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Contingency management for treatment attendance: A meta-analysis
Rory A Pfund1, Meredith K Ginley2, Carla J Rash3
1Center on Alcohol, Substance use, and Addictions, 2650 Yale Blvd SE, Albuquerque, NM 87106, United States of America.
Journal of Substance Abuse Treatment
|July 2, 2021
Summary
Contingency management targeting attendance (ATT CM) moderately improves treatment engagement but has smaller effects on drug abstinence compared to rewarding abstinence (ABS CM). No significant differences were found between ATT CM and combined ABS + ATT CM approaches.
Area of Science:
- Addiction treatment research
- Behavioral psychology
- Public health interventions
Background:
- Contingency management (CM) rewards abstinence (ABS CM).
- Its effectiveness for treatment engagement via attendance (ATT CM) is less understood.
- This study investigates ATT CM's impact on attendance and abstinence.
Purpose of the Study:
- To systematically review and meta-analyze the effects of ATT CM on treatment attendance and drug abstinence.
- To compare ATT CM with combined ABS CM + ATT CM.
- To understand the magnitude of ATT CM's treatment effects.
Main Methods:
- Systematic literature search for studies on ATT CM, alone or combined with ABS CM.
- Meta-analysis of 10 studies (12 CM treatments, 1841 participants).
- Estimation of effect sizes for ATT CM and ABS CM + ATT CM on attendance and abstinence.
Main Results:
- ATT CM showed a moderate effect (d=0.47) on attendance versus non-reward conditions.
- ATT CM had a small effect (d=0.22) on abstinence.
- No significant differences in outcomes between ATT CM and ABS CM + ATT CM.
Conclusions:
- ATT CM effectively increases treatment engagement, with lesser impact on abstinence.
- Effects on abstinence are smaller than previously reported for ABS CM.
- Clinics should consider behavioral targets when selecting CM strategies.
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