Contingency Management in Substance Abuse Treatment

Stephen T. Higgins, PhD, is Professor of Psychiatry and Psychology at the University of Vermont. The recipient of numerous national awards for research excellence, Dr. Higgins is currently President of the College on Problems of Drug Dependence and principal and coinvestigator on numerous grants from the National Institute on Drug Abuse (NIDA). He has published extensively on furthering scientific understanding of the behavioral and pharmacological processes involved in substance use disorders. Kenneth Silverman, PhD, served as a staff fellow in the Clinical Trials Section of NIDA’s Intramural Research Program in Baltimore from 1991 to 1993. He is currently Professor of Psychiatry and Behavioral Sciences at Johns Hopkins University School of Medicine. Dr. Silverman’s research focuses on developing operant treatments to address the interrelated problems of poverty and drug addiction. His primary research has focused on the development and evaluation of abstinence reinforcement interventions for heroin and cocaine addiction in poor, inner-city adults, and the integration of those abstinence reinforcement contingencies into model employment settings. Sarah H. Heil, PhD, is Research Assistant Professor of Psychiatry and Psychology at the University of Vermont. Her research interests include the behavioral and pharmacological processes involved in substance use disorders, with a special focus on pregnant and recently postpartum women. She is a regular contributor to the scientific literature on drug abuse and has received several honors and awards for research excellence.

• 1. Introduction, Stephen T. Higgins and Kenneth SilvermanI. Contingency Management Across Substances2. Cocaine, Stephen T. Higgins, Sarah H. Heil, Randall E. Rogers, and Laura Chivers3. Opioids, David H. Epstein and Kenzie L. Preston4. Marijuana, Alan J. Budney and Catherine Stanger5. Methamphetamines, John M. Roll and Thomas Newton6. Tobacco, Stacey C. Sigmon, Richard J. Lamb, and Jesse Dallery7. Alcohol, Conrad J. Wong, Kenneth Silverman, and George E. Bigelow8. Medication Compliance, Bruce J. Rounsaville, Marc Rosen, and Kathleen M. CarrollII. Special Populations9. Homeless Populations, Jesse B. Milby and Joseph Schumacher10. Pregnant and Postpartum Women, Sarah H. Heil. Jin H. Yoon, and Stephen T. Higgins11. People with Mental Illness, Jennifer W. Tidey and Rick Ries12. Adolescents, Suchitra Krishnan-Sarin, Amy M. Duhig, and Dana A. CavalloIII. Dissemination13. Large-Scale Dissemination Efforts in Drug Abuse Treatment Clinics, Maxine L. Stitzer and Scott Kellogg14. Lowering Costs in Drug Abuse Treatment Clinics, Nancy M. Petry and Sheila M. Alessi15. Use of Community Donations and Clinic Rebates to Fund Contingency Management in Community Treatment Clinics, Leslie Amass and Jonathan B. Kamien16. Contingency Management in an Entitlement Rehabilitation Setting: An Example from the Veterans Health Administration, Charles Drebing, Bruce J. Rounsaville, and Robert Rosenheck17. Employment-Based Reinforcement in the Treatment of Drug Addiction, Wendy D. Donlin, Todd W. Knealing, and Kenneth Silverman18. Contingency Management in Adult Criminal Drug Courts, Douglas B. Marlowe and Conrad J. Wong

