title: Use of a low-cost incentive intervention to improve counseling attendance among methadone-maintained patients.
abstract: Despite the importance of counseling in methadone maintenance treatment, many patients do not take advantage of these services. Incentives for attending group counseling were offered to methadone-maintained patients during an orientation phase of treatment or during required attendance at a relapse group later in treatment. Upon attending each counseling session, patients could draw for prizes under an escalating draw system with a 50% probability that draws would result in a prize. Incentives included small (1dollar), moderate (5 dollars), and large (20 dollars) prizes, with chances of winning inversely related to prize costs, and a maximum possible total of 160 dollars per patient. It was anticipated that this policy would provide a relatively low-cost approach to improving counseling attendance in our methadone clinic. The incentive policy significantly increased the percent of counseling sessions attended (52% vs. 76%) and promoted periods of continuous attendance. These data further support the effectiveness of low-cost incentive programs in enhancing counseling attendance among methadone patients.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 5510 Nathan Shock Drive, Baltimore, MD 21224, USA. stacey.sigmon@uvm.edu
authors.forename: Stacey C
authors.initials: SC
authors.lastname: Sigmon
authors.forename: Maxine L
authors.initials: ML
authors.lastname: Stitzer
mesh_terms: D000328:Adult; D001071:Appointments and Schedules; D015142:Baltimore; D001521:Behavior Therapy; D003362:Cost-Benefit Analysis / Q000706:statistics & numerical data; D003376:Counseling / Q000191:economics*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D009042:Motivation; D009294:Narcotics / Q000008:administration & dosage*; D009293:Opioid-Related Disorders / Q000191:economics* / Q000534:rehabilitation*; D016134:Organizational Policy; D010343:Patient Admission / Q000191:economics; D010358:Patient Participation / Q000191:economics*; D011615:Psychotherapy, Group / Q000191:economics*; D016320:Substance Abuse Treatment Centers / Q000191:economics; D014040:Token Economy; D016312:Treatment Refusal
chemical_list: D009294:Narcotics; D008691:Methadone