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Contingency management in community programs treating adolescent substance abuse: a feasibility study.

Therese K Killeen¹, Aimee L McRae-Clark, Angela E Waldrop

¹College of Medicine, Institute of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA. killeent@musc.edu

Journal of Child and Adolescent Psychiatric Nursing : Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc

|February 4, 2012

Summary

Contingency management (CM) for adolescent marijuana use disorder showed no significant benefits over standard treatment. Integrating CM into community programs proved challenging, suggesting modifications are needed for effectiveness.

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Area of Science:

Addiction Medicine
Adolescent Psychiatry
Public Health

Background:

Adolescent substance abuse is a significant public health concern requiring improved treatment strategies.
Marijuana use disorder in adolescents necessitates effective and accessible interventions.

Purpose of the Study:

To assess the feasibility and preliminary effectiveness of a cost-effective contingency management (CM) intervention.
To evaluate CM as an adjunct to community-based substance abuse treatment for adolescents with marijuana use disorder.

Main Methods:

Randomized controlled trial involving 31 adolescents with marijuana use disorder.
Comparison of a prize-based CM intervention with a noncontingent control group.
Outcomes measured by percent negative urine drug screens (UDS), sustained negative UDS, and treatment retention.

Main Results:

No statistically significant differences were observed between the CM and control groups.
Key outcome measures including negative UDS and treatment retention did not differ between groups.
Contingency management integration into community settings presented implementation challenges.

Conclusions:

Contingency management did not demonstrate effectiveness as an adjunct to standard community treatment for adolescent marijuana use disorder.
Difficulties in integrating CM into existing programs suggest a need for procedural modifications.
Future research should explore adapting CM for adolescents, addressing staff attitudes, and combining CM with other psychosocial treatments.