Contingency Management

Contingency management (CM) is based on operant conditioning and involves a structured and consistently administered system of consequences that are used to reinforce behaviors consistent with treatment goals. Basic principles include close temporal proximity of consequence to targeted behavior, performance of targeted behavior easy to verify and verified often, positive consequence given and escalated for continuous positive behavior change, and positive consequence removed when targeted behavior not performed. CM has been shown to be more effective when a single targeted behavior is addressed at a time and when resumption of continuous positive change is reinforced after a brief slip. Barriers include funding sources to cover the cost of rewards and determining appropriate length of treatment for this method. Advantages of CM include the breadth of behavioral changes that can be targeted and its demonstrated success in patients with severe and complex substance use disorders (Petry et al., 2001).

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