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Substance misuse and comorbid psychiatric disorders
Published in Ilana B. Crome, Richard Williams, Roger Bloor, Xenofon Sgouros, Substance Misuse and Young People, 2019
Also, it is noteworthy that implementation of interventions is not always clear-cut. Introducing contingency management, for example, may be beset with hurdles such as negative staff attitudes or the type and value of the incentives. Suggested ways forward include combining psychological and pharmacological treatment interventions, or using more than one type of pharmacological agent together with psychological interventions.
Sympathomimetics
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
Currently, the most effective therapy incorporates a comprehensive behavioral treatment approach that combines behavioral therapy, family education, individual counseling and support, drug testing, and encouragement for nondrug-related activities. Contingency management interventions, which provide tangible incentives in exchange for engaging in treatment and maintaining abstinence, have also been shown to be effective. Unlike the use of methadone or buprenorphine in opioid addiction, there are no treatment programs for MA addiction that include therapeutic drug intervention.
Food Addiction
Published in Hanna Pickard, Serge H. Ahmed, The Routledge Handbook of Philosophy and Science of Addiction, 2019
Ashley Gearhardt, Michelle Joyner, Erica Schulte
Contingency management (CM) techniques may be adapted to emphasize abstinence, and this approach is of growing interest for the treatment of substance-related addictions. Contingency management is based on operant conditioning principles and provides individuals with rewards (e.g., gift cards) for treatment participation or achieving goals (e.g., abstaining from use) (Prendergast et al., 2006). Contingency management aims to reduce the rewarding value of addictive substances by reinforcing behavior inconsistent with drug use. Previous studies have observed that adding CM to standard treatment (e.g., psychoeducation, coping skills), relative to standard treatment alone, resulted in greater likelihood and longer duration of abstinence, reduced drop-out rates, and increased attendance of treatment sessions (for a review, see Zajacet al. in this volume). Relatedly, Kong and colleagues (2016) observed that alternative reinforcers may be useful in reducing the reinforcing effects of food. Thus, CM may also be effective in helping some individuals abstain or reduce their consumption of potentially addictive foods. For example, individuals with addictive-like eating behavior may be rewarded with incentives for abstaining from highly triggering foods. Overall, future research is needed to evaluate whether applying these addiction-related intervention approaches would improve clinical outcomes related to obesity and binge eating.
Rewarding recovery: the time is now for contingency management for opioid use disorder
Published in Annals of Medicine, 2022
Despite decades of research supporting the effectiveness of contingency management and generally positive beliefs held by front-line addiction treatment providers and patients alike [23,24], its application in real-world clinical settings is limited for a variety of reasons; many of which, as this paper will demonstrate, can be overcome. There are a number of obstacles described elsewhere regarding the low uptake of contingency management, including concerns about the durability of long-term effects and the potential for external reinforcement to impede intrinsic motivation to change [25–27]. The literature has largely found that contingency management does not have an adverse effect on readiness to change, and decades of support clearly indicate robust short-term benefits of contingency management with some evidence showing durable long-term improvements even after reinforcers are no longer delivered [25]. Barriers to implementation covered here will focus on the lack of innovation as well as the moral, philosophical, ethical, legal, and economic concerns often voiced by opponents of contingency management.
Effects of a behaviour management technique for nursing staff on behavioural problems after acquired brain injury
Published in Neuropsychological Rehabilitation, 2019
Ieke Winkens, Caroline van Heugten, Climmy Pouwels, Anne-Claire Schrijnemaekers, Resi Botteram, Rudolf Ponds
In their systematic review on the effectiveness of behavioural interventions for individuals with behaviour problems after TBI, Ylvisaker et al. (2007) distinguished two main categories of intervention procedures: contingency management procedures, that is, the deliberate manipulation of consequences to encourage or discourage specific actions, and proactive antecedent-focused procedures, methods that manage immediate antecedents of behaviour. Examples of contingency management procedures are positive reinforcement, negative reinforcement, extinction and punishment (Alderman & Wood, 2013; Ylvisaker et al., 2007). Examples of pro-active antecedent-focused procedures are specifically planned tailor-made environmental structuring, provision of meaningful and well-understood daily routines and proactive development of positive communication alternatives to negative behaviour. Pro-active antecedent focused procedures often form part of a multicomponent intervention, which may also include contingency management procedures (Ylvisaker et al., 2007).
Treatment Outcomes of a Multi-Component Mobile Health Smoking Cessation Pilot Intervention for People with Schizophrenia
Published in Journal of Dual Diagnosis, 2020
Alyssa M. Medenblik, Adam M. Mann, Tiffany A. Beaver, Eric A. Dedert, Sarah M. Wilson, Patrick S. Calhoun, Jean C. Beckham
Currently, rates of long-term abstinence among smokers with schizophrenia are low (Cather et al., 2017). Meta-analysis of bupropion and bupropion combined with a transdermal nicotine patch reported 6-month abstinence rates of 20% and 12-month rates of 12% (Evins et al., 2007; Tsoi et al., 2013). One novel addition to bupropion and nicotine replacement therapy (NRT) would be behavioral treatment. Among substance use disorders, contingency management (CM) is an intensive behavioral treatment often utilized to achieve initial abstinence. CM is a behavioral neuroeconomic application that provides tangible incentives for verified abstinence (Glimcher & Rustichini, 2004; Potenza et al., 2011).