title: Contingency Management Reduces Symptoms of Psychological and Emotional Distress among Homeless, Substance-dependent Men Who Have Sex with Men.
abstract: BACKGROUND
  This prospective analysis evaluated the efficacy of a contingency management (CM) intervention to improve the psychological health of non-treatment seeking, homeless, substance-dependent, men who have sex with men in Los Angeles. It was hypothesized that administration of CM would be associated with reductions in participants' symptoms of psychological and emotional distress.
  
  
  METHODS
  One hundred and thirty-one participants were randomized into either a voucher-based contingency management (CM;n= 64) condition reinforcing substance abstinence and prosocial/health-promoting behaviors, or to a control condition (n= 67). Participants' symptoms of psychological and emotional distress were assessed at intake and at 12-months post-randomization.
  
  
  RESULTS
  Participants randomized into the CM intervention exhibited significantly lower levels of psychological distress in all measured symptom domains up to one year post randomization, reductions not evidenced in the control arm. Omnibus tests resultant from seemingly unrelated regression analysis confirmed that CM was significantly associated with reductions in symptoms of psychological and emotional distress, even when controlling for biomarker-confirmed substance use outcomes (χ2(9)= 17.26;p< 0.05).
  
  
  CONCLUSIONS
  Findings demonstrate that a CM intervention reduced symptoms of psychological and emotional distress among a sample of non-treatment seeking, homeless, substance-dependent men who have sex with men.
authors.affiliation: Friends Research Institute, Inc., 90028, USA.
authors.forename: Jesse B
authors.initials: JB
authors.lastname: Fletcher
authors.affiliation: David Geffen School of Medicine at UCLA, Department of Family Medicine, 90024, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Shoptaw
authors.affiliation: Friends Research Institute, Inc., 90028, USA.
authors.forename: James A
authors.initials: JA
authors.lastname: Peck
authors.affiliation: Friends Research Institute, Inc., 90028, USA ; UCLA Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, 90024, USA.
authors.forename: Cathy J
authors.initials: CJ
authors.lastname: Reback
keywords: Contingency Management; Dual Diagnosis; Homeless; MSM; Psychological Distress; Substance Use