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Contigency Essay

3031 words - 13 pages


Contingency Management and Human Service Delivery

Table of Contents
Introduction …………………………………………………… ..Page 3
What is Contingency Management? …………………………….Page 3
Traditional delivery of Treatment …………………………….....Page 4
What is the role of the Human service Worker?…………………Page 5
What Does Outcome Studies Report? …………………………..Page 7
Conclusion ………………………………………………………Page 11
References ………………………………………………………Page 13

Contingency management in medicine is a treatment plan that gives ...view middle of the document...

By using contingency management the effective treatment of marijuana abuse and the ability to abstain will be investigated.
What is contingency management?
Contingency management (CM) interventions are efficacious in treating substance use disorders. Typically, CM treatments involve providing tangible reinforcers, usually in the form of vouchers exchangeable for retail goods and services, whenever abstinence is noted. Substantial evidence suggests that such CM treatments reduce drug use. For example, Higgins et al. (1994) found that more than half the cocaine-dependent patients who were randomly assigned to a voucher contingent treatment achieved at least 2 months of continuous abstinence, compared with only 15.0% of patients receiving the same type of psychotherapy but without contingent vouchers. In this and others studies, longest duration of abstinence achieved during treatment was associated with abstinence at follow-up conducted 1-2 years later (Petry et al., 2006)
Although most CM studies have reinforced drug abstinence, others behaviors can also be targeted for change. Some CM studies provided vouchers contingent on completion of steps related to long-term treatment goals. In other words, if a patient desires to improve his or her living situation, he or she may make an appointment at a housing agency one week, attend the appointment the next week, and subsequently visit several rental apartments. If the patient provides verification that he or she has completed these steps, reinforcement is provided. A combined CM treatment, reinforcing both abstinence and activity completion, reduced drug use during opioid detoxification. A study in methadone patients found that vouchers contingent on activity completion alone recued drug use to a greater extent that voucher contingent only on abstinence.

Standard Treatment Conditions.
Standard intensive outpatient treatment consisted of group therapy sessions that included relapse prevention, coping and life skill training, AIDS education, and 12-step treatment. Intensive care (up to 4hr/day, 5 days/week) lasted 4 weeks and was followed by gradual reductions in care. Aftercare consisted of one group session per week for up to 12 months. One of six clinicians led the standard therapy groups, with leaders varying by days and group times. The clinician ranged in educational background from associate’s degrees to master’s degrees in social work. All standard treatment was group based, except in rare cases of clinical emergencies, which were handled on an individual basis by the first available clinician.

Traditional Delivery of Treatment for Substance Abusers
Brief motivational interventions have been evaluated in several studies with adolescents with some encouraging results. In a recent paper (Baer, Garrett, Beadnell, Wells, & Peterson, 2007), we reported the use of a BMI with homeless adolescents, a subpopulation of youth at extremely high...

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