title: Improved Clinical Functioning for Patients Receiving Fee Discounts That Reward Treatment Engagement.
abstract: OBJECTIVE
  Financial incentives may have utility in promoting psychotherapy attendance and adherence, leading to improved clinical functioning. This study presents results from a novel application of financial incentives-a progressively lowered pay scale that rewards therapy attendance and adherence.
  
  
  METHODS
  Overall, 110 outpatients participated; 56 patients (51%) were enrolled in the financial incentives condition and received a 5% fee discount-applied iteratively across sessions-if they followed defined criteria (e.g., completed homework).
  
  
  RESULTS
  There were no statistically significant differences between groups in terms of the number of sessions attended, therapy duration, and number of no-shows and cancellations. However, adjusting for Global Assessment of Functioning (GAF) at intake, patients receiving the financial incentives had significantly higher GAF rating at termination compared with those who did not receive the intervention.
  
  
  CONCLUSIONS
  Financial incentives that reward therapy attendance and adherence with discounted fees is associated with improved clinical functioning.
authors.affiliation: Florida State University.
authors.forename: Ian H
authors.initials: IH
authors.lastname: Stanley
authors.affiliation: Florida State University.
authors.forename: Carol
authors.initials: C
authors.lastname: Chu
authors.affiliation: Florida State University.
authors.forename: Tiffany A
authors.initials: TA
authors.lastname: Brown
authors.affiliation: University of Washington School of Medicine.
authors.forename: Kathryn A
authors.initials: KA
authors.lastname: Sawyer
authors.affiliation: Florida State University.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Joiner
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance; D011613:Psychotherapy / Q000191:economics / Q000379:methods*; D012201:Reward; D016896:Treatment Outcome; D055815:Young Adult
keywords: adherence; attendance; financial incentive; homework; psychotherapy