A review of the literature on contingency management in the treatment of substance use disorders, 2009–2014

• Published in: Preventive medicine Vol. 92; pp. 36 - 46
• Main Authors: Davis, Danielle R., B.S, Kurti, Allison N., PhD, Skelly, Joan M., MS, Redner, Ryan, PhD, White, Thomas J., PhD, Higgins, Stephen T., PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2016
• Subjects: Behavior change; Behavioral economics; Behavioral interventions; Contingency management; Economics, Behavioral; Financial incentives; Humans; Internal Medicine; Motivation; Psychosocial interventions; Reward; Substance use disorders; Substance-Related Disorders - therapy; Treatment Outcome; Substance use disorders; Contingency management; Behavioral interventions; Behavior change; Financial incentives; Psychosocial interventions; Behavioral economics
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2016.08.008

Abstract This report describes a systematic literature review of voucher and related monetary-based contingency management (CM) interventions for substance use disorders (SUDs) over 5.2 years (November 2009 through December 2014). Reports were identified using the search engine PubMed, expert consultations, and published bibliographies. For inclusion, reports had to (a) involve monetary-based CM; (b) appear in a peer-reviewed journal; (c) include an experimental comparison condition; (d) describe an original study; (e) assess efficacy using inferential statistics; (f) use a research design allowing treatment effects to be attributed to CM. Sixty-nine reports met inclusion criteria and were categorized into 7 research trends: (1) extending CM to special populations, (2) parametric studies, (3) extending CM to community clinics, (4) combining CM with pharmacotherapies, (5) incorporating technology into CM, (6) investigating longer-term outcomes, (7) using CM as a research tool. The vast majority (59/69, 86%) of studies reported significant ( p < 0 .05) during-treatment effects. Twenty-eight (28/59, 47%) of those studies included at least one follow-up visit after CM was discontinued, with eight (8/28, 29%) reporting significant ( p < 0 .05) effects. Average effect size (Cohen ' s d) during treatment was 0.62 (95% CI: 0.54, 0.70) and post-treatment it was 0.26 (95% CI: 0.11, 0.41). Overall, the literature on voucher-based CM over the past 5 years documents sustained growth, high treatment efficacy, moderate to large effect sizes during treatment that weaken but remain evident following treatment termination, and breadth across a diverse set of SUDs, populations, and settings consistent with and extending results from prior reviews.