Substance Abuse

Paper Summary:

This paper aims to provide an understanding of the controlled studies using contingency management (CM) in the substance abuse field and community reinforcement approach (CRA). The paper further aims to emphasize the studies that incorporate CM with a community reinforcement approach (CRA). This paper offers a critical review of the literature with an eye toward identifying important and unresolved theoretical and research questions.

Outline:
Objective
Background of the Study
Literature Review
Non-Voucher Contingency Management
Community Reinforcement Approach and Contingency Management Procedure Combined Treatment
Discussion and Indications for future Research

From the Paper:

"Findings of the study state that: "the addition of abstinence-based CM to standard care resulted in greater retention in treatment, a higher number of drug-negative samples submitted and longer durations of abstinence." The CM activity condition was found to be "less efficacious" than the CM abstinence condition in relation to retention in treatment and as to "some drug abuse outcomes measures". Petry et al states that: "These data contrast with those of Iguchi et al (1997) who found that CM treatment had reinforced activity completion resulted in greater reductions in drug use than a CM treatment that reinforced abstinence directly." (Petry, et al 2006) Stated as well is that "although an activity-based CM intervention was not particularly efficacious in this study when applied alone, reinforcement for compliance with goal-related activities is efficacious when applied in conjunction with reinforcement for abstinence."(Ibid) In the present study Petry et all states that "few overall differences were noted between the two CM conditions in terms of changes in ASI scores over the treatment period, and the lack of effects may reflect the individualized nature of activity selection. Some patients chose to work on employment goals, others legal goals, and still others family-related activities." (Ibid) It was also found that the "prize-based CM intervention for abstinence was efficacious, but effects on drug abuse outcomes were confounded by differences in retention rates." (Ibid)"

Sample of Sources Used:

• "Pathways of Addiction: Opportunities in Drug Abuse Research (1996) Institute of Medicine (IOM)
• Abbott PJ; Moore BA; Weller SB; Delaney (1998) AIDS risk behavior in opioid dependent patients treated with community reinforcement approach and relationships with psychiatric disorders. Journal of Addictive Diseases 17(4): 33-48, 1998
• Alessi, SM; Badget, GJ; Higging, ST (2004)An Experimental Examination of the Initial weeks of Abstinence in Cigarette Smokers. Experimental and Clinical Psychopharmacology 12(4); 276-2897, 2004.
• Bickel WK, Amass L, Higgins ST et al. (1997), The effects of adding behavioral treatment to opiod detoxification with buprenorphine. J Consult Clinical Psychology 65(5):803-810.
• Bickel, Warren and Marsch, Lisa (2001) Toward A Behavioral Economic Understanding of Drug Dependence: Delay Discounting Processes. Journal of Addiction 2001: 96, 73.

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