Ask a Counselor: What is Contingency Management?

Updated: Sep 12

By Addiction Policy Forum



Contingency Management (CM) is a behavioral therapy based on Operant Conditioning Theory, which includes the idea that if a certain behavior is “reinforced” by a reward, that behavior will continue and if a certain behavior is “punished” that behavior will cease.

There is evidence to support Contingency Management as an effective type of behavioral treatment. Clinical trials have shown its efficacy in behavioral treatment attendance, in improving adherence to psychiatric medications, in decreasing and sustaining a healthy weight, in the maintenance of exercise routines, and in reducing substance use. The changed behaviors are rewarded by the provision of financial reinforcers, or by the delivery of vouchers that can be exchanged for retail goods or services to the clients.


Contingency Management can be an effective component of substance use disorder treatment. One program that has exposed its effectiveness is an incentive-based intervention where Voucher-Based Reinforcement (VBR) is provided for adults misusing opioids, stimulants or both in exchange for a negative toxicology test. The VBR can have a monetary value that can be traded for food, movie tickets, or many other benefits, and the VBR value increases as the number of free-drug urine samples rises, which promotes abstinence, attendance, and adherence to a recovery program.


Contingency Management can help participants to have an increased rate of attendance and participation and promotes recovery and wellness. As with any treatment, the care plan needs to be individualized and continuously evaluated for continued efficacy as the patient progresses through the levels of care.




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