Low-cost contingency management in community clinics: Delivering incentives partially in group therapy
Low-cost contingency management in community clinics: Delivering incentives partially in group therapy
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DOI：
10.1037/1064-1297.15.3.293
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发表时间：
2007-06-01
影响因子：
2.3
通讯作者：
Petry, Nancy M.
中科院分区：
文献类型：
--
作者：
Alessi, Sheila M.;Hanson, Tressa;Petry, Nancy M.
本研究考察了奖励性应急管理（CM）的可行性和有效性，即在团体治疗中实施出勤激励，在个人会议中实施戒断激励。三个社区药物滥用治疗项目参与了这项两阶段交叉设计研究。纳入符合可卡因、阿片类药物和酒精滥用或依赖诊断标准的门诊患者（N = 103）。在标准条件下，参与者接受标准治疗，并提交呼气和尿液样本，在第1-6周每周两次测试酒精、可卡因和阿片类药物，在第7-12周每周一次。在CM条件下，参与者接受相同的标准治疗、样本和出勤监测，并有机会赢得阴性样本和治疗出勤奖励。在服药时评估人口统计信息和药物滥用史，并在第6个月和第9个月随访时评估治疗后药物使用情况（毒理学结果和自我报告）。主要结局是治疗持续周数和最长持续戒断时间（LDA）。在cm条件下，LDA显著更高，但各组之间的保留周数没有差异。在第9个月，CM参与者的物质使用率较低，但在第6个月没有。这项研究表明，在团体治疗中提供出勤激励是可行的，但需要进一步的研究来了解对出勤的适度影响。讨论了本研究的优势和局限性。
This study examined the feasibility and effectiveness of prize-based contingency management (CM) when incentives for attendance were administered in group therapy and incentives for abstinence were administered in individual meetings. Three community substance abuse treatment programs participated in this two-phase, crossover design study. Outpatients (N = 103) entering treatment who met diagnostic criteria for cocaine, opiate, and alcohol abuse or dependence were recruited. During the standard condition, participants received standard treatment and submitted breath and urine samples that were tested for alcohol, cocaine, and opiates twice weekly during Weeks 1-6 and once weekly during Weeks 7-12. During the CM condition, participants received the same standard treatment and sample and attendance monitoring, plus the opportunity to win prizes for negative samples and treatment attendance. Demographic information and substance abuse history were evaluated at intake, and posttreatment substance use (toxicology results and self-report) was evaluated at Month 6 and Month 9 follow-up interviews. Primary outcomes were weeks retained in treatment and longest duration of sustained abstinence (LDA). LDA was significantly greater in CM-condition participants, but weeks retained did not differ between groups. Rates of substance use were lower in CM participants at Month 9 but not at Month 6. This study suggests that it is feasible to deliver incentives for attendance in group therapy, but that further research is needed to understand the modest effects on attendance. Strengths and limitations of this study are discussed.