What is Contingency Management?

Contingency Management (CM) reinforces and establishes a permanent change of behavior by rewarding positive behavior as a behavioral therapy program. The idea behind contingency management therapy is that when someone meets a goal or achieves their objective of remaining clean and or sober, they are rewarded as encouragement and reinforcement to continue in the rewarding behavior.  This type of therapy as a method can be helpful for patients who lack the motivation to remain abstinent from their drug or alcohol use. CM differs from other therapy types that it is often confused with, such as ‘motivational interviewing’ or ‘motivational enhancement therapy. The premise of contingency management is not to motivate positive change but rather to maintain it.

Contingency management refers to a type of behavioral therapy in which individuals are ‘reinforced,’ or rewarded, for evidence of positive behavioral change. (NIH)

What are the Rewards?

By using rewards and incentives to promote behavior changes, Contingency Management promotes recovery from addictions. The positive reinforcement as a reward can be money, vouchers, or more privileges if institutionalized (at detox or treatment, etc.,) gift cards for Amazon, and other valuable items. The following rewards, also called incentives, are common in CM therapy:

  • Voucher-based Reinforcements
  • Prize Incentives
  • Gift Cards
  • More Privileges

What are the Voucher-Based Reinforcements (VBR)?

The National Institute on Drug Abuse is one of the first government agencies to document the effectiveness of contingency management. They describe the voucher-based reinforcements.

VBR is for adults who primarily abuse opioids, stimulants, or both. In VBR, the patient receives a voucher for every drug-free urine sample provided. The voucher has monetary value that can be exchanged for food items, movie passes, or other goods or services consistent with a drug-free lifestyle. The voucher values are low at first but increase as the number of consecutive drug-free urine samples increases; VBR is effective in promoting abstinence from opioids and cocaine in patients undergoing detoxification. (NIDA)

Facts About Prize Incentives

Prize incentives are very similar to voucher-based reinforcement. It, however, rewards the contingency management patients with prizes instead of vouchers. With Prize Incentives, the patients will win actual cash from 10 dollars to 100 dollars or more. In addition, the patients who continue in the right direction are incentivized by being entered into the prize drawing every day or week.  They also receive larger prizes for the more goals and objectives they meet.

For example, participants who continuously supply positive drug-free urine or breath tests or attend all necessary counseling sessions will receive a higher dollar amount of a price. At the same time, if someone relapses or has an unexcused absence from treatment, the number of prize entries they can participate in goes down.

Understanding Gift Cards and More Privileges

Not all treatment centers will adhere precisely to the contingency management model of vouchers and prizes. Instead, many treatment centers reward their patients with gift cards or more privileges as they continue to grow in their recovery. Contingency management is most common in community-based treatment centers where the patients are less likely to have a stable income or have no income. However, the research on CM indicates it is effective. When combined with other forms of therapy and counseling, CM can help patients enter into long-term recovery.

What Programs Complement Contingency Management?

Contingency management can also be used in conjunction with other evidence-based approaches. Riverwalk Recovery provides in-depth therapy that is evidence-based. We offer cognitive behavioral therapy, dialectical behavioral therapy, motivational interviewing, one-on-one counseling, trauma counseling, and holistic therapy. All of our treatment programs begin in medically supervised detox. We recommend long-term treatment for three months to help all of our patients achieve meaningful and lasting recovery from their addictions.

We have the expertise and the experience. Do not let another day go by in active addiction or alcoholism. Life is easier without the hassle and misery of drugs and drinking every day. Let us show you a much better way to exist. We promise, and you are worth it! Call now to begin now.

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