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Poster presented at the College on Problems of Drug Dependence (CPDD) annual meeting, San Juan, Puerto Rico, June 14-19, 2008.
Ryan Vandrey, PhD, Maxine L. Stitzer, PhD (both from Johns Hopkins University, MA Node).
Pay-for-performance strategies have been shown to improve employee productivity and morale in business settings and variations are now gaining support for use in medical care settings. Recent studies in Delaware and Massachusetts suggest that providing substance abuse counselors with contingent incentives based on client outcomes can improve treatment retention rates. This pilot study assessed whether providing feedback and performance-based incentives to counselors at a community drug treatment clinic could improve client attendance at group counseling sessions. Each week, counselors at Harbel Prevention & Recovery Center in Baltimore (Mid-Atlantic Node) were given feedback regarding client attendance at each of 15 regularly held group sessions (range 7-18 clients), longitudinal attendance charts for individual clients assigned to groups they conducted, and strategies for improving client attendance were discussed. Also, each group that met a benchmark attendance cut-off of 80% was entered into a weekly drawing, and the counselor(s) who conducted the winning group received a $25 gift card. An additional token was placed in the drawing for each consecutive week a group met the benchmark attendance criteria to improve chances of winning among best performing groups.
After 8 weeks, 12 out of 15 groups met the 80% attendance benchmark at least once, and average attendance rates across the clinic increased from 63% to 69%. Interviews with the counselors indicate that they support pay-for-performance incentives, and in response to the program they increased the frequency of existing behaviors and developed new strategies they felt helped improve client attendance at group sessions. These findings suggest that a relatively inexpensive feedback and incentive program can positively impact counselor performance, and, indirectly, client engagement in treatment services. Further research is needed to investigate effects of the intervention on other client outcomes (drug use, retention), the mechanism of the intervention (feedback vs. incentives), and the feasibility of implementing the intervention across more diverse clinic settings. (Poster, PDF, English, 2008)
 Keywords: Community health services | Counselors | Contingency Management (CM) | CTN platform/ancillary study | Motivational incentives | Retention - Treatment | College on Problems of Drug Dependence (CPDD) annual meeting, 2008
Document No: 299
Approved by Ryan Vandrey, PhD, Johns Hopkins University, MA Node, (9/3/2008). |
