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Interest and Preferences for Contingency Management Design Among Addiction Treatment Clientele.

American Journal of Drug and Alcohol Abuse 2016;42(3):287-295. [doi: 10.3109/00952990.2015.1096365]

Bryan Hartzler, PhD and Sharon Garrett, MA, MPH (Alcohol & Drug Abuse Institute, University of Washington, PN Node).

Despite strong support for its efficacy, debates persist about how dissemination of contingency management is most effectively undertaken. Currently-promoted contingency management methods are empirically-validated, yet their congruence with interests and preferences of addiction treatment clientele is unknown. Such client input is a foundational support for evidence-based practice. This study documented interest in incentives and preferences for fixed-ratio vs. variable-ratio and immediate vs. distal distribution of earned incentives among clients enrolled at three community programs affiliated with the National Institute on Drug Abuse Clinical Trials Network. This multi-site CTN platform study included anonymous survey completion by an aggregate sample of 358 treatment enrollees. Analyses first ruled out site differences in survey responses, and then tested age and gender as influences on client interest in financial incentives, and preferences for fixed-ratio vs. variable-ratio reinforcement and immediate vs. distal incentive distribution. Results found that interest in different types of $50 incentives (i.e. retail vouchers, transportation vouchers, cash) was highly inter-correlated, with a mean sample rating of 3.49 (0.83) on a five-point scale. While consistent across client gender, age was an inverse predictor of client interest in incentives, with youth exhibiting more interest in incentives). A majority of clients stated preference for fixed-ratio incentive magnitude and distal incentive distribution (67% and 63%, respectively), with these preferences voiced by a larger proportion of females.

Conclusions: This study offered a helpful glimpse into client perspectives about design features of contingency management interventions, and found that those preferences contradicted currently-promoted contingency management design features. Future efforts to disseminate contingency management may be more successful if flexibly undertaken in a manner that incorporates the interests and preferences of local client populations. (Article (Peer-Reviewed), PDF, English, 2016)

Keywords: Behavior therapy | Contingency Management (CM) | CTN platform/ancillary study | Motivational incentives | American Journal of Drug and Alcohol Abuse (journal)

Document No: 1181, PMID: 26646619, PMCID: PMC4877230 (available 5/1/2017).

Submitted by CTN Dissemination Librarians, 12/21/2015.

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Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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