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Motivation and Contingency Management Treatments for Substance Use Disorders

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Behavioral Neuroscience of Motivation

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 27))

Abstract

Contingency management (CM) is a highly efficacious psychosocial treatment for substance use disorders based on the principles of behavioral analysis. CM involves delivering a tangible positive reinforcer following objective evidence of submission of a drug-negative urine sample. Although CM interventions primarily involve applying extrinsic rewards, a patient’s intrinsic motivation to change substance use behavior may also be impacted by CM. This chapter provides an introduction to CM interventions for substance use disorders and examines the impact of CM on intrinsic motivation . It also addresses applications of this intervention to other conditions and patient populations.

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References

  • Alessi SM, Petry NM (2014) Smoking reductions and increased self-efficacy in a randomized controlled trial of smoking abstinence-contingent incentives in residential substance abuse treatment patients. Nicotine Tob Res Off J Soc Res Nicotine Tob 16:1436–1445. doi:10.1093/ntr/ntu095

    Article  Google Scholar 

  • Andrade LF, Barry D, Litt MD, Petry NM (2014) Maintaining high activity levels in sedentary adults with a reinforcement-thinning schedule. J Appl Behav Anal 47:523–536. doi:10.1002/jaba.147

    Article  PubMed  PubMed Central  Google Scholar 

  • Blanchard KA, Morgenstern J, Morgan TJ et al (2003) Motivational subtypes and continuous measures of readiness for change: concurrent and predictive validity. Psychol Addict Behav 17:56–65. doi:10.1037/0893-164X.17.1.56

    Article  PubMed  Google Scholar 

  • Budney AJ, Higgins ST, Radonovich KJ, Novy PL (2000) Adding voucher-based incentives to coping skills and motivational enhancement improves outcomes during treatment for marijuana dependence. J Consult Clin Psychol 68:1051–1061

    Article  CAS  PubMed  Google Scholar 

  • Budney AJ, Moore BA, Rocha HL, Higgins ST (2006) Clinical trial of abstinence-based vouchers and cognitive-behavioral therapy for cannabis dependence. J Consult Clin Psychol 74:307–316. doi:10.1037/0022-006X.4.2.307

    Article  PubMed  Google Scholar 

  • Callaghan RC, Taylor L, Moore BA et al (2008) Recovery and URICA stage-of-change scores in three marijuana treatment studies. J Subst Abuse Treat 35:419–426. doi:10.1016/j.jsat.2008.03.004

    Article  PubMed  Google Scholar 

  • Cameron J, Banko KM, Pierce WD (2001) Pervasive negative effects of rewards on intrinsic motivation: the myth continues. Behav Anal MABA 24:1–44

    CAS  Google Scholar 

  • Deci EL, Ryan RM (1985) Intrinsic motivation and self-determination in human behavior. Plenum, New York

    Book  Google Scholar 

  • Deci EL, Koestner R, Ryan RM (1999) A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. Psychol Bull 125:627–668. doi:10.1037/0033-2909.125.6.627

    Article  CAS  PubMed  Google Scholar 

  • DiClemente CC (1999) Motivation for change: implications for substance abuse treatment. Psychol Sci 10:209–213. doi:10.1111/1467-9280.00137

    Article  Google Scholar 

  • DiClemente CC, Hughes SO (1990) Stages of change profiles in outpatient alcoholism treatment. J Subst Abuse 2:217–235

    Article  CAS  PubMed  Google Scholar 

  • DiClemente CC, Schlundt D, Gemmell L (2004) Readiness and stages of change in addiction treatment. Am J Addict 13:103–119. doi:10.1080/10550490490435777

    Article  PubMed  Google Scholar 

  • Dutra L, Stathopoulou G, Basden SL et al (2008) A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry 165:179–187. doi:10.1176/appi.ajp.2007.06111851

    Article  PubMed  Google Scholar 

  • Edens JF, Willoughby FW (2000) Motivational patterns of alcohol dependent patients: a replication. Psychol Addict Behav J Soc Psychol Addict Behav 14:397–400

    Article  CAS  Google Scholar 

  • El-Bassel N, Schilling RF, Ivanoff A et al (1998) Stages of change profiles among incarcerated drug-using women. Addict Behav 23:389–394. doi:10.1016/S0306-4603(97)00036-1

