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Improving contingency management programs for addiction.

R J Lamb1, K C Kirby, A R Morral

  • 1Department of Psychiatry and Pharmacology, University of Texas Health Science Center at San Antonio, TX 78229, USA. lamb@uthscsa.edu

Addictive Behaviors
|March 31, 2004
PubMed
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Contingency management can be more effective for substance use by ensuring participants can earn rewards. Modified payment schedules and percentile schedules improved outcomes for smokers and treatment seekers aiming for abstinence.

Area of Science:

  • Behavioral Psychology
  • Addiction Science
  • Public Health

Background:

  • Contingency management (CM) interventions are effective for problem substance use.
  • CM effectiveness is limited when participants do not earn rewards due to unmet behavioral targets.
  • Optimizing reward accessibility is key to enhancing CM efficacy.

Purpose of the Study:

  • To investigate if modifying CM reward contingencies improves intervention effectiveness.
  • To examine the impact of payment amount and target criterion difficulty on reward attainment.
  • To assess the efficacy of percentile schedules in shaping reduced substance use behaviors.

Main Methods:

  • Two analog studies were conducted with smokers not planning to quit.
  • Study 1: Participants received varying daily payments for achieving breath carbon monoxide (CO) levels below 4 ppm or half their baseline.

Related Experiment Videos

  • Study 2: Percentile schedules were used to shape lower breath CO levels and tested for abstinence in treatment seekers.

    • Main Results:

    • Higher payments and easier criteria increased the likelihood of participants meeting targets in Study 1.
    • Participants often maintained reduced CO levels even after payments ceased.
    • Percentile schedules effectively shaped lower breath CO levels and promoted abstinence in Study 2.

    Conclusions:

    • CM interventions can be enhanced by arranging contingencies to improve reward accessibility.
    • Percentile schedules represent a promising strategy for shaping and maintaining desired behaviors, including abstinence.
    • Optimized CM approaches hold potential for broader application in substance use treatment.