DIAGNOSIS: Substance-Use Disorders

TREATMENT: Group Contingency Management Therapy for Opioids 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. CM for opioids use disorder is a behavioral strategy that is not always delivered by therapist, but a CM technician.


Bolívar, H. A., Klemperer, E. M., Coleman, S. R. M., DeSarno, M., Skelly, J. M., & Higgins, S. T. (2021). Contingency Management for Patients Receiving Medication for Opioid Use Disorder: A Systematic Review and Meta-analysis. JAMA psychiatry, 78(10), 1092–1102.

Carroll, K. M., Ball, S. A., Nich, C., O’Connor, P. G., Eagan, D. A., Frankforter, T. L., Triffleman, E. G., Shi, J., & Rounsaville, B. J. (2001). Targeting behavioral therapies to enhance naltrexone treatment of opioid dependence: efficacy of contingency management and significant other involvement. Archives of General Psychiatry, 58(8), 755–761.

Kropp, F., Lewis, D., & Winhusen, T. (2017). The effectiveness of ultra-low magnitude reinforcers: Findings from a “real-world” application of contingency management. Journal of Substance Abuse Treatment, 72, 111–116.

Petry, N. M., & Carroll, K. M. (2013). Contingency management is efficacious in opioid-dependent outpatients not maintained on agonist pharmacotherapy. Psychology of Addictive Behaviors, 27(4), 1036–1043.

Petry, N. M., & Martin, B. (2002). Low-cost contingency management for treating cocaine- and opioid-abusing methadone patients. Journal of Consulting and Clinical Psychology, 70(2), 398–405.

Sayegh, C. S., Huey, S. J., Zara, E. J., & Jhaveri, K. (2017). Follow-up treatment effects of contingency management and motivational interviewing on substance use: A meta-analysis. Psychology of Addictive Behaviors, 31(4), 403–414.