What is Contingency Management Therapy?

Addiction treatment involves many interventions, services, and settings. Contingency management (CM) is a therapeutic intervention commonly used to treat substance use disorders (SUDs).

This article will discuss contingency management, how it’s used in addiction treatment, and how it differs from other behavioral therapies and resources in addiction treatment centers near you.

What Is Contingency Management?

Contingency management is a therapeutic intervention that rewards individuals for making positive changes.2 This form of therapeutic intervention utilizes the concept of positive reinforcement to elicit positive behavioral change,1 and it can be used along with several other evidence-based therapies. In addiction recovery, contingency management is used to promote and encourage abstinence.

How Does Contingency Management Work?

The basic tenet behind contingency management is rewarding positive behavioral change. Rewards are usually for tangible things, such as gift cards, but can vary depending on a person’s individual goals and motivations.

You and the treatment professional will establish motivational rewards for specific benchmarks, goals, or desired behavior while participating in treatment. Incentives used in CM can vary; however, two common incentive types include voucher-based reinforcement (VBR) and prize incentives (PI).1

In voucher-based reinforcements you:1

  • Receive a voucher that has monetary value.
  • Can redeem the voucher for food, goods, or entertainment.

The value of the vouchers increases as the number of positive behaviors increases over time.

Prize incentives (PI) are like voucher-based rewards; however, instead of earning vouchers, you receive a chance to win cash prizes and:1

  • The number of draws you receive increases with each positive behavior change.
  • Your number of draws resets if you engage in harmful or maladaptive behavior.

In substance use disorder treatment, positive behaviors can include:1

  • Having a clean urinalysis/drug screen.
  • Attending counseling sessions.
  • Completing other goal-related activities identified in your treatment plan.

How Does Contingency Management Work in Addiction Treatment?

CM harnesses the power of positive reinforcement to encourage positive behavioral changes. Motivation is an essential element in changing substance use behaviors.3 The rewards used in CM act as external motivators to change behavior. In substance use disorders, the targeted behaviors are substance use behaviors such as drinking alcohol, misusing opioid medication, or using cocaine.

Studies show that contingency management can increase the abstinence rate in individuals undergoing addiction treatment. In one study, the average number of successive abstinent weeks was 4.4 for individuals who received CM and 2.9 for those who did not.2 Contingency management has also been shown to decrease overall substance use. For example, individuals who smoked cigarettes (with no intention of quitting) and received CM significantly reduced their smoking. Contingency management has also been shown to decrease the use of alcohol, benzodiazepines, and marijuana.2

Expectations of Contingency Management

Each treatment plan is different, and the specifics of contingency management intervention are unique to each individual and treatment provider. If CM is included as part of your comprehensive treatment plan, you may expect to:

  • Create and sign a behavioral contract that outlines rewards and consequences for your specific behaviors.3
  • Meet certain behavioral benchmarks such as having clean drug screens and breath analysis.1
  • Potentially participate in other types of interventions and psychotherapies to encourage long-term abstinence, as CM is frequently used in conjunction with other types of behavioral therapies.5

Using Contingency Management with Other Therapies.

Effective substance use disorder treatment includes various services and addiction therapy types like contingency management and dialectical behavior therapy, or rational-emotive behavioral therapy. Research has consistently demonstrated the efficacy of contingency management in reducing and stopping substance misuse with the use of external motivators to change behavior.5

Many researchers theorize that, while CM is effective in stopping substance use, to sustain long-term abstinence, the individual needs to change any underlying problematic thoughts and emotions that contribute to the development of the substance use disorder in order to promote healthy coping mechanisms.5 This is why contingency management is generally used in conjunction with other forms of behavioral therapy, as CM alone does not get to the root of the problem that fueled the addiction.

By incorporating the skills and concepts used in behavioral therapy sessions, an individual can achieve long-term abstinence by:5

  • Addressing problematic thought processes and behaviors that led to addiction.
  • Strengthen your awareness of potential triggers to relapse.
  • Teach the skills necessary to cope with cravings and triggers to prevent relapse effectively.

Find Professional Addiction Therapy Treatment at Oxford

Oxford Treatment Center offers comprehensive addiction treatment if you are struggling with a substance use disorder. By calling you can speak to a trained and compassionate admissions navigator to get more information about inpatient addiction treatment, rehab admissions, and levels of addiction treatment. Our inpatient drug and alcohol rehab center in Mississippi also offers a wide variety of addiction therapies.

Our navigators can answer questions about drug and alcohol rehab insurance coverage and rehab payment options available to you.


Was this page helpful?
Thank you for your feedback.

American Addiction Centers (AAC) is committed to delivering original, truthful, accurate, unbiased, and medically current information. We strive to create content that is clear, concise, and easy to understand.

Read our full editorial policy

While we are unable to respond to your feedback directly, we'll use this information to improve our online help.

You aren't alone. You deserve to get help.
Oxford is located in Etta, Mississippi, which is easily accessible from Memphis and Birmingham.
Take your next step toward recovery:
✔ learn more about our addiction treatment programs.
✔ see how popular insurance providers such as Aetna or Humana offer coverage for rehab.
view photos of our facility.