Contingency management for patients with cooccurring disorders: evaluation of a case study and recommendations for practitioners
- PMID: 22937413
- PMCID: PMC3420718
- DOI: 10.1155/2012/731638
Contingency management for patients with cooccurring disorders: evaluation of a case study and recommendations for practitioners
Abstract
Research indicates that contingency management (CM) has potential to improve a number of outcomes (e.g. substance use, treatment attendance, quality of life) among individuals with substance use and cooccurring disorders. However, multiple factors must be considered on a case-by-case basis in order to promote optimal treatment effects. The present study describes an individualized CM protocol for a US Veteran with substance dependence and cooccurring severe mental illness. CM targeted attendance at outpatient appointments and appropriate use of hospital resources. Effects of CM were assessed by comparing the 3-month baseline and CM periods. The CM intervention marginally reduced unnecessary hospital admissions, resulting in cost savings to the medical center of over $5,000 in three months for this individual. However, CM did not affect outpatient attendance. Several complications arose, highlighting challenges in using CM in populations with substance use and cooccurring disorders. Practical suggestions are offered for maximizing the effects of CM.
Similar articles
-
Systematic reviews of the effectiveness of day care for people with severe mental disorders: (1) acute day hospital versus admission; (2) vocational rehabilitation; (3) day hospital versus outpatient care.Health Technol Assess. 2001;5(21):1-75. doi: 10.3310/hta5210. Health Technol Assess. 2001. PMID: 11532238 Review.
-
Clinician-delivered contingency management increases engagement and attendance in drug and alcohol treatment.Drug Alcohol Depend. 2015 Jul 1;152:62-7. doi: 10.1016/j.drugalcdep.2015.04.021. Epub 2015 May 4. Drug Alcohol Depend. 2015. PMID: 25982007 Clinical Trial.
-
The Effectiveness of Ultra-Low Magnitude Reinforcers: Findings From a "Real-World" Application of Contingency Management.J Subst Abuse Treat. 2017 Jan;72:111-116. doi: 10.1016/j.jsat.2016.06.012. Epub 2016 Jun 29. J Subst Abuse Treat. 2017. PMID: 27422452
-
An economic evaluation of a contingency-management intervention for stimulant use among community mental health patients with serious mental illness.Drug Alcohol Depend. 2015 Aug 1;153:293-9. doi: 10.1016/j.drugalcdep.2015.05.004. Epub 2015 May 14. Drug Alcohol Depend. 2015. PMID: 26026494 Free PMC article. Clinical Trial.
-
Solving the problem of non-attendance in substance abuse services.Drug Alcohol Rev. 2014 Nov;33(6):625-36. doi: 10.1111/dar.12194. Epub 2014 Sep 6. Drug Alcohol Rev. 2014. PMID: 25196817 Review.
References
-
- Higgins ST, Heil SH, Lussier JP. Clinical implications of reinforcement as a determinant of substance use disorders. Annual Review of Psychology. 2004;55:431–461. - PubMed
-
- Higgins ST, Wong CJ, Badger GJ, Ogden DEH, Dantona RL. Contingent reinforcement increases cocaine abstinence during outpatient treatment and 1 year of follow-up. Journal of Consulting and Clinical Psychology. 2000;68(1):64–72. - PubMed
-
- Sigmon SC, Higgins ST. Voucher-based contingent reinforcement of marijuana abstinence among individuals with serious mental illness. Journal of Substance Abuse Treatment. 2006;30(4):291–295. - PubMed
Publication types
LinkOut - more resources
Full Text Sources
Other Literature Sources