"This book provides the most up-to-date summary of the broad range of applications of contingency management for substance abuse. Many practical examples bring to life the conceptual and empirical underpinnings of the approach. Well organized and comprehensive, this is a most useful text for training practitioners and students in an important therapeutic technique."--Thomas R. Kosten, MD, Jay H. Waggoner Chair and Professor of Psychiatry and Neuroscience, Baylor College of Medicine"This volume constitutes the state of the art of one of the most effective empirically based therapies for addiction. The contributors clearly lay out the fundamental approach, the breadth and depth of the application, and the utility of this treatment for addiction in its many forms. In my view, this book should be required reading for students, professionals working with addiction, and scientists."--Warren K. Bickel, PhD, Director, Center for Addiction Research, University of Arkansas for Medical Sciences"This well-written book offers a comprehensive overview of contingency management. The authors provide evidence-based information on the treatment of a wide range of substance use disorders in different populations and treatment settings. The coverage of dissemination issues is very welcome. Highly recommended for all those working in the field of addiction or psychiatry, from students to experienced clinicians."--Cor A.J. de Jong, MD, PhD, Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University Nijmegen, The Netherlands"If a new addiction medication were developed that produced results comparable to contingency management, the FDA would approve it enthusiastically and drug companies would pay big dollars to own the patent. This book makes it crystal clear just how powerful contingency management is, how easy it is to use, and how well it works across diverse populations, problems, and settings. Like Marlatt and Gordon's Relapse Prevention and Miller and Rollnick's Motivational Interviewing, this is a seminal volume on psychological/behavioral addiction treatment. The book will be valuable in undergraduate psychology classes, graduate programs on addiction, and clinical psychology training programs. It is also a very valuable research resource."--Richard A. Rawson, PhD, Associate Director, Integrated Substance Abuse Programs, University of California at Los Angeles"This book reflects the depth and variety of applications of the contingency management approach. The chapters are unified by basic CM principles and cover a wide range of settings and populations. It can be used as a classroom text at the graduate level or in specialty addiction training programs. With authors well known for their specific expertise, this is an excellent source for those seeking a review of evidence-based principles and interventions."--Joan E. Zweben, PhD, Department of Psychiatry, University of California, San Francisco; staff psychologist, San Francisco VA Medical Center- Leadership and management in the field of addiction should read this book to understand when, where, and how contingency management is and is not effective. --Journal of Clinical Psychiatry, 9/28/2007ƒƒ This book provides a useful and informative compilation of the empirical base for contingency management across numerous substances of abuse, populations, and types of settings. It is comprehensive and up to date. Concerns and issues are excellently handled, and the introduction provides an exceptionally fine overview. Discussion of issues in disseminating the approach to community settings is particularly interesting, although complexity and cost remain major deterrents. Anyone who plans to use contingency management in research would benefit from having this reference. --Social Service Review, 9/28/2007ƒƒ Presents a solid evidence base for the application of contingency management in a variety of settings and with a range of different client types....This book will suit a range of clinicians and researchers from the alcohol and drug sector....This book will help novice readers and more experienced researchers and clinicians to think about and clarify their thinking around contingency management. The book presents compelling evidence, both positive and negative, and makes recommendations regarding future research, and while the focus is primarily in the research arena there is enough to hold the interest of any clinician interested in exploring contingency management for their own work-place. --Drug and Alcohol Review, 9/28/2007ƒƒ The book is very well written, informative, and enjoyable to read....One chapter reads as a 'how to' manual designed to assist the practitioner in implementation of this approach within his/her own practice. As a result, upon completion of the book, most psychologists in applied practice would likely feel confident in their ability to utilize contingency management techniques/programs with their own patients. This volume would be a useful resource for any researcher or practitioner in the area of substance abuse treatment. --PsycCRITIQUES, 9/28/2007ƒƒ Each chapter in the book can be used by itself, or as a whole. Potential audience for the book is wide; individuals including rehabilitation counselors, mental health counselors, psychologists, addiction specialists, social workers, criminal justice majors, attorneys, and judges would all benefit from reading it. Additionally, it could be used in upper-level undergraduate, graduate, and continuing education courses. The editors and authors are to be congratulated for applying basic principles of behavior science to the creative treatment of an entire array of addictions. This book shines the way toward more research in the interventions and findings that will emerge from that study toward best practices in the treatment of addictive behaviors in many populations and settings. --Journal of Applied Rehabilitation Counseling, 9/28/2007