Contingency Management (or sometimes referred to as Motivational Incentives or Prize Contingency Management) represents one of the most effective ways to enhance motivation among substance abusers by leveraging their personal strengths and focusing on positive gains.
Contingency Management (CM) is a scientifically-based treatment approach grounded in the principles of behavior management and cognitive-behavioral therapy that provides incentives for abstaining from drug abuse, changing thinking patterns, and improving coping skills.
Techniques involved in this treatment include positive reinforcement for drug abstinence and other treatment gains, functional assessments to identify triggers for use and the thoughts and feelings associated with use and non-use, development of self-management plans to develop coping skills and predict and plan for future barriers to success.
CM is a celebration of success that helps the client remain motivated to change and provides a positive and welcoming treatment environment.
CM is Supported by Leading Agencies as being an Effective Treatment
Addiction Technology Transfer Center: CM Part 1: An Evidence-Based Approach to Positive Change
Addiction Technology Transfer Center: CM Part 2: The Founding Principles
Behavioral Interventions
An integral part of the CM treatment approach is the use of behavior plans to reinforce positive changes. The therapist, in full collaboration with the client and their support network, create a system where the client has the ability to earn rewards and access privileges for negative urine screens and other positive therapeutic gains. This system helps drive motivation to avoid drugs by giving clients a positive goal to work toward that is an alternative to seeking drugs.
Cognitive-Behavioral Interventions
The cognitive-behavioral interventions used in CM target the social-skill and problem-solving skill struggles that are commonly found with substance abuse problems. Throughout treatment the therapist works closely with the client and their supports to closely examine the specific triggers of the drug use.
This is a highly individualized process during which the therapist helps the client walk through the specific people, places, times, situations, thoughts and feelings that drive the drug seeking and drug using behaviors. Through this highly individualized approach the client learns to recognize triggers and develop strategies to avoid high-risk situations, cope with unavoidable risky situations, use effective drug refusal skills, and utilize alternative coping strategies. The support network can play an active part in this process by helping offer strategies to avoid triggers and supporting the client’s use of new skills for refusing drugs.
These strategies include:
- Avoiding triggers and situations that can lead to drug use or drug seeking behaviors
- Rearranging the environment to remove triggers and items associated with use
- Making a plan to increase access to positive activities and decrease access to drug-using peers
- Practice skills for navigating high-risk social situations
Contingency Management Treatment Structure
In this training you will learn to effectively implement contingency management in your outpatient practice. The CM protocol includes a series of interventions that can be adapted to fit the individual client’s needs. Factors such as engagement in services, involvement of a social support system, severity of use, and presence of co-occurring disorders are all considered when determining the timing and duration of treatment and frequency of sessions.
Overview of the Initial TrainingThe typical course of treatment is between 14 to 18 weeks and includes these key modules:
Module 1: Determining the Need for Substance Abuse Treatment
Module 2: Introducing CM to the Client and Social Supports
Module 3: Point-and-Level or Fishbowl Reward System
Module 4: ABC Assessment of Drug Use
Module 5: Self-Management Planning and Drug Refusal Skill Training
Module 6: Drug Testing Protocol
Module 7: Planning for Discharge