The impact of contracting and prompting substance abuse treatment entry: a pilot trial

Contracting and prompting clients to attend substance abuse treatment aftercare substantially improves treatment adherence and outcome. However, this approach has not been evaluated for improving entry into initial treatment. We recruited 102 individuals scheduled to begin a 28-day substance use disorder (SUD) residential treatment program and randomly assigned them to receive either our standard treatment (STX) or STX plus attendance contracting and prompting (CP). CP participants showed fewer subsequent hospitalization days, lower hospitalization costs, greater improvement in alcohol problem scores, and lower legal problem scores at a 3-month follow-up than the STX group. The two groups did not differ on treatment entry rate, time in treatment, or drug use problem scores. The clinical utility of CP procedures and areas for future research are discussed.