Motivational incentives in the CTN: Results, clinical implications, and dissemination.
Substance abusers who enter treatment require a combination of motivation, skills and opportunities to make the behavior changes needed that will advance their recovery. One technique that has been helpful in boosting and sustaining motivation for successful participation and behavior change during treatment involves the use of tangible incentives that are awarded to clients by clinic staff contingent upon objective evidence of goal attainment. Contingency Management and Motivational Incentives are synonymous names for this technique. A large body of research provides evidence that motivational incentives, when implemented appropriately, can increase length of treatment participation and promote sustained periods of drug abstinence. Further, the technique has been shown efficacious when applied to users of a variety of abused substances including cocaine, alcohol and marijuana.
A large multi-site clinical trial conducted within the National Drug Abuse Treatment Clinical Trials Network supported effectiveness for treatment of stimulant users when abstinence-contingent incentives were added to usual care in community treatment programs that provided either psychosocial counseling alone or opiate substitution therapy (methadone) as well. Data from this trial will be used to demonstrate the magnitude and generality of these effects. Motivational incentives have been well accepted and widely adopted by substance abuse treatment researchers including those in CTN, to support adequate participation and/or to promote abstinence among research volunteers. The technique can also improve substance abuse treatment outcomes but has been less well accepted and widely adopted within the realm of clinical practice, despite being one of the most effective known behavioral interventions available for use in these settings. Nevertheless, adoption is gradually increasing as more training and dissemination materials become available and as solutions to perceived adoption impediments are addressed. During this presentation, dissemination resources will be provided and lessons learned about adoption discussed.
Related protocols: CTN-0006, CTN-0007