Contingency management is a type of therapy that provides rewards to clients for positive behavior changes while in treatment. By rewarding clients for positive outcomes, it increases the likelihood that the behavior will happen again. In the context of substance use disorder (SUD) treatment, this can involve providing a reward (a gift card, cash, or other prize) for a positive behavior in line with treatment goals, such as producing a negative urine drug test result or attending a scheduled individual or group therapy session.
Decades of research has demonstrated that contingency management is one of the most effective treatments for SUD because it significantly improves treatment engagement, retention, and outcomes. It is particularly helpful for stimulant use disorders, which still do not have any FDA-approved medication treatments. Contingency management is included in SAMHSA’s guide for the Treatment of Stimulant Use Disorders, and the U.S. Department of Veterans Affairs has incorporated it into their health services.
Over thirty years of research has consistently demonstrated the positive impacts of contingency management, including:
It is also easy to implement in a variety of treatment settings and works well in conjunction with other forms of treatment.
Despite the overwhelming evidence, contingency management is not widely used as part of addiction treatment. Some barriers include:
With adequate resources and support, these obstacles can be overcome.