    Article  CAS  PubMed  Google Scholar 

  • Field CA, Adinoff B, Harris TR et al (2009) Construct, concurrent and predictive validity of the URICA: data from two multi-site clinical trials. Drug Alcohol Depend 101:115–123. doi:10.1016/j.drugalcdep.2008.12.003

    Article  PubMed  PubMed Central  Google Scholar 

  • Higgins ST, Budney AJ, Bickel WK et al (1994) Incentives improve outcome in outpatient behavioral treatment of cocaine dependence. Arch Gen Psychiatry 51:568–576

    Article  CAS  PubMed  Google Scholar 

  • Higgins ST, Budney AJ, Bickel WK et al (1995) Outpatient behavioral treatment for cocaine dependence: one-year outcome. Exp Clin Psychopharmacol 3:205–212. doi:10.1037/1064-1297.3.2.205

    Article  Google Scholar 

  • Higgins ST, Badger GJ, Budney AJ (2000a) Initial abstinence and success in achieving longer term cocaine abstinence. Exp Clin Psychopharmacol 8:377–386

    Article  CAS  PubMed  Google Scholar 

  • Higgins ST, Wong CJ, Badger GJ et al (2000b) Contingent reinforcement increases cocaine abstinence during outpatient treatment and 1 year of follow-up. J Consult Clin Psychol 68:64–72. doi:10.1037/0022-006X.68.1.64

    Article  CAS  PubMed  Google Scholar 

  • Higgins ST, Alessi SM, Dantona RL (2002) Voucher-based incentives: a substance abuse treatment innovation. Addict Behav 27:887–910. doi:10.1016/S0306-4603(02)00297-6

    Article  PubMed  Google Scholar 

  • Higgins ST, Silverman K, Heil SH (2008) Contingency management in substance abuse treatment. Guilford Press, New York

    Google Scholar 

  • Hubbard RL (1989) Drug abuse treatment: a national study of effectiveness. University of North Carolina Press, Chapel Hill

    Google Scholar 

  • Hubbard RL, Gail S, Flynn PM et al (1997) Overview of 1-year follow-up outcomes in the drug abuse treatment outcome study (DATOS). Psychol Addict Behav 11:261–278. doi:10.1037/0893-164X.11.4.261

    Article  Google Scholar 

  • Hunt YM, Rash CJ, Burke RS, Parker JD (2010) Smoking cessation in recovery: comparing 2 different cognitive behavioral treatments. Addict Disord Their Treat 9:64–74. doi:10.1097/ADT.0b013e3181bf0310

    Article  Google Scholar 

  • Kadden RM, Litt MD, Kabela-Cormier E, Petry NM (2007) Abstinence rates following behavioral treatments for marijuana dependence. Addict Behav 32:1220–1236. doi:10.1016/j.addbeh.2006.08.009

    Article  PubMed  PubMed Central  Google Scholar 

  • Ledgerwood DM, Petry NM (2006) Does contingency management affect motivation to change substance use? Drug Alcohol Depend 83:65–72. doi:10.1016/j.drugalcdep.2005.10.012

    Article  PubMed  Google Scholar 

  • Lussier JP, Heil SH, Mongeon JA et al (2006) A meta-analysis of voucher-based reinforcement therapy for substance use disorders. Addiction 101:192–203. doi:10.1111/j.1360-0443.2006.01311.x

    Article  PubMed  Google Scholar 

  • Miller WR (1985) Motivation for treatment: a review with special emphasis on alcoholism. Psychol Bull 98:84–107. doi:10.1037/0033-2909.98.1.84

    Article  CAS  PubMed  Google Scholar 

  • National Institute for Health and Clinical Excellence (2007) NICE clinical guideline 51: drug misuse: psychosocial interventions. 2007. http://www.nice.org.uk/guidance/cg51. Accessed 29 Dec 2014

  • Pantalon MV, Nich C, Franckforter T, Carroll KM (2002) The URICA as a measure of motivation to change among treatment-seeking individuals with concurrent alcohol and cocaine problems. Psychol Addict Behav 16:299–307. doi:10.1037/0893-164X.16.4.299

