Challenges in the transfer of contingency management techniques: comment on Silverman et al. (2001)

This article critiques K. Silverman, D. Svikis, E. Robles, M. L. Stitzer, and G. E. Bigelow's (2001) study of a contingency management intervention for reinforcing development of job-related skills in substance abusing women. The strengths of Silverman et al.'s study include studying a patient population of major public health concern, expanding contingency management techniques to a vocational training setting, reinforcing gradual approximations, implementing the intervention for a long duration, and carefully designing and executing the experimental procedures. However, many of these strengths may also be interpreted as weaknesses if the ultimate goal is to apply contingency management techniques in self-sustaining, community-based settings. The need to evaluate long-term cost-effectiveness of these procedures is described, and the difficulties in transferring contingency management techniques to real-world settings is discussed.