Reinforcing Positive Behaviors to Encourage Long-Term Abstinence
What Is Contingency Management?Contingency management involves offering tangible rewards in the form of cash or vouchers to reinforce positive behaviors like remaining abstinent, and it serves to increase retention in treatment and promote sobriety. The elegantly simple underlying philosophy of contingency management is that if a behavior is rewarded and reinforced, it’s more likely to occur in the future. Two common types of contingency management interventions are voucher-based reinforcement and prize incentive contingency management. When used within a drug and alcohol rehab setting, positive behaviors such as adhering to a rehab program structure or maintaining abstinence from drugs and alcohol are reinforced with tangible rewards such as extra recreational activities or day passes to visit with family members. Conversely, negative behaviors provide opportunities for personal reflection and productive discussion about motives and the effects those negative behaviors have on others, such as family members, friends, and peers in treatment. Contingency management is an incentive-based intervention that can be used within a very diverse population of clients who are working to complete an alcohol and drug rehab program. It is extremely effective in promoting long-term recovery and several scientific research studies have demonstrated evidence of its efficacy in reducing substance abuse and increasing treatment program compliance. An article published in the journal Psychiatric Times points to several studies that have found contingency management to be particularly beneficial for keeping individuals engaged in treatment. One study found that 75 percent of participants in a contingency management program completed addiction treatment for cocaine compared to 40 percent who received the same type of treatment without tangible rewards. Additionally, over half of the participants who received vouchers or cash achieved at least 10 weeks of continuous abstinence, compared to just 15 percent in the non-voucher group.
Benefits of Contingency Management
- Reinforces long-term abstinence from drugs and/or alcohol
- Reinforces other treatment-related goals
- Reinforces medication compliance during treatment
- Reinforces regular program attendance
- Discourages client discharge against medical advice
How Contingency Management Is Used in Addiction TreatmentContingency management isn’t just used in one particular instance during our addiction treatment program here at Nova—it is deeply embedded into our community culture. Contingency management is used throughout all aspects of addiction treatment at our rehab center. Our multidisciplinary treatment teams work with clients individually and in group settings to emphasize the principles of this therapy by appropriately rewarding positive behaviors and thoroughly addressing harmful behaviors. In doing so, we help clients address the behaviors that may have caused or contributed to their addiction and provide structure to encourage personal growth through consistent learning opportunities and discussion. Examples of contingency management within our 90-day drug and alcohol rehab program include rewarding clients’ positive behaviors with things like:
- Extra recreational activities
- Special sporting events
- Day passes with family members
- Access to musical instruments
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