Contingency management treatments

The British Journal of Psychiatry (Impact Factor: 7.34). 09/2006; 189:97-8. DOI: 10.1192/bjp.bp.106.022293
Source: PubMed

ABSTRACT Contingency management is highly efficacious in improving outcomes in substance misuse. Whereas a great deal of research has evaluated these interventions empirically, few treatment providers integrate this approach in practice. The rationale for contingency management is described, with a call for expansion of this technique outside the USA.

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    • "A number of effective behavioral treatments have been developed for addictive behaviors (Carroll and Onken, 2005; Dutra et al., 2008; Miller and Wilbourne, 2002). Among those with the strongest level of empirical support from randomized clinical trials are contingency management (CM, where abstinence or other targeted outcomes are reinforced with incentives)(Higgins et al., 1991; Petry, 2006), motivational interviewing (MI, where a specific, nonjudgmental interviewing style is used to enhance motivation and harness the individuals capacity for change)(Hettema et al., 2005; Miller, 1985), and cognitive behavioral therapy (CBT, which teaches specific strategies and skills to reduce substance use) (Carroll et al., 1994; Marlatt and George, 1984). In contrast to the specificity of effects of most medications for drugs of abuse (e.g., methadone or buprenorphine have demonstrated efficacy for opioid dependence with little effect on concomitant cocaine use), empirically validated behavioral therapies tend to be effective across the range of substance use disorders. "
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    • "In addition to our focus on the techniques of behavior change themselves, concerning which there are many technical aspects (e.g., Stitzer & Petry, 2006), we are also interested in how behavioral therapists and counselors attempt to engage their clients in the process of change. That is, the techniques of goal setting and contingency management, which are techniques used to change behavior within treatment settings, do not speak to the clinicians' orientation "
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