    Article  PubMed  Google Scholar 

  • Paul-Ebhohimhen V, Avenell A (2008) Systematic review of the use of financial incentives in treatments for obesity and overweight. Obes Rev Off J Int Assoc Study Obes 9:355–367. doi:10.1111/j.1467-789X.2007.00409.x

    Article  CAS  Google Scholar 

  • Petry NM (2012) Contingency management for substance abuse treatment: a guide to implementing this evidence-based practice. Routledge, New York

    Google Scholar 

  • Petry NM, Martin B (2002) Low-cost contingency management for treating cocaine- and opioid-abusing methadone patients. J Consult Clin Psychol 70:398–405

    Article  PubMed  Google Scholar 

  • Petry NM, Martin B, Cooney JL, Kranzler HR (2000) Give them prizes, and they will come: contingency management for treatment of alcohol dependence. J Consult Clin Psychol 68:250–257

    Article  CAS  PubMed  Google Scholar 

  • Petry NM, Martin B, Simcic F (2005a) Prize reinforcement contingency management for cocaine dependence: integration with group therapy in a methadone clinic. J Consult Clin Psychol 73:354–359. doi:10.1037/0022-006X.73.2.354

    Article  PubMed  Google Scholar 

  • Petry NM, Peirce JM, Stitzer ML et al (2005b) Effect of prize-based incentives on outcomes in stimulant abusers in outpatient psychosocial treatment programs: a national drug abuse treatment clinical trials network study. Arch Gen Psychiatry 62:1148–1156. doi:10.1001/archpsyc.62.10.1148

    Article  PubMed  Google Scholar 

  • Petry NM, Alessi SM, Hanson T, Sierra S (2007) Randomized trial of contingent prizes versus vouchers in cocaine-using methadone patients. J Consult Clin Psychol 75:983–991. doi:10.1037/0022-006X.75.6.983

    Article  PubMed  Google Scholar 

  • Petry NM, Barry D, Pescatello L, White WB (2011) A low-cost reinforcement procedure improves short-term weight loss outcomes. Am J Med 124:1082–1085. doi:10.1016/j.amjmed.2011.04.016

    Article  PubMed  PubMed Central  Google Scholar 

  • Petry NM, Rash CJ, Byrne S et al (2012) Financial reinforcers for improving medication adherence: findings from a meta-analysis. Am J Med 125:888–896. doi:10.1016/j.amjmed.2012.01.003

    Article  PubMed  PubMed Central  Google Scholar 

  • Petry NM, Andrade LF, Barry D, Byrne S (2013) A randomized study of reinforcing ambulatory exercise in older adults. Psychol Aging 28:1164–1173. doi:10.1037/a0032563

    Article  PubMed  PubMed Central  Google Scholar 

  • Petry NM, DePhilippis D, Rash CJ et al (2014) Nationwide dissemination of contingency management: the veterans administration initiative. Am J Addict Am Acad Psychiatr Alcohol Addict 23:205–210. doi:10.1111/j.1521-0391.2014.12092.x

    Google Scholar 

  • Petry NM, Alessi SM, Byrne S, White WB (2015) Reinforcing adherence to antihypertensive medications. J Clin Hypertens Greenwich Conn 17:33–38. doi:10.1111/jch.12441

    Article  Google Scholar 

  • Prendergast M, Podus D, Finney J et al (2006) Contingency management for treatment of substance use disorders: a meta-analysis. Addiction 101:1546–1560. doi:10.1111/j.1360-0443.2006.01581.x

    Article  PubMed  Google Scholar 

  • Prochaska JO, DiClemente CC, Norcross JC (1992) In search of how people change: applications to addictive behaviors. Am Psychol 47:1102–1114. doi:10.1037/0003-066X.47.9.1102

    Article  CAS  PubMed  Google Scholar 

  • Promberger M, Marteau TM (2013) When do financial incentives reduce intrinsic motivation? Comparing behaviors studied in psychological and economic literatures. Health Psychol 32:950–957. doi:10.1037/a0032727

    Article  PubMed  PubMed Central  Google Scholar 

  • Rawson RA, McCann MJ, Flammino F et al (2006) A comparison of contingency management and cognitive-behavioral approaches for stimulant-dependent individuals. Addict Abingdon Engl 101:267–274. doi:10.1111/j.1360-0443.2006.01312.x

