Counselor attitudes toward the use of motivational incentives in addiction treatment.

Counselor attitudes toward evidence-based practices, such as motivational incentives/contingency management (MI/CM), are important in bridging the gap between research and practice. Mailed surveys from 1,959 substance abuse treatment counselors showed ambivalence toward MI/CM and strong disagreement with using monetary rewards for achievement of treatment goals. Attitudes were associated with counselors’ educational attainment, a 12-step treatment ideology, affiliation with NIDA’s Clinical Trials Network (where two multi-site clinical trials of MI/CM have been conducted, in both drug-free outpatient programs and opioid treatment programs), and working in opioid treatment programs. Exposure to MI/CM via training was more strongly associated with attitudes when counselors worked in programs that had adopted MI/CM, but overall, the extent to which counselors have received such training was relatively low. While there is substantial resistance to MI/CM, dissemination and training about the essential elements of MI/CM may enhance counselors’ receptivity toward the intervention.

This research contributes to the growing literature about the value of research networks in influencing attitudes toward evidence-based treatment practices.

Related protocols: CTN-0006, CTN-0007