This program is for adults who are in outpatient substance abuse treatment.

Contingency Management (CM), a community-based, substance abuse treatment program, is designed to promote behavior change to reduce drug use and improve substance abuse treatment rates by offering rewards and incentives as reinforcers.

Evaluations of CM have revealed mixed findings. Compared to non-participants, those who participated in the program were more likely to stay in treatment and to experience longer periods of abstinence from substance use. Results related to overall use of substances, however, were mixed with only some studies linking the program to lower rates of use as indicated by urine and breath samples. In addition, effects tended to fade over time and the sustainability of positive outcomes beyond program completion and the removal of abstinence incentives is of concern.

CM is an outpatient behavior modification intervention and is often used as an adjunctive program to other approaches such as Cognitive Behavioral Therapy or other substance abuse treatment interventions such as Twelve Step Facilitation. The program focuses on altering participants' substance abuse behaviors by utilizing behavioral principles. This program consists of three main parts.

• Behavior targeted for change – Abstain from substances, which is demonstrated by mandatory urinalysis or breathalyzer tests that come back negative, and adhere to treatment goals and meeting attendance expectations.
• Reinforcers for the intended behavior - Provide money, prize drawings, or vouchers that represent tangible items and can be redeemed at a later time.
• Consequences for undesirable behavior - Eliminate reinforcers when participants submit substance-positive samples, do not attend meetings, or fail to comply with treatment goals.

CM programs can be adapted for diverse populations and audiences and can be applied to other areas, including weight loss, enhancing exercise, medication adherence, and diabetes management. The CM for Substance Abuse Treatment manual provides guidelines for creating a customized program.

CM has been used widely across the United States since the late 1960s. In February 2011, the Department of Veterans Affairs launched an initiative to increase veterans’ access to CM for the treatment of substance use disorders.

This program is delivered by clinicians who have a doctoral degree or who are doctoral candidates. Training is suggested and is available in a variety of formats. Please use details in the Contact section for more information on training and costs.

Considerations for implementing this program include recruiting dedicated professionals to implement the program, acquiring participant monetary prizes, and obtaining participant buy-in.

The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

If you are interested in implementing CM, the Clearinghouse is interested in helping you! Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Program length varies based on needs of participants; however, typical length is 3 months.

Material costs vary based on program length and the reinforcers used. The CM for Substance Abuse Treatment Manual is $55.19 as an eBook, $55.16 as a paperback book, and $168 as a hard back book. This manual provides a guideline to help determine the costs of implementation. Please visit https://www.routledge.com/Contingency-Management-for-Substance-Abuse-Treatment-A-Guide-to-Implementing/Petry/p/book/9780415882897 for more information and to place orders.

To move CM to the Promising category on the Clearinghouse Continuum of Evidence, at least one evaluation should be performed demonstrating positive effects that do not fade over time and last at least one year from the beginning of the program or at least six months from program completion.

The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu

Contact the Clearinghouse with any questions regarding this program. Phone: 1-877-382-9185 or by email: Clearinghouse@psu.edu

You may also contact Contingency Management by mail UConn Health, 263 Farmington Avenue, Farmington, CT 06030-3944, email cmrewards@uchc.edu, or visit https://health.uconn.edu/contingency-management/contact-us/

https://www.hazeldenbettyford.org/articles/contingency-management, http://contingencymanagement.uchc.edu/index.html, and https://www.recoveryanswers.org/resource/contingency-management/

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Forster, S. E., DePhilippis, D., & Forman, S. D. (2019). “I's” on the prize: A systematic review of individual differences in contingency management treatment response. Journal of Substance Abuse Treatment, 100, 64-83. https://doi.org/10.1016/j.jsat.2019.03.001

Sayegh, C. S., Huey, S. J., Zara, E. J., & Jhaveri, K. (2017). Follow-up treatment effects of contingency management and motivational interviewing on substance use: A meta-analysis. Psychology of Addictive Behaviors, 31(4), 403-414. https://doi.org/10.1037/adb0000277

Secades-Villa, R., Aonso-Diego, G., García-Pérez, Á., & González-Roz, A. (2020). Effectiveness of contingency management for smoking cessation in substance users: A systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 88(10), 951-964. https://doi.org/10.1037/ccp0000611

Toegel, F., Toegel, C., & Silverman, K. (2024). Contingency management as a maintenance intervention in the long‐term treatment of substance use disorders. Addiction, 119(9), 1515-1516. https://doi.org/10.1111/add.16534