title: A review of the literature on contingency management in the treatment of substance use disorders, 2009-2014.
abstract: This report describes a systematic literature review of voucher and related monetary-based contingency management (CM) interventions for substance use disorders (SUDs) over 5.2years (November 2009 through December 2014). Reports were identified using the search engine PubMed, expert consultations, and published bibliographies. For inclusion, reports had to (a) involve monetary-based CM; (b) appear in a peer-reviewed journal; (c) include an experimental comparison condition; (d) describe an original study; (e) assess efficacy using inferential statistics; (f) use a research design allowing treatment effects to be attributed to CM. Sixty-nine reports met inclusion criteria and were categorized into 7 research trends: (1) extending CM to special populations, (2) parametric studies, (3) extending CM to community clinics, (4) combining CM with pharmacotherapies, (5) incorporating technology into CM, (6) investigating longer-term outcomes, (7) using CM as a research tool. The vast majority (59/69, 86%) of studies reported significant (p<0.05) during-treatment effects. Twenty-eight (28/59, 47%) of those studies included at least one follow-up visit after CM was discontinued, with eight (8/28, 29%) reporting significant (p<0.05) effects. Average effect size (Cohen's d) during treatment was 0.62 (95% CI: 0.54, 0.70) and post-treatment it was 0.26 (95% CI: 0.11, 0.41). Overall, the literature on voucher-based CM over the past 5years documents sustained growth, high treatment efficacy, moderate to large effect sizes during treatment that weaken but remain evident following treatment termination, and breadth across a diverse set of SUDs, populations, and settings consistent with and extending results from prior reviews.
authors: Vermont Center of Behavior & Health, University of Vermont, United States; Departments of Psychiatry, University of Vermont, United States; Psychological Science, University of Vermont, United States.
authors: Danielle R
authors: DR
authors: Davis
authors: Vermont Center of Behavior & Health, University of Vermont, United States; Departments of Psychiatry, University of Vermont, United States.
authors: Allison N
authors: AN
authors: Kurti
authors: Medical Biostatistics, University of Vermont, United States.
authors: Joan M
authors: JM
authors: Skelly
authors: Vermont Center of Behavior & Health, University of Vermont, United States; Behavior Analysis and Therapy Program, Rehabilitation Institute, Southern Illinois University, United States.
authors: Ryan
authors: R
authors: Redner
authors: Central California VA Healthcare System, United States.
authors: Thomas J
authors: TJ
authors: White
authors: Vermont Center of Behavior & Health, University of Vermont, United States; Departments of Psychiatry, University of Vermont, United States; Psychological Science, University of Vermont, United States. Electronic address: Stephen.Higgins@uvm.edu.
authors: Stephen T
authors: ST
authors: Higgins
mesh_terms: D060909:Economics, Behavioral; D006801:Humans; D009042:Motivation; D012201:Reward; D019966:Substance-Related Disorders / Q000628:therapy*; D016896:Treatment Outcome
keywords: Behavior change; Behavioral economics; Behavioral interventions; Contingency management; Financial incentives; Psychosocial interventions; Substance use disorders