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Are Incentives Effective in Improving Participation and Outcomes in Treatment for Substance-Abusing Offenders?. Michael L. Prendergast, Ph.D. Elizabeth A. Hall, Ph.D. Integrated Substance Abuse Programs University of California, Los Angeles. ACJRC October 22, 2010. Contingency Management.

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Are Incentives Effective in Improving Participation and Outcomes in Treatment for Substance-Abusing Offenders?

Michael L. Prendergast, Ph.D.

Elizabeth A. Hall, Ph.D.

Integrated Substance Abuse Programs

University of California, Los Angeles

ACJRC

October 22, 2010

contingency management
Contingency Management
  • Procedures that arrange the environment so that certain actions (behaviors) are reliably and predictably followed by certain consequences.
  • Consists of a schedule of reinforcement, which specifies the relationship between the behavior and the delivery of the consequence, either a reinforcer or a punisher.
operant conditioning
Operant Conditioning
  • Operant Conditioning
    • type of learning in which behavior is strengthened if followed by reinforcement or diminished if followed by punishment
  • Law of Effect
    • Thorndike’s principle that behaviors followed by favorable consequences become more likely, and behaviors followed by unfavorable consequences become less likely
operant conditioning1
Operant Conditioning
  • Reinforcer
    • any event that strengthens the behavior it follows
ways to increase behavior
Operant conditioning term

Positive reinforcement

Negative reinforcement

Description

Add a positive stimulus (e.g., incentives such as a privilege, money, candy)

Remove an aversive stimulus (e.g., daily reporting, seatbelt buzzer)

Ways to increase behavior:
principles of reinforcement
Principles of Reinforcement
  • Primary reinforcer
    • innately reinforcing stimulus
    • i.e., satisfies a biological need (fish)
  • Conditioned reinforcer
    • stimulus that gains its reinforcing power through its association with primary reinforcer (e.g., fishclicker)
    • secondary reinforcer (e.g., money)
typical contingency management procedures in drug treatment
Typical Contingency Management Procedures in Drug Treatment
  • Participants earn vouchers for providing drug-free urines, which indicate recent abstinence.
  • Participants may also earn vouchers for other behaviors that promote treatment goals.
  • Vouchers can be exchanged for goods or services that are consistent with the individual participant's treatment plan.
increasing engagement in prison based drug treatment
Increasing Engagement in Prison-based Drug Treatment

PI: William Burdon, PhD

Aims:

  • Test the impact of a behavioral reinforcement intervention on inmate engagement in prison-based substance abuse treatment
    • thereby improving psychosocial functioning over the course of treatment and post-release outcomes (e.g., decreased drug use, reincarceration)
  • Assess the process by which this evidence-based innovation is implemented and sustained within prison-based treatment programs
study features
Study Features
  • Variety of behaviors were reinforced
  • Client and staff buy-in
  • Low cost incentives
evaluating voucher based contingencies in a drug court sacpa prop 36 court
Evaluating Voucher-based Contingencies in a Drug Court & SACPA (Prop 36) Court

PI: Michael Prendergast, PhD

Aims:

  • Determine the impact of vouchers to reinforce abstinence from illicit drugs and completion of treatment plan goals during participation in a drug court treatment program.
  • Determine the impact of vouchers to reinforce abstinence from illicit drugs and completion of treatment plan goals six months after completing the drug court treatment program.
study features1
Study Features
  • Participants were referred by the Drug Court or Prop 36 Court into substance abuse treatment (MATRIX model)
participants were randomly assigned to 1 of 4 experimental conditions
Participants were randomly assigned to 1 of 4 experimental conditions:
  • Standard Treatment (ST) ($0)
  • ST + Drug Testing Group ($20/wk; $540 max)
  • ST + Treatment Plan Group ($20/wk; $540 max)
  • ST + Combined Group ($40/wk; $1,080 max)
study features cont
Study Features (cont.)
  • Flat reinforcement schedule
  • Incentives were delivered by research staff
  • Vouchers were exchangeable for goods or services that were consistent with the participant’s treatment goals
using incentives to improve parolee participation and attendance in community treatment
Using Incentives to Improve Parolee Participation and Attendance in Community Treatment

PI: Michael Prendergast, PhD

Aims:

  • Determine whether offering an incentive (voucher) increases admission to community treatment
  • Determine whether providing incentives for attendance results in greater retention in treatment
  • Assess the long-term impact of the use of incentives on drug use, crime, and psychosocial outcomes
  • Assess issues of acceptability, satisfaction, and sustainability of the use of incentives among staff and clients
study features2
Study Features
  • One behavior (attendance) reinforced
  • Escalating reinforcement schedule
  • Staff involvement in design and delivery of incentive
thank you
Thank You

Questions?

www.uclaisap.org

Acknowledgements

NIDA Grants R01DA13114, R01DA13114S, R01DA017856