Contingency management interventions represent one of the most effective ways to enhance motivation among substance abusers by leveraging their personal strengths and focusing on positive gains.
Contingency management 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. Techniques involved in this treatment include positive reinforcement for drug abstinence and negative consequences for returning to drug use, with the emphasis on positive reinforcement and the celebration of success. This celebration of success helps the family and youth remain motivated to change and provides a positive and welcoming treatment environment.[typography font=”Lobster” size=”24″ size_format=”px” color=”#882605″]Behavioral Interventions[/typography]
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 youth and caregivers, create a system where the youth has the ability to earn rewards and access privileges for clean urine screens but also earn age-appropriate consequences for dirty screens.
This system helps drive the youths motivation to become clean by giving them a positive goal to work toward that is an alternative to seeking drugs. The caregiver plays an integral part in this stage of treatment by helping set the rules, identifying the rewards and consequences and monitoring and supervising the youth. By being active participants in the treatment, the caregivers help create a framework of clear expectations around substance abuse that, over time, help the youth develop their own internal rules, good judgement, and problem-solving skills[typography font=”Lobster” size=”24″ size_format=”px” color=”#882605″]Cognitive-Behavioral Interventions[/typography]
The cognitive-behavioral interventions used in CM target the social-skill and problem-solving skill deficits that are commonly found in youth with substance abuse problems. Throughout treatment the therapist works closely with the youth and caregiver(s) to closely examine the specific triggers of the youths drug use.
This is a highly individualized process during which the therapist helps the youth walk through the specific people, places, times, situations, thoughts and feelings that drive the youths drug seeking and drug using behaviors. Through this highly individualized approach the youth learns to recognize triggers and develop strategies to avoid high-risk situations, cope with unavoidable risky situations, use drug refusal skills and utilize alternative coping strategies. The caregiver is an active participant in this process by helping offer strategies to avoid triggers and support the teens 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