Contingency Management In Substance Abuse Treatment

Isn’t it unethical to pay people to do what they should be doing anyway? Won’t patients just sell the reinforcers and buy drugs? Others didn’t get prizes for not using. Why should they? The concerns surrounding Contingency Management (CM) are many and reflect how poorly understood and rarely utilized this evidence-based treatment model is in practice settings. Despite being identified as the most efficacious intervention for substance use disorders, a significant gap persists between research and practice, at the client’s expense. Nancy Petry, an experienced researcher and consultant for organizations such as the National Institute of Health, has begun to fill this gap by authoring the first clinician-oriented text that focuses on CM protocol development and implementation. In this well-organized and clear book she provides a foundation for understanding CM and details how to design and implement a program that can work for any clinician, whether he or she works for a well-funded program or not. She also addresses realistic concerns such as: How to describe CM to eligible and ineligible patients How to calculate the costs of CM interventions How to solicit donations and raise funds to support CM interventions How to stock a prize cabinet and keep track of prizes Over 50 charts, worksheets, and tables are provided to help the clinician pinpoint exactly which behaviors to target, brainstorm how to reinforce change, and develop a treatment plan that incorporates cost, length of treatment, and method for determining patient compliance. Included with the book is a CD-ROM of editable logs, forms, tables, and worksheets for personal use. More than just filling a void, Dr. Petry provides all of the tools clinicians require to successfully apply a novel treatment in practice.

Timely and authoritative, this volume brings together leading clinical researchers to describe contemporary applications of contingency management principles across a wide range of substance use disorders and patient populations. Contingency management uses a system of incentives and disincentives to motivate patients to meet their treatment goals, and has been implemented successfully in community treatment clinics, drug courts, and other settings. Featuring illustrative case material, the book presents a cogent empirical rationale and practical strategies for targeting major drugs of abuse and working with specific populations, including adolescents, pregnant women, and dually diagnosed and homeless individuals. Also addressed are the nuts and bolts of developing and funding contingency management programs.

This practical manual is based on extensive research and the collaboration of hundreds of community-based therapists. It provides step-by-step guidelines for implementing contingency management (CM)—one of the most effective treatments for substance abuse—with adolescents and their caregivers. Strategies are detailed for assessing substance use disorders, developing individualized cognitive and behavioral interventions, using behavioral contracts and contingencies to reinforce abstinence, and overcoming frequently encountered treatment roadblocks. Extensive sample dialogues illustrate what CM looks like in action. In a convenient large-size format, the book includes more than three dozen reproducible handouts, checklists, and forms.

The National Health System in the United Kingdom has supported the integration of CM because of its evidence basis. CM has recently been implemented in clinics in Spain, the Netherlands, and Israel, and the author has been asked to consult on its integration in treatment settings in Canada, South Africa, Turkey, China, and Australia. The completion of the National Institute on Drug Abuse Clinical Trials Network study of CM interventions has raised awareness and interest throughout the US and abroad, most notably in Canada and the UK.

This book is the first complete guide to implementing the Community Reinforcement Approach (CRA), an empirically based, highly effective cognitive-behavioral program for treating alcohol problems. CRA acknowledges the powerful role of environmental contingencies in encouraging or discouraging drinking, and attempts to rearrange these contingencies so that a non-drinking lifestyle is more rewarding than a drinking one. Unique in its breadth, the approach utilizes social, recreational, familial, and vocational strategies to aid clients in the recovery process. This authoritative manual is a hands-on guide to applying these therapeutic procedures. The authors present a step-by-step guide to each component of the treatment plan, many of which have been shown to be effective forms of treatment in themselves. Topics include behavioral skills training, social and recreational counseling, marital therapy, motivational enhancement, job counseling, and relapse prevention. Each chapter provides detailed instructions for conducting a procedure, describes what difficulties to expect, and presents strategies for overcoming them. Sample dialogues between clients and therapists, annotated by the authors, further illuminate the treatment process. The book concludes with a chapter that both addresses the common mistakes made when implementing CRA, and emphasizes the flexibility and benefits of this total treatment plan. This book is an invaluable resource for a wide range of practitioners including psychologists, psychiatrists, substance abuse counselors, and social workers.

In Psychotherapy for the Treatment of Substance Abuse, leading authorities on substance abuse treatment techniques review and illustrate the most common interventions for opioid-related and alcohol-related substance abuse disorders, as well as crucial methodologies for testing and patient placement. Methods reviewed include self-help fellowships such as Alcoholics Anonymous, cognitive-behavioral and psychodynamic treatments, motivational enhancement, group and family therapy, contingency management, and the multimodal approach called Network Therapy, which recruits the support of friends and family to prompt abstinence and prevent relapse. Each chapter includes vivid case studies to illustrate the approach described, as well as a review of the key clinical concepts and a list of essential readings. Adapting a new, clinically focused manual from their popular American Psychiatric Publishing Textbook of Substance Abuse Treatment, now in its fourth edition, Dr. Galanter and Dr. Kleber have designed Psychotherapy for the Treatment of Substance Abuse to be of practical application to both experienced clinicians and those new to the field. The accompanying DVD demonstrates Network Therapy in practice and includes enlightening commentary on key issues that are relevant across the many modalities of substance abuse treatment discussed in the book.

Addiction is increasingly being recognized as a major global public health issue, and an ever-growing number of medical specialties, psychological and social science training programs, and professional associations are including addiction as part of their training and continuing education curricula. The first edition of this book presented an overview of the spectrum of addiction-related problems across different cultures around the globe. Sharing the experience and wisdom of more than 260 leading experts in the field, and promoted by the International Society of Addiction Medicine, it compared and contrasted clinical practices in the field of addiction medicine on the basis of neurobiological similarities as well as epidemiological and socio-cultural differences. Building on the success of this inaugural edition, and taking into account the formal and informal comments received as well as an assessment of current need, this textbook presents general updated information while retaining the most requested sections of the first edition as demonstrated by the number of chapter downloads. It also provides a basic text for those preparing for the ISAM annual certification exam. Written by some 220 international experts, it is a valuable reference resource for anyone interested in medicine, psychology, nursing, and social science.