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Evaluation ViewAttendees 6

Traditional Workshop - Ticketed

Addictive Behaviors

Workshop 4 - Designing and Implementing Contingency Management Interventions for Health Behavior Change

Friday, November 15, 2024
12:00 PM - 3:00 PM EST
Location: 411/412, Level 4, Downtown Marriott
Earn 3 Credit
Ticketed Session
Keywords: Substance Abuse, Health Psychology, Evidence-Based Practice
Level of Familiarity: Basic to Moderate
Recommended Readings: Rash, C. J., Stitzer, M., & Weinstock, J. (2017). Contingency management: New directions and remaining challenges for an evidence-based intervention. Journal of Substance Abuse Treatment, 72, 10-18.,   Becker, S. J., DiClemente-Bosco, K., Rash, C. J., & Garner, B. R. (2023). Effective, but underused: Lessons learned implementing contingency management in real-world practice settings in the United States. Preventive Medicine, 176, 107594.,   Oluwoye, O., Kriegel, L., Alcover, K. C., McPherson, S., McDonell, M. G., & Roll, J. M. (2020). The dissemination and implementation of contingency management for substance use disorders: A systematic review. Psychology of Addictive Behaviors, 34(1), 99–110. https://doi.org/10.1037/adb0000487,   Rash, C. J., Alessi, S. M., & Zajac, K. (2020). Examining implementation of contingency management in real-world settings. Psychology of Addictive Behaviors, 34(1), 89–98. https://doi.org/10.1037/adb0000496,   Rash, C. J. (2023). Implementing an evidence-based prize contingency management protocol for stimulant use. Journal of Substance Use and Addiction Treatment, 151, 209079.

    Presenter(s)

  • Jeremiah Weinstock, Ph.D.

    Professor of Psychology
    Saint Louis University
    St. Louis, Missouri, United States

  • Carla J. Rash, Ph.D.

    Associate Professor of Medicine
    University of Connecticut Health Center
    Farmington, Connecticut, United States

Contingency management (CM) is an efficacious behavioral intervention that provides tangible reinforcement when target behaviors are completed and objectively verified. A large evidence-base supports CM’s use for treating substance use disorders (SUD). For example, a meta-analysis of psychological treatments for SUDs found that CM had the largest effect size (Dutra et al., 2008) and a comprehensive review highlights its diverse applications (Rash, Stitzer, & Weinstock, 2017). Other meta-analyses find medium to large effects of CM (Prendergast et al., 2006; Bentzley et al., 2021; Bolivar et al., 2021). Many applications of CM in treating SUD focus on abstinence, providing monetary rewards or prizes when clients provide objective evidence of drug abstinence (e.g., urine samples). Contingency management has also been adapted to reinforce other behaviors, including treatment attendance, medication adherence, treatment-related activities (e.g., attending medical appointments), physical activity, chronic disease management (e.g., glucose monitoring), and therapeutic homework. Despite this strong empirical foundation, CM has only been widely disseminated within large self-contained healthcare systems (e.g., Veterans Affairs) and only recently did SAMHSA funded State Opioid Response grants allow for CM dissemination and implementation activities for treating stimulant use disorder. Most state SOR grants have yet to implement CM.
In this workshop, we will review the application of CM to promote positive behavior change in various health behaviors. Attendees will learn how to design and implement a CM program using guidelines that can be adapted to a variety of target behaviors. Specifically, we will describe 1) the theoretical underpinnings and supporting empirical literature, 2) different types of CM programs (i.e., voucher, prize), 3) effective design features, 4) common barriers to and problems with implementation, 5) how to calculate costs of a CM program, and 6) how to implement CM programs in individual and group settings.

Outline:

Topic 1: Landscape of Substance Use Disorders Treatment and Where Does Contingency Management Fit In
A. Use of punishment in substance use disorders treatment
B. Use of positive reinforcement in substance use disorders treatment

Topic 2: Defining Contingency Management and Brief Review of Empirical Literature
A. Central tenets of effective contingency management interventions
B. Overview of the three contingency management reinforcement systems
C. Behaviors targeted for change by contingency management interventions
D. Efficacy data on contingency management interventions

Topic 3: Contingency Management Intervention Design Considerations
A. Selecting a behavior to reinforce
B. Choosing a reinforcer
C. Determining monitoring schedules and costs
D. Integrating behavioral principles

Topic 4: Implementation of Contingency Management
A. Clinical demonstration of contingency management session
B. Implementing contingency management in community-based agencies from the perspective of the Consolidated Framework for Implementation Research (i.e., lessons learned)
C. Brief review of mHealth contingency management apps

Learning Objectives:

At the end of this session, the learner will be able to:
  1. Select, monitor, and reinforce target behaviors in a CM intervention.
  2. Develop voucher- and prize-based CM protocols.
  3. Recognize effective features of CM reinforcement schedules.
  4. Design and calculate costs for a prize-based contingency management intervention.
  5. Implement CM with clients.
  6. Long-term Goal: Attendees will gain knowledge about the evidence-base supporting contingency management, including critical facets of the intervention to ensure its efficacy.
  7. Long-term Goal: Attendees will identify potential barriers to dissemination and implementation of contingency management and ways to address these issues.