of drugs. Contingency management rewards recovering addicts for successfully passing regular drug screenings. Some programs only test for the addict’s drug of choice, but others require that patients take no mind-altering drugs whatsoever, including alcohol, to prevent patients from simply substituting one addiction for another.
  • Therapy participation – Contingency management often supplements additional therapies, such as cognitive-behavioral therapy. Patients receive rewards for committing to their other therapies with regular attendance and motivated participation.
  • Lifestyle improvements – Building a more stable and fulfilling life is critical to keeping off of drugs. This aspect of contingency management encourages patients to take small, tangible steps toward life goals, such as getting job training or reconnecting with friends and family. These goals are highly personal, so therapists will need to customize this aspect of treatment to each patient.

Types of rewards

Rewards used by contingency management can vary. Prize incentive therapy rewards patients with raffle tickets to enter drawings for cash rewards. Patients receive more raffle tickets for each consecutive goal met and reset back to one when they fail an objective. This structure encourages patients to maintain a perfect record. The cash rewards also increase in value as treatment progresses to keep patients motivated to follow through to the end.

Another popular version of contingency management uses vouchers that patients can exchange for a variety of items and services promoting a healthy and drug-free lifestyle. These rewards might include food delicacies, sporting event tickets, massages, gift cards to retail stores or any other goods and services that the patients would find desirable. The value of these vouchers increases just like cash prizes. Vouchers provide control over what the patient can receive as prizes, which prevents the prize from being used to purchase drugs.

Treatments like contingency management keep addicts committed to the recovery process, but the first step is to seek treatment. If you or someone you know has developed a prescription drug abuse problem, call the Prescription Drug Abuse Helpline of California at 855-738-2770 for information and advice on all of your treatment options.