Question

Find a scholarly research article which discusses the effectiveness of the contingency managment treatment method. What was the population under study? Were the methods used, results, and practical implications of this study? Do you think the results of this study would be effective for all population? Why or why not? Would another treatment have worked better for the population under study? Why or why not?

Answer 1

The present study was conducted by National Treatment Agency for Substance Abuse in England (2007). The study utilized the contingency method because it was widely practiced in the United States and had high success rates for cocaine and opiate addicts. The aim of the study was to measure the extent to which the method of incentives was used in treatments in England and to find out the attitude of clinicians who practice the contingency method.

The study surveyed institutions that utilized such treatment methods for opiate addiction. The data was collected through questionnaires which were sent to clinicians in each institution. The data was collected from 191 institutions. In addition to questionnaire method, two clinics were observed in regards to the use of contingency management. Also qualitative assessments were done by interviewing clinicians to assess the effectiveness of this method.

It was found that motivational interviewing, CBT, relapse prevention therapy was more widely used than contingency management. However, the survey found that majority of the clinics use positive reinforcements in terms of praising the clients. The clinicians revealed that they were skeptical about the use of contingency management but was willing to learn about it in order to incorporate that as part of treatment. The study found that the use of positive reinforcement was highly effective as it helps individuals to improve performance through positive support and encouragement. However, none of the clinics employed formal procedures for rewards or contingencies.

In one study conducted in a clinic, they utilized voucher scheme for a period of 12 weeks among cocaine addicts .the population were female workers that were difficult to manage and urine sample was done thrice a week and individuals with negative results were awarded with vouchers that they could later redeem in shops. However, it was found difficult to monitor drug use constantly. Also tailoring vouchers as per the interests of the client was found to be difficult. Clinics do not have the funds or resources to constantly test drug use through urine sample and provide vouchers.

Implications of the study: Contingency management is   less likely to be accepted by clinicians. A strict protocol regarding contingencies should be made. The practitioners must be highly committed to the treatment and must possess adequate knowledge regarding the drugs.

This method will not be effective for all types of population. This method will work best for individuals with limited financial resources. Individuals form a higher socio-economic background will less likely to be motivated by rewards. Also the type of reward given to participants has to be tailored for a particular group. Not all members of the population will be motivated by one type of reward. Some individuals may not find the reward interesting or exciting and thus will not be motivated to improve behavior. Thus the problem of tailoring rewards for each participant will arise. This type of treatment is expensive for the clinics to administer as they may have limited resources.

Another limitation to this method is that contingency will work best for the short term but will not be effective in the long run when there is absence of rewards or punishments. This is because the participants are not taught about other strategies to improve their behavior since the treatment focuses only on external motivation. During the course of the treatment, participants must be taught on strengthening their internal motivation as well.

In my opinion a single method of treatment may not be completely effective in improving behavior. Individuals should not be limited to only a single treatment method. Clinicians should employ multiple treatment methods during the course of treatment as one treatment does not cover all that needs to be learnt. Combing cognitive behavioral therapy and using relapse prevention therapy along with contingency therapy may be effective. Rewards can be effective for the short term, but the participant needs to develop skills that one can utilize to maintain sobriety post contingency management treatment. Also different individuals respond to different treatments differently.

Retrieved from

https://www.drugsandalcohol.ie/11939/1/NTASM_rb33_contingency_management_summary.pdf