Contingency Management for Substance Abuse

Contingency Management for Substance Abuse

Contingency management is recognition for a job well done. Critics of the process claim contingency management is an expensive tactic based in bribery for persons with addiction to remain sober. Discover the ins and outs of contingency management and why it may be an option to consider for individuals seeking support in sobriety.


What is Contingency Management

One of the treatment strategies used in both inpatient and outpatient rehab centers is contingency management where clinicians provide positive consequences in response to appropriate behaviors. Encouragement of positive behavioral change and negative or punitive consequences for undesirable ones is meant to reward ‘good’ behavior (prizes, praise) while punishing ‘bad’ behavior (lost privileges, etc).


Contingency management may sound like a parenting technique and feel as such to individuals in treatment but boundaries and rewards are important to the treatment and recovery process. Not every rehab setting is right for this type of program or individual but contingency management treatment may be supportive for the right individuals ready to effect positive change.


Why it Works

Behaviors are monitored and consequences meted out immediately. Contingency management exhibits positive clinical outcomes in both inpatient and outpatient drug treatment programs that apply basic principles. The following are some instances where it works:

  • Particularly useful in group settings meeting once  week to several times per week
  • Frequently monitor behavior trying to change
  • Tangible, immediate positive reinforcement provided each time behavior occurs
  • Withhold positive reinforcement when behavior does not occur


Staff are required to monitor behaviors frequently and provide reinforcement on a consistent basis. In this way, interventions using contingency management can be most effective to:

  • Reduce alcohol and drug use
  • Retain alcoholics and persons with addiction in treatment
  • Improve participation in employment opportunities


Types of Contingency Management

Two different types of programs exist for contingency management:

  • Voucher based programs use vouchers earned for every alcohol or drug-free urine sample or breath test. The voucher is assigned a monetary value that can be exchanged for different items like food or passes for a movie. The value of vouchers can increase as positive behavior increases.
  • Prize incentive programs use similar principles rather than vouchers


Individuals participating in either voucher-based or prize incentive interventions may also be reinforced for attending therapeutic sessions, completion of other goals or taking medication where prescribed. Contingency management is used in programs that are three months or longer to allow a person time to experience success in earning prizes for good behavior. The success rate really depends on the individual person who is going through treatment. While some may experience success, others may struggle to deal with the circumstances of treatment protocol. It is best to do research and find appropriate treatment programs which support a healthy long term recovery.


The Villa works to support individuals with addiction find treatment programs with an individualized approach. Each program is as unique as the individual. If you are searching for the right place to receive help for addiction, we can help you get there.