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What is Contingency Management in Addiction Treatment

by | Last updated Feb 10, 2021 at 11:08AM | Published on Oct 16, 2020 | Addiction Treatments

What is Contingency Management

Addiction treatment is extensive and often taps into various forms of therapy to help people. Contingency management in addiction treatment is evidence-based treatments that can help people struggling with alcohol dependence, marijuana, opioids, and stimulants addiction. Like other therapy forms, it can be beneficial for people who can’t incorporate medications to manage their addiction or withdrawal symptoms. Let’s explore how contingency management plays a role in most treatment facilities. 

What is Contingency Management?

Contingency management (CM) is an evidence-based behavioral therapy that taps into motivational incentives and tangible rewards to help people abstain from drugs and alcohol. This type of treatment encourages sobriety and healthy behaviors. It can increase treatment retention rates and sobriety span. However, it doesn’t work as a stand-alone treatment program. To be effective, CM needs to become part of a more extensive comprehensive program that includes:

How Does Contingency Management Work

How Does Contingency Management Work?

Studies conducted in both methadone programs and psychosocial counseling treatment programs demonstrate that incentive-based interventions effectively increase treatment retention and promote abstinence from drugs.

Unlike other forms of therapy, contingency management operates following an agreement or contract. This contract outlines the arrangement and holds the person accountable for following the program. It uses two forms of motivational or reward-based systems to promote recovery.

Voucher-Based Reinforcement (VBR)

The first one is the voucher-based reinforcement system. Here, patients receive a voucher for each drug-free urine sample or negative breathalyzer result. Each voucher has a value that can trade for goods, services, retail items, or more. These vouchers are meant to encourage activities that will become part of a balanced, sober life.

According to the National Institute on Drug Abuse (NIDA), this method helps individuals addicted to opioids and stimulants, with particular benefits for cocaine dependence.

Prize Incentives

The second method involves using prize incentives. These programs last at least three months, in combination with other treatment methodologies. In this method, patients supplying drug-negative urine or breath tests draw from a fishbowl at least once a week for the opportunity to win a prize. 

The slips they take out from the bowl sometimes include encouraging quotes. Others have a cash value or can consist of an extra individual therapy session. According to the NIDA, research has shown that prize incentives do not encourage gambling behaviors in treatment participants.

Contingency Management in Integrated Care

Although successful, contingency management on its own won’t be effective. To have tremendous success, it needs to be part of an integrated care plan. Intensive psychotherapy is necessary to help someone overcome the root cause of addiction and attend any co-occurring mental disorder. Integrated care often involves cognitive-behavioral therapy and dialectical-behavioral therapy.

Some treatment facilities will also incorporate alternative therapies that promote mind-body-spirit wellness. These therapies include stress management, acupuncture, yoga, music therapy, art, and more. 

Beyond addiction, contingency management can also help treat other conditions that usually accompany those with a substance use disorder, including:

Some research believes incorporating CM in integrated care can be beneficial for those with a dual diagnosis — someone who has both a mental health and substance use disorder. Used this way, this therapy was shown to reduce psychiatric symptoms both during and after treatment.

Why People Oppose to This Type of Treatment

Contingency management is an outside-of-the-box therapy alternative. Even though there’s evidence that proves its effectiveness, many still criticize this approach. Here are some of the most common criticisms CM faces:

  • Too expensive
  • Promotes gambling
  • Doesn’t treat the root cause of addiction
  • It is too restrictive

While on the surface, these criticisms are valid, it’s not always the case. Research estimates that the cost of implementing contingency management is about $200 per patient, but that it can drastically improve outcomes. So far, research hasn’t found a correlation between prize incentives and gambling behavior among participants. 

As far as treating the root cause of addiction, contingency management doesn’t claim to do this. Instead, it positions itself as a complementary treatment program that can improve outcomes and promote long-term recovery. CM is an extremely flexible form of therapy that can adapt to work well with other types of treatments. 

Is It Right for Me?

What makes contingency management stand apart from other treatment approaches is the emphasis on positive reinforcement versus punishment. For example, if a person fails to meet their goals or has a positive drug test, they would not receive a voucher or prize. A Traditional punishment approach often alienates a person from the therapeutic community of treatment, breaks their self-confidence, and reduces their motivation for change.

On the contrary, by promoting positive behaviors, CM can help patients start building healthy habits.

Essentially, there’s no harm in trying this form of therapy throughout your treatment plan. Consider talking to your therapist to see what your options are. Like many forms of treatment, this isn’t a one-size-fits-all therapy. You know yourself better and can probably figure out if a reward-system approach might help you. 

Not to mention, contingency management therapy can help you find yourself lacking the motivation to maintain specific healthy habits that impact your recovery. For example, eating healthy, attending support group meetings, and so forth. If that’s your cause, maybe this form of therapy can motivate you and give you a sense of challenge or purpose to keep going and make significant progress in adopting new sober habits. 

However, keep in mind that it requires a long-term commitment to this therapy type to be effective. Most research states that you need at least three months of CM to reap its real benefits. 

Getting Help

For the most part, plenty of drug addiction treatment centers will implement contingency management in their programs. In fact, the use of CM is expanding, as the National Institute on Drug Abuse is advocating for its utilization based on the track record of success. 

Tailoring a treatment plan to a patient’s strengths and significant areas of concern offers the best chance at success, which is our philosophy here at Lighthouse Recovery Institute. We begin each person’s journey by creating a treatment plan that will best meet their needs and help them reach their goals.

Building a connection between a client and a therapist can be challenging, but the payoffs are well worth the work it takes to achieve. That’s the importance of choosing a treatment facility that offers comprehensive therapies that promote healing.

No matter what you’ve been through or what type of substance use disorder you struggle with, recovery is possible. Lighthouse Recovery Institute offers several approaches and all different therapies to address the conditions’ real, underlying causes. Look no further for help than right here. We are ready to be with you every step of the way toward recovery.

Geraldine Orentas

Geraldine Orentas

Geraldine is Lighthouse Recovery Institute’s Digital Marketing Manager. She has a Bachelor’s in Journalism and experience in the digital media industry. Geraldine’s writing allows her to share valuable information about mental health, wellness, and drug addiction facts, hoping to shed light on the importance of therapy and ending the stigma.
Medical Disclaimer:

Lighthouse Recovery Institute aims to improve the quality of life for anyone struggling with substance use or mental health disorder. We provide fact-based content about the nature of behavioral health conditions, treatment options, and their outcomes. The material we publish is researched, cited, edited, and reviewed by licensed medical professionals. The information we provide in our posts is not intended to be a substitute for professional medical advice, diagnosis, or treatment. It should never be used in place of the advice of your physician or another qualified healthcare provider.

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