What is Contingency Management Therapy?

Contingency management therapy is a behavioral therapy based on motivational incentives.

It works similarly to positive rewards that teachers give in the classroom. For instance, when I was teaching in urban schools, I would begin every year explaining “Utti Dollars” to my students. Utti Dollars would be given for a variety of things: staying in line during transition, not missing any homework all week, raising your hand in class, participation, getting “caught” being good (being on task, helping another student, keeping voice at a low level during collaborative work, etc.), and a variety of other positive behaviors. At the end of every week, the students could use their dollars to purchase items from my school store, change their seat, or get a homework pass. By reinforcing the correct behaviors from the very beginning of the year, the goal was for students to eventually learn these intrinsically.

Research has proven that contingency management principles work for helping people maintain sobriety. Similar to my Utti Dollars, two types of reinforcements  are generally used: voucher-based reinforcement and prize incentives. Voucher-based reinforcements may be used for those in inpatient or community-based treatment. For instance, a voucher may be given every time a clean urine is provided. People can save up the vouchers and exchange them for food items, restaurant certificates, sports equipment, movie tickets, or electronics.

Prize incentives work on the same principle, but the clients are given cash prizes instead of vouchers. This can be effective in a variety of ways. The client may be collect tickets for good behavior; the tickets can be traded in for a monetary reward or entered into a weekly drawing for a larger prize.

Positive incentives for behavior modification do work. Teachers have been using them in the classroom for years. Parents use positive reinforcements with their children to teach appropriate behavior and to reward good grades in school. Contingency management therapy is a simple tool for addiction because it is more rewarding than getting drunk or high.