DIAGNOSIS: Substance-Use Disorders

TREATMENT: Group Contingency Management Therapy for Cocaine Use Disorders


  • Basic premise: Contingency management (CM) refers to a type of behavioural therapy in which individuals are ‘reinforced’, or rewarded, for evidence of positive behavioural change. These interventions have been widely tested and evaluated in the context of substance misuse treatment, and they most often involve provision of monetary-based reinforcers for submission of drug-negative urine specimens. Contingency management is a highly effective treatment for substance use and related disorders. Contingency management interventions can be applied in the context of psychiatric treatments more generally, including increasing abstinence in individuals with dual diagnoses, encouraging attendance in mental health treatment settings (also group therapy), enhancing adherence to psychiatric medications, reducing weight, and improving exercise.


Alessi, S. M., Hanson, T., Wieners, M., & Petry, N. M. (2007). Low-cost contingency management in community clinics: Delivering incentives partially in group therapy. Experimental and Clinical Psychopharmacology, 15(3), 293–300.

Epstein, D. H., Hawkins, W. E., Covi, L., Umbricht, A., & Preston, K. L. (2003). Cognitive behavioral therapy plus contingency management for cocaine use: findings during treatment and across 12-month follow-up. Psychology of Addictive Behaviors, 17(1), 73–82.

Garcia-Rodriguez, O., Secades-Villa, R., Higgins, S. T., Fernandez-Hermida, J. R., Carballo, J. L., Errasti Perez, J. M., & Al-halabi Diaz, S. (2009). Effects of voucher-based intervention on abstinence and retention in an outpatient treatment for cocaine addiction: a randomized controlled trial. Experimental and Clinical Psychopharmacology, 17(3), 131–138.

Ledgerwood, D. M., Alessi, S. M., Hanson, T., Godley, M. D., & Petry, N. M. (2008). Contingency management for attendance to group substance abuse treatment administered by clinicians in community clinics. Journal of applied behavior analysis, 41(4), 517–526.

Petry, N. M., Alessi, S. M., & Hanson, T. (2007). Contingency management improves abstinence and quality of life in cocaine abusers. Journal of Consulting and Clinical Psychology, 75(2), 307–315.

Petry, N. M., Weinstock, J., Alessi, S. M., Lewis, M. W., & Dieckhaus, K. (2010). Group-based randomized trial of contingencies for health and abstinence in HIV patients. Journal of Consulting and Clinical Psychology, 78(1), 89–97.

Petry, N. M., Martin, B., & Simcic, F. (2005). Prize reinforcement contingency management for cocaine dependence: integration with group therapy in a methadone clinic. Journal of Consulting and Clinical Psychology, 73(2), 354–359.

Rawson, R. A., Huber, A., McCann, M., Shoptaw, S., Farabee, D., Reiber, C., & Ling, W. (2002). A comparison of contingency management and cognitive-behavioral approaches during methadone maintenance treatment for cocaine dependence. Archives of General Psychiatry, 59(9), 817–824.