|Current Applications of Contingency Management
|Saturday, May 27, 2017
|4:00 PM–5:50 PM
|Hyatt Regency, Centennial Ballroom H
|Area: BPN/CBM; Domain: Applied Research
|Chair: David William Sottile (Western Michigan University)
|Discussant: Wendy Donlin Washington (University of North Carolina Wilmington)
|CE Instructor: Wendy Donlin Washington Washington, Ph.D.
Contingency management is a useful behavior analytic technique that can readily be applied to problem behaviors related to health. Contingency management has been validated as an effective treatment for substance use disorders by many randomized controlled trials. Recently contingency management techniques have been used to treat new behavior targets and new populations. The presentations delivered during this symposium will cover several of these new targets and populations and review the modern expansion of contingency management. Specific topics include application of contingency management to reduce opiate use and HIV sex risk behaviors in women arrested for prostitution, using remote alcohol monitoring to facilitate alcohol abstinence reinforcement, and the use of the good behavior game to increase physical activity in elementary school children. The discussant has published frequently in this area, with relevant publications in journals such the Journal of Applied Behavior Analysis, Addiction, and Translational Issues in Psychological Science. Taken together, this symposium offers its audience a broad overview of current research in contingency management.
|Instruction Level: Intermediate
|Keyword(s): Alcohol, Criminal Justice, Opiates, Physical Activity
|The Expansion of Contingency Management Treatment
|LEONARDO F. ANDRADE (University of Connecticut School of Medicine)
|Abstract: Contingency management is a behavioral analytical intervention that has been primarily applied to the treatment of drug abuse. In this type of treatment, tangible reinforcers are delivered contingent upon the objective verification of the target behavior—drug abstinence. This approach has been extensively tested in randomized clinical trials and described in meta-analysis as the most efficacious psychosocial treatment for substance-use disorders (Dutra et al., 2008). In the past few years, researchers in this field have increasingly turned their attention to new behavioral targets in an effort to explore the broad utility of the contingency management approach. The extension of this approach to new target behavior includes behaviors that can improve treatment outcomes, such as attendance at group meetings and homework compliance. In addition, this approach been increasingly applied to preventive medicine targets, including compliance with medication, diabetes self-monitoring, and engagement in physical activity and weight loss programs. In summary, this presentation will highlight past and current efforts to expand this effective approach, providing a snapshot of the current state of affairs and future directions.
|Employment Based Abstinence Reinforcement Improves Key Behavioral Outcomes in Women Arrested for Prostitution
|DAVID WILLIAM SOTTILE (Western Michigan University), Anthony DeFulio (Western Michigan University)
|Abstract: The traditional criminal justice response to prostitution and drug crime is expensive and ineffective. Behaviorally based drug abuse treatments such as the therapeutic workplace may help improve outcomes if incorporated into diversion to treatment strategies in the context of criminal justice. In the therapeutic workplace people with problem drug use can work and earn wages contingent on provision of drug free urine samples. The purpose of this study was to assess the therapeutic workplace as a means of increasing drug abstinence and decreasing HIV risk behaviors in women arrested for prostitution. Participants (N=38) were opiate dependent adults arrested for prostitution whose cases were being processed in early resolution court. All participants were either enrolled in methadone or buprenorphine treatment prior to enrolling in this study. Participants were randomly assigned to usual care or usual care plus the therapeutic workplace. Drug abstinence contingencies were implemented in four steps (No drug abstinence contingencies, cocaine abstinence, cocaine and opiate abstinence, cocaine, opiate, marijuana, and amphetamine abstinence). Results show that the opiate abstinence contingency increased opiate abstinence in opiate-dependent adults charged with prostitution. Results also show that the intervention decreased the frequency of HIV risk behaviors in the therapeutic workplace group.
Remote Alcohol Monitoring to Facilitate Abstinence Reinforcement
|DEREK POPE (Virginia Tech Carilion Research Institute), Anita Kablinger (General Psychiatry Research, Carilion Medical Cent), Warren K. Bickel (Virginia Tech Carilion Research Institute and Department of Psychology, Virginia Tech), Mikhail Koffarnus (Virginia Tech Carilion Research Institute)
The delivery of monetary incentives contingent on verified abstinence is an effective treatment for drug and alcohol abuse. However, technological barriers to accurate, frequent biochemical verification of alcohol abstinence have limited the dissemination of this technique for the treatment of problematic alcohol use. In the present study, we are using a breathalyzer device that allows remote collection of a breath alcohol sample, text messaging, and reloadable debit cards for remote delivery of incentives to test a contingency management treatment for alcohol use that can be delivered with no in-person contact. We are comparing two groups: a Contingent and Noncontingent group. The Contingent group receives nearly immediate monetary payments over the internet each day they remotely provide negative breathalyzer samples. The Noncontingent group receives payments each day they successfully provide samples independent of the alcohol content of those samples. Results support the efficacy, acceptability, and feasibility of this intervention. Abstinence rates in the Contingent group were over 40% higher than the Noncontingent group (p < .001), breathalyzer collection adherence rates were over 95% in both groups, and participant ratings of acceptability were high.
Using the Good Behavior Game to Increase Physical Activity With Elementary School Students at Recess
|LESLIE GALBRAITH (University of the Pacific), Matthew P. Normand (University of the Pacific)
For health and wellness, children should engage in 60 min of moderate-to-vigorous physical activity daily, though many children do not. We evaluated the effects of a modified version of the Good Behavior Game on the number of steps taken by elementary school students during their recess periods. Students in the class were divided into two teams, and the team with the highest pedometer step-counts at the end of each game earned raffle tickets that they entered into a school-wide lottery. The Good Behavior Game was compared to traditional recess periods without the game using an alternating-treatments design. On average, students on both teams took more steps while playing the Good Behavior Game than they did during recess periods without the game. These results, though preliminary, are promising and suggest that the Good Behavior Game can be used to increase physical activity with groups of young children in typical school settings.