    Article  Google Scholar 

  • Roll JM, Higgins ST (2000) A within-subject comparison of three different schedules of reinforcement of drug abstinence using cigarette smoking as an exemplar. Drug Alcohol Depend 58:103–109

    Article  CAS  PubMed  Google Scholar 

  • Roll JM, Higgins ST, Badger GJ (1996) An experimental comparison of three different schedules of reinforcement of drug abstinence using cigarette smoking as an exemplar. J Appl Behav Anal 29:495–504; quiz 504–505. doi: 10.1901/jaba.1996.29-495

  • Roll JM, Reilly MP, Johanson C-E (2000) The influence of exchange delays on cigarette versus money choice: a laboratory analog of voucher-based reinforcement therapy. Exp Clin Psychopharmacol 8:366–370. doi:10.1037/1064-1297.8.3.366

    Article  CAS  PubMed  Google Scholar 

  • Rowan-Szal G, Joe GW, Chatham LR, Simpson DD (1994) A simple reinforcement system for methadone clients in a community-based treatment program. J Subst Abuse Treat 11:217–223

    Article  CAS  PubMed  Google Scholar 

  • Ryan RM, Deci EL (2000) Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol 55:68–78. doi:10.1037/0003-066X.55.1.68

    Article  CAS  PubMed  Google Scholar 

  • Siegal HA, Li L, Rapp RC, Saha P (2001) Measuring readiness for change among crack cocaine users: a descriptive analysis. Subst Use Misuse 36:687–700

    Article  CAS  PubMed  Google Scholar 

  • Sigmon SC, Higgins ST (2006) Voucher-based contingent reinforcement of marijuana abstinence among individuals with serious mental illness. J Subst Abuse Treat 30:291–295. doi:10.1016/j.jsat.2006.02.001

    Article  PubMed  Google Scholar 

  • Silverman K, Wong CJ, Higgins ST et al (1996) Increasing opiate abstinence through voucher-based reinforcement therapy. Drug Alcohol Depend 41:157–165

    Article  CAS  PubMed  Google Scholar 

  • Simpson DD, Sells SB (1982) Effectiveness of treatment for drug abuse. Adv Alcohol Subst Abuse 2:7–29. doi:10.1300/J251v02n01_02

    Article  Google Scholar 

  • Stitzer ML, Iguchi MY, Felch LJ (1992) Contingent take-home incentive: effects on drug use of methadone maintenance patients. J Consult Clin Psychol 60:927–934

    Article  CAS  PubMed  Google Scholar 

  • Volpp KG, John LK, Troxel AB et al (2008) Financial incentive-based approaches for weight loss: a randomized trial. J Am Med Assoc (JAMA ) 300:2631–2637. doi:10.1001/jama.2008.804

    Article  CAS  Google Scholar 

  • Volpp KG, Troxel AB, Pauly MV et al (2009) A randomized, controlled trial of financial incentives for smoking cessation. N Engl J Med 360:699–709. doi:10.1056/NEJMsa0806819

    Article  CAS  PubMed  Google Scholar 

  • Willoughby FW, Edens JF (1996) Construct validity and predictive utility of the stages of change scale for alcoholics. J Subst Abuse 8:275–291

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Calhoun Cardiology Center and Department of Medicine, University of Connecticut School of Medicine (MC 3944), 263 Farmington Ave., Farmington, CT, 06030-3944, USA

    Kimberly N. Walter & Nancy M. Petry

Authors
  1. Kimberly N. Walter
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  2. Nancy M. Petry
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Corresponding author

Correspondence to Nancy M. Petry .

Editor information

Editors and Affiliations

  1. New York State Psychiatric Institute, Columbia University Medical Center, New York, New York, USA

    Eleanor H. Simpson

  2. Barnard College, Columbia University Barnard College, New York, New York, USA

    Peter D. Balsam

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Walter, K.N., Petry, N.M. (2015). Motivation and Contingency Management Treatments for Substance Use Disorders. In: Simpson, E., Balsam, P. (eds) Behavioral Neuroscience of Motivation. Current Topics in Behavioral Neurosciences, vol 27. Springer, Cham. https://doi.org/10.1007/7854_2015_374

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