APC: Contingency Management: Dominic DePhilippis, PhD-Slides

Slides

Pdf Summary

Contingency Management (CM) is an effective approach in the treatment of substance use disorder (SUD). The challenges of recovery from SUD include neurophysiological, time, treatment attrition, and cognitive-behavioral challenges. CM addresses these challenges by providing immediate, tangible reinforcement for recovery-supportive behaviors, such as abstaining from substances or attending treatment sessions. <br /><br />CM utilizes the principles of operant conditioning and focuses on selecting a specific target behavior, measuring it objectively, providing immediate reinforcement when the behavior occurs, escalating the size of the reinforcement for consistent behavior, and resetting the reinforcement for the next occurrence of the target behavior. CM can reinforce various behaviors, including abstinence, treatment attendance, and recovery activities.<br /><br />There are several criticisms of CM, such as it being perceived as bribery or paying people to do what they ought to do. However, CM does not fit these definitions as it reinforces behaviors that are in the patient's best interest and it is an evidence-based treatment for SUD. Other criticisms include concerns about diminishing internal motivation for recovery, the belief that the effects of CM stop when it ends, and the perception that CM is incompatible with harm reduction. However, empirical literature shows that CM is effective in promoting abstinence and attendance to recovery-related activities.<br /><br />The implementation of CM has been successful in various patient populations, including homeless individuals, those with serious mental illness or PTSD, people with HIV, justice-involved patients, veterans, pregnant women, and individuals of different ages, races, and income levels.<br /><br />Implementing CM has numerous benefits, including its effectiveness, briefness, low cost, compatibility with other treatment approaches, and the positive and engaging experience it offers to patients. Overall, CM is an evidence-based and versatile intervention that can greatly support individuals in their recovery from SUD.

Keywords

Contingency Management

Substance Use Disorder

Treatment

Reinforcement

Abstinence

Treatment attendance

Criticisms

Evidence-based treatment

Patient populations

Benefits

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