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The Contingency Management Approach

A discussion of the contingency management approach in addiction therapy, emphasizing motivation and behavioral reinforcement.

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    The Contingency Management Approach The Contingency Management Approach The contingency management approach is a behavioral modification system designed to provide a formal system of rewards (or po sitive reinforcements) and, sometimes, punishments that make continued drug use and other misbehaviors less attractive than more desirable alternatives (Griffith, Rowan - Szal, Roark, & Simpson, 2000). For instance, Alcoholics Anonymous (AA) meetings use the chip system that denotes the length of sobriety. Drug courts provide positive incentives on these chips. Therefore, when a client earns recovery time and a positive, prosocial,law - abiding behavior, he or she is awarded by decreasing his or her treatment from three times a week to two times a week. Principles of the contingency management models emphasize on the importance of replacing maladaptive behaviors with new healthier behaviors, resulting in behavioral modification. Read the following scenario: John is a thirty - six - year - old divorcee residing with a roommate at his present in - patient residential stay. John has a long history of alcohol and cocaine use, starting from the age of nineteen years. Although he had previously attempted to complete the treatment several times, he always left it prematurely and against medical advice. Consider you are an addiction counselor. After completing detoxification, John has been transferred to your program for thirty days. During the initial conversation with you, he presents a willingness to stay clean and sober. However, later during the program, he exhibits some denial and resistance to the program rules and the requirements of attending the AA and Narcotic Anonymous (NA) programs. John presents the following risk factors for relapse: • Has no current sober living environment (as he previously stayed with a known addict) • Has lost his job due to a recent driving under the influence conviction • Has limited exposure to sober supports and leisure activities • Had relapsed in the past due to triggers such as stress, limited support, and refusal to follow through with outpatient treatment and AA or NA meetings In this scenario, the contingency management (cm) approach can be effectively employed to address john’s addiction and relapse risks. Contingency management is particularly suitable here

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