Implementation of Contingency Management at a Large VA Addiction Treatment Center
Open accessAbstract
Contingency management (CM) is an evidence-based intervention that reinforces target behaviors of patients, such as abstinence from substance use. This column discusses the experiences and lessons learned at a large U.S. Department of Veterans Affairs Addiction Treatment Center during implementation of CM as part of the VA's national rollout. Challenges are discussed related to staff reception and limited initial referrals, identifying a drug testing method and staff confidence in that method, training requirements, and financial resources needed. Local innovations and CM expansion since 2012 are also reviewed.
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Contingency management is the most promising behavioural treatment but is yet to become routinely available owing to implementation challenges.
“Contingency management, the use of structured incentives to promote abstinence, is the most promising behavioural treatment but is yet to become routinely available owing to implementation challenges [10].”
From Psilocybin‐assisted psychotherapy for methamphetamine use disorder: A pilot open‐label safety and feasibility study. (2025) · cites this paper as [10]
The Abstract describes contingency management as an evidence-based intervention that reinforces behaviors such as abstinence. The section “CM IMPLEMENTATION AT THE VA'S LARGEST ATC” says its uptake in community treatment programs remains low despite its efficacy, and the Implementation Challenges section describes barriers to adoption. The paper does not establish the comparative claim that it is the most promising behavioural treatment. (LLM, conf=0.87)
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Cites
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Prize-based contingency management for the treatment of substance abusers: a meta-analysis
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Petry, N. M., DePhilippis, D., Rash, C. J., Drapkin, M. L., & McKay, J. R. (2014) · American Journal on Addictions · doi:10.1111/j.1521-0391.2014.12092.x · Cited by 110 · see citing works
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Rewarding early abstinence in Veterans Health Administration addiction clinics
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“…toward CM after initial implementation using qualitative methods (Hagedorn et al., 2014; Hartzler et al., 2014; Kellogg et al., 2005; Kropp et al., 2016; Neale et al., 2016; Ruan et al., 2017) while only one assess barriers after implementation using quantitative methods (Henggeler et al., 2008).”
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“However, clinical use of CM has been limited (10), and so there is a dire need to fi nd novel and effective approaches to treat MA dependence.”
Functioning of adults in alcohol use disorder treatment: Role of concerned others
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Brett, J., Lea, T., Knock, E., Albert, S. M., Acheson, L. S., Siefried, K. J., & Job, S. (2025) · Addiction · doi:10.1111/add.70284
- Authors
- Ruan, H., Bullock, C. L., & Reger, G. M.
- Affiliations
- United States Department of Veterans Affairs (US)
- Venue
- Psychiatric Services
- Published
- 2017-12-01
- Volume
- 68
- Issue
- 12
- Pages
- 1207-1209
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2754028604
- Cited by
- 12
- References
- 7
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 1 · 2018: 1
- FWCI
- 0.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- contingency management, addiction treatment, veterans, addiction treatment centers, implementation barriers, employee training, drug testing, referral barriers, financial resources, evidence-based interventions
- MeSH terms
- Adult, Ambulatory Care, Attitude of Health Personnel, Humans, Motivation, United States, United States Department of Veterans Affairs, Program Development, Disease Management, Substance-Related Disorders
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