Psychology Book Review
Contingency Management expert Nancy Petry provides a definition of Contingency Management as follows, "the systematic reinforcement of desired behaviors and the withholding of reinforcement or punishment of undesired behaviors, is an effective strategy in the treatment of alcohol and other drug (AOD) use disorders." More simply, in CM, provision is made for rewards or granting privileges for specific positive behaviors. The idea of CM was first formerly applied in animal research, but research in controlled settings in affecting changes in human behavior have shown evidence that it is an effective adjunct therapy, complimentary to other forms of therapy already being implemented.
Petry states in Psychiatric Times that the concept of Contingency Management (CM) is often used by parents when they provide or withhold an allowance contingent upon the child performing certain household tasks such as making their own bed or keeping their grades up. CM is implemented in the classroom by some teachers on a limited basis, a pizza party at the end of the week if the class as a whole meets certain behavioral expectations, rewards from the school at the end of the year for perfect attendance or academic achievements.
The primary idea in Petry's book Contingency Management for Substance Abuse Treatment: A Guide to Implementing This Evidence-Based Practice, is with respect to use in substance abuse treatment in a clinical setting, but also has broader application in any type of controlled or clinical setting with adults or adolescents.
To be effectively used in a clinical setting, Contingency Management must be carefully managed with a strict and well-implemented protocol
CM, according to Petry's research, while used in a clinical setting for several decades, is underutilized and needs to be implemented according to stricter protocol in order to be effective. Petry addresses most if not all potential issues involved with CM in a clinical setting, including costs and controlling costs, using scientific studies/evidence to support her suggestions or as a basis for her suggestions.
The book addresses CM on two fronts, in general terms, which can provide some good ideas for anyone involved with addressing behavioral issues including parents and teachers, especially teachers in settings involving marginal youth. But the book also provides specific and detailed guidance for effective implementation of CM in a clinical or other controlled setting. She discusses problems that can occur, addressed possible ethical objections, and provides evidence for increased probability of long-term positive outcomes, with sometimes dramatic statistical increase of success-rate using this CM in conjunction with other methods. CM is described as complimentary rather than a replacement for other therapies.
The book is easy to read and interesting, is not filled with personal or anecdotal case studies, but draws more on evidence and scientific studies. She details the results and methods of these studies, critically analyzes the strength and weaknesses of historical and current clinical studies. Petry's research has much value for anyone involved with substance abuse treatment or mental health treatment, and especially with adolescents. It has specific and broad application.
References for Contingency Management and Substance Abuse Treatment
Contingency Management - Incentives for Sobriety
, (1999). Stephen T. Higgins, Ph.D., and Nancy M. Petry, Ph.D. National Institute on Alcohol Abuse and Alcoholism
Contingency Management for Substance Abuse: A Practical Guide to Implementing This Empirically-based Treatment, (2011). Nancy Petry, Ph.D. Rutledge
Contingency Management in Addiction Treatment
, (February 1, 2002). Nancy Petry, M.D. Psychiatric Times
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