Using Contingency Management as a Treatment Modality

6 Feb, 2023
using contingency management as a treatment modality

using contingency management as a treatment modality

In behavioral psychology, the use of a reward and punishment system to achieve a desired behavioral goal has been studied since the early 1900s. One such method is operant conditioning. Operant conditioning is a method of learning that proposes that our learned behaviors result from the consequences associated with them. A classic lab experiment using operant conditioning is the rat and lever experiment. The rats seek food by pressing a lever based on the frequency or consistency of the award or punishment. A type of modern-day therapy, contingency management, applies the principles of operant conditioning.

While human behavior is more nuanced than a rat and a lever, behaving in ways that beget positive consequences versus negative ones is universally desirable. Operant conditioning has many applications outside of the laboratory and is even observed in the natural world.

What Is Contingency Management?

Contingency Management is a therapy modality that incentivizes recovery goals. Incentives can include badges, prizes, and other motivational incentives. Contingency management is a highly effective evidence-based therapy that reinforces the continuation of positive practices. Other names for this therapy include the prize method or the carrot-and-stick method.

Creating a reward system for positive behaviors to promote their perpetuation is effective in many everyday scenarios. For example, when an employer rewards high performers with seasonal bonuses and raises, they can expect the performance to continue or exceed the level at which they’ve been rewarded. This also applies to parents rewarding their children for completing chores or maintaining high grades. It is unlikely that positive reinforcement for these behaviors will result in the behaviors ceasing.

Contingency Management in Addiction Treatment

In addiction treatment, contingency management uses the same reward principles to increase and encourage healthy behaviors. Typically, in Alcoholics Anonymous (AA) meetings, individuals who have lasted a certain amount of days without drinking will receive badges and other types of praise to reward their accomplishments.

Contingency management is beneficial for a recovery program at any level. Using rewards programs offers something to look forward to. Achieving the recovery goals is subsequently rewarded with a variety of prizes ranging from gift cards, vouchers, or badges. A reward does not necessarily have to be a physical item, either. Receiving praise from one’s community for their achievements can also increase the likelihood that positive behaviors will continue.

When people receive rewards for actions such as testing negative for drugs or consistent therapy attendance, the likelihood increases that these behaviors will continue. Everyone is different, however, in terms of what motivates them and creates a true feeling of accomplishment. A licensed professional can help people figure out what modifications can benefit them in recovery.

Forms of Contingency Management

Contingency management typically has two primary forms that are used during treatment: voucher-based contingency management and prize incentive contingency management.

Voucher-Based Contingency Management

Voucher-based contingency management offers patients vouchers that can be redeemed for real-life privileges or tangible goods. For example, receiving a voucher for reaching treatment goals can offer a patient more independence in a recovery program. More independence can look like less frequent drug testing or the ability to take home treatment medication doses. Receiving these vouchers can be a signal of positive progress and helps the person in recovery regain confidence in their ability to maintain their improvement.

Prize-Incentive Contingency Management

Prize-incentive contingency management offers gifts and goods for reaching recovery goalposts. This can look like gift cards and other prizes for drug-free test results. Because substance use disorders (SUDs) typically affect the neurotransmitters responsible for people’s natural reward systems, using different prizes as treatment methods to reprogram this system can facilitate long-term recovery.

Contingency management does not always have to be done within a clinical setting. Setting goals and treating oneself to a gift or experience after achieving these goals can also be beneficial. Families of someone in recovery can also use contingency management principles to help keep recovery on track.

What Happens to Behavior After Rewards Are No Longer Offered?

It is easy to argue that these behaviors would stop once the rewards are no longer offered. However, contingency management is about choice. Each individual treated under this method is making the conscious choice to continue these actions. Likewise, reverting to maladaptive behaviors also requires the choice to do so.

Making the decision every day to work toward developing beneficial habits is only supplemented by contingency management. Being recognized for hard work and diligence with a reward, no matter how small, can help a person in recovery feel as though their efforts are not going unnoticed. It is important for people to be able to look back at progress in recovery. These little reminders can greatly impact staying engaged throughout a recovery program and beyond.

Treatment for addiction takes many different forms. Therapies can be complicated, but sometimes what we need is as simple as a candy bar or a gift card to keep us on the right track. Don’t underestimate the benefit of simple strategies to promote recovery. Sober Life offers a variety of treatment methods to help you work toward a better you. Our staff guides you through personalized treatment modalities and partners with you to provide the help you need on your terms. With inpatient, outpatient, and even virtual treatment programs, Sober Life is here for you every step of the way. Call us today at (619) 542-9542 to speak with a professional for more information on our treatment options. 

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