Contingency management is a type of treatment for drug addiction that uses rewards to reinforce positive behaviors. This type of treatment has been used to help individuals overcome their drug and alcohol addictions. Reinforcements are given to individuals when they accomplish a certain treatment goal like abstinence for a certain period of time.

This practice is very similar to how classical condition works. Pavlov did an experiment that involved a dog, food, and a bell. In this experiment, the dog was given food after the bell rang for a certain amount of trials, but at some point, the bell was rung and no food was given. Results showed that the dog would still salivate, indicating an anticipation of receiving food, at the sound of the bell, regardless of whether the dog received food or not. This process was coined classical conditioning and the way the dog salivated was called a conditioned response to a conditioned stimulus.

This idea grew in behavioral psychology and more experiments were conducted that created the theories of reinforcement and punishment that operate under operant conditioning. Reinforcement can be broken down into positive reinforcement when a person is given a reward for a certain behavior, and negative reinforcement when a negative stimulus is removed and the person experienced relief from that negative stimulus. Positive punishment is when a negative stimulus like a shock is added and negative punishment is when a positive stimulus like a reward is removed, which induces discomfort in the individual.

Contingency management plays with positive and negative reinforcement. When treatment goals are met, a reward is given, which is the process of positive reinforcement. This reinforces the behavior of complying with treatment by the expectation of an award for that compliance. Positive reinforcement occurs simultaneously with negative reinforcement because while an award is given after a certain period of time, the individual is denied the award of drug use. Negative punishment is received when the individual fails to comply and the anticipated reward is taken away.

Voucher-based programs within contingency management are monetary points an individual can earn by cooperating and continuing treatment. Vouchers can be exchanged for food passes or movie tickets and vouchers start at a low value and slowly increase the longer the individual complies with treatment. These vouchers act like rewards in positive reinforcement and entice the individual to continue compliance with treatment longer to achieve more rewards. Drug use in this situation starts becoming a negative punishment that creates more displeasure than pleasure.

Prize incentive programs operate in a similar manner by offering chances to win rewards in exchange for cooperating with treatment. Most of these methods of reinforcement are designed to reinforce abstinence from the drug, but other behaviors like attending counseling sessions, completing activities, and taking medications are also reinforced. Since it takes time for the rewards in voucher programs to build up, this form of treatment normally lasts up to 3 months at a time. Research has strongly suggested that contingency management works most effectively for the first parts of treatment and that this method increases attendance at sessions. Contingency management has been shown to be most effective for alcohol, marijuana, opiates, and cocaine.

Asana Recovery offers multiple treatments and services for those struggling with drug or alcohol addiction. They are a supportive community of professionals with the goal of helping others achieve sobriety. Call (949) 438-4504 to learn more about their treatment programs.


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