Contingency Management Therapy
Incentivizing Commitment to Recovery
Motivation is a powerful force for those trying to recover from substance use disorder or manage mental illness. Contingency Management (CM) therapy can help provide that motivation by incentivizing positive behavioral changes. Eventually, those behaviors become habitual, leading to long-term recovery.
What is Contingency Management Therapy
A type of behavioral therapy, CM therapy uses positive reinforcement to encourage patients in their recovery efforts. When a patient demonstrates positive behavior, this is reinforced with a reward, usually in the form of prizes or vouchers exchangeable for retail items and services.
Contingency Management Therapy is based on the principle that people will try harder to follow their treatment plan if they know there is a tangible reward to mark their success. While providing individuals in recovery material incentives forever is not realistic, CM therapy operates on the idea that after a while, these behavioral modifications will become hard-to-break habits that don’t require rewards, allowing patients to achieve lasting sobriety.
CM Therapy Techniques
Contingency management has been used successfully in conjunction with other forms of therapy, such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). It is an effective treatment for several different disorders including substance use disorders and dual diagnosis.
The disorders CM is used to treat often start as learned behavior or habit that are eventually exacerbated by the biological and chemical effects of addiction and environmental influences such as peer pressure. The use of CM as an intervention holds that lasting recovery is possible if the patient receives consistent reinforcement of desired behaviors.
For example, one area that many addiction treatment centers emphasize is consistent attendance. If an individual arrives on time for their group therapy session one day, their names are entered into a drawing. If they are on time for the subsequent session, their name may be drawn to win a prize. In this process, the individual is incentivized to attend therapy and be punctual, making their recovery efforts more successful.
The Therapeutic Process
The use of contingency management for substance abuse is often combined with other therapies, such as cognitive behavioral therapy (CBT) or dialectical behavioral therapy (DBT). Treatment plans may look different depending on an individual’s conditions and needs; however, most will participate in all or some of the following.
Initial Assessment And Diagnosis
Individuals will first meet with a dedicated admissions specialist to discuss current needs, past experiences, and coexisting medical conditions. Based on this assessment, a customized treatment approach will be outlined, and the next steps toward recovery mapped out.
Detoxification
Substance use disorder is one of the most common conditions CM therapy is used to treat. Before beginning any therapy, however, patients must rid their bodies of any and all harmful substances. Though the process can be uncomfortable, qualified and professional support is there for you every step of the way.
How (and Why) CM Therapy Works
There is a significant body of evidence that CM therapy is an effective tool for the treatment of substance use disorders.[1] It is a form of operant conditioning, which is a behavioral therapy technique focusing on the utilization of reinforcement and punishment to encourage or discourage certain behaviors.
The primary concept behind operant conditioning is that voluntary behaviors are more likely to occur frequently when they are rewarded. In practice, CM therapy may look like providing movie tickets or gift cards to patients when they show up on time to therapy sessions or pass a drug test.
In a study evaluating the effectiveness of prize-based incentives in outpatient psychosocial treatment programs involving 415 cocaine and methamphetamine users, it was found that incentive-based programs significantly improved abstinence-associated outcomes.[2] Similar results were found in a study of 388 participants receiving methadone maintenance drug abuse treatment where prizes valuing approximately $120 per individual were awarded for passed drug tests.[3]
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What We Treat with Contingency Management Therapy
Cost of CM Therapy
The cost of CM therapy varies based on the individual’s specific treatment plan and insurance coverage. A knowledgeable admissions counselor at Alpas Wellness will discuss payment options and help you verify insurance during your consultation.
Frequently Asked Questions about CM Therapy
Does DBT use contingency management?
Contingency management is a commonly used technique used in DBT therapy and other types of psychological therapies such as CBT and MET.
Who benefits from contingency management therapy?
CM Therapy is useful in individuals with a wide range of substance use disorders, from alcohol to opioids to nicotine.
What is contingency management in simple terms?
In short, CM therapy is the practice of providing immediate reward(s) for target behavior in patients, making it more likely they’ll continue that type of behavior.
Additional Contingency Management Resources
Lussier, J.P., et al. (2006). A meta‐analysis of voucher‐based reinforcement therapy for substance use disorders. Retrieved from A meta‐analysis of voucher‐based reinforcement therapy for substance use disorders – Lussier – 2006 – Addiction – Wiley Online Library on 19 July 2023
Petry, N.M., et al. (2005). Effect of Prize-Based Incentives on Outcomes in Stimulant Abusers in Outpatient Psychosocial Treatment Programs: A National Drug Abuse Treatment Clinical Trials Network Study. Retrieved from Effect of Prize-Based Incentives on Outcomes in Stimulant Abusers in Outpatient Psychosocial Treatment Programs: A National Drug Abuse Treatment Clinical Trials Network Study | Substance Use and Addiction Medicine | JAMA Psychiatry | JAMA Network on 19 July 2023
Peirce, J.M., et al. (2006). Effects of Lower-Cost Incentives on Stimulant Abstinence in Methadone Maintenance Treatment: A National Drug Abuse Treatment Clinical Trials Network Study. Retrieved from Effects of Lower-Cost Incentives on Stimulant Abstinence in Methadone Maintenance Treatment: A National Drug Abuse Treatment Clinical Trials Network Study | Psychiatry and Behavioral Health | JAMA Psychiatry | JAMA Network on 19 July 2023
