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A simple reinforcement system for methadone clients in a community-based treatment program

G Rowan-Szal1, G W Joe, L R Chatham

  • 1Institute of Behavioral Research, Texas Christian University, Fort Worth 76129.

Journal of Substance Abuse Treatment
|May 1, 1994
PubMed
Summary

This study on methadone treatment found that rewarding clients with stars for attending counseling and providing clean urines increased attendance. Higher rewards led to more stars earned and fewer positive urines post-intervention.

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Area of Science:

  • Addiction Medicine
  • Behavioral Psychology

Background:

  • Community-based methadone treatment programs aim to improve patient outcomes.
  • Contingency management is a behavioral intervention strategy used in addiction treatment.

Purpose of the Study:

  • To evaluate the effectiveness of a star-based reward system for improving attendance and urine sample results in a methadone program.
  • To compare the impact of different reward schedules (high, low, delayed) on client behavior.

Main Methods:

  • Clients earned stars for attending counseling and providing clean urines.
  • Stars were redeemed for rewards on one of three schedules: high, low, or delayed.
  • A 3-month intervention period was implemented, with behavioral data collected before, during, and after.

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Main Results:

  • Clients in the high-reward group increased star earnings over time.
  • All clients significantly increased group counseling attendance when rewards were available.
  • Post-intervention, high-reward clients had fewer positive urines compared to low-reward or delayed-reward groups.

Conclusions:

  • A simple star and prize system can effectively increase clinic attendance in methadone programs.
  • Contingent reinforcement is a valuable tool for reducing positive urines and improving treatment adherence.
  • Modest incentives can positively influence specific client behaviors in community-based addiction treatment.