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MEASURING THE EFFECTIVENESS OF CONTINGENCY MANAGEMENT INTERVENTION ON PATIENTS’ TREATMENT ENGAGEMENT AND INTERNAL MOTIVATION: A RANDOMIZED CONTROLLED TRIAL
Corresponding Author(s) : Mohamad Salleh Abdul Ghani
Humanities & Social Sciences Reviews,
Vol. 7 No. 1 (2019): January
Abstract
Purpose: The purpose of the study was to determine the effect of the implementation of Contingency Management (CM) intervention in a mandatory treatment center in Malaysia. Treatment engagement within psycho social sessions and treat- ment motivation were monitored in a randomized controlled trial study.
Methodology: A total of 44 patients were chosen as participants and randomly assigned into two groups namely the experimental group of treatment as usual + contingency management (TAU+CM) (n=22) and the controlled group of treatment as usual (TAU) (n=22). The TAU+CM group followed a 12-week CM intervention and 4-week maintenance period without CM reinforcement. Meanwhile, the TAU group went through 16 weeks of usual psychosocial session implemented in the center.
Measurements: The main outcome of the research was the effect of CM toward treatment engagement within treatment session and a secondary analysis to measure the patients’ treatment motivation using Treatment Motivation Questionnaire (TMQ) during pre, post, maintenance phase and follow up after four months. CM reinforcement using reward stickers with monetary value were contingent with every achieved treatment engagement behavior. No reward was given to the TAU group.
Findings: CM found to be effective on treatment engagement of the patient and has a significant effect on motivation especially toward internal motivation.
Conclusion: CM proven to be effective in improving patients’ treatment engagement and patients’ motivation internally compared to the usual program.
Keywords
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- Ali, J., Hassan, S., and Karim, N. A. A. (2009). Kos Ekonomi Penyalahgunaan Dadah. Jurnal Antidadah Malaysia, 6(5):107–121.
- Bartholomew, N. G., Rowan-Szal, G. A., and Simpson, D. D. (2005). Contingency Management Strategies and Ideas: A Planning guide for using rewards and start charts to reinforce goal setting, early engagement in treatment settings.
- Benishek, L. A., Dugosh, K. L., Kirby, K. C., Matejkowski, J., Clements, N. T., Seymour, B. L., and Festinger, D. S. (2014). Prize-based contingency management for the treatment of substance abusers: A meta-analysis. Addiction, 109(9):1426– 1436. DOI: https://doi.org/10.1111/add.12589
- Cahill, M. A., Adinoff, B., Hosig, H., Muller, K., and Pulliam, C. (2003). Motivation for treatment preceding and following a substance abuse program. Addictive Behaviors, 28(1):67–79. DOI: https://doi.org/10.1016/S0306-4603(01)00217-9
- Cameron, J., Banko, K. M., and Pierce, W. D. (2001). Pervasive Negative Effects of Rewards on Intrinsic Motivation: The Myth Continues. The Behavior Analyst, 24(1):1–44. DOI: https://doi.org/10.1007/BF03392017
- Carroll, K. M. and Onken, L. S. (2005). Behavioral Therapies for Drug Abuse. American Journal of Psychiatry, 162:1452– 1460. DOI: https://doi.org/10.1176/appi.ajp.162.8.1452
- Daly, J. C. and Cohen, J. (1977). Statistical Power Analysis for the Behavioral Sciences, Revised Edition. Journal of the American Statistical Association. DOI: https://doi.org/10.2307/2286629
- Davis, D. R., Kurti, A. N., Skelly, J. M., Redner, R., White, T. J., and Higgins, S. T. (2016). A review of the literature on contingency management in the treatment of substance use disorders, 2009–2014. Preventive Medicine, 92:36–46. DOI: https://doi.org/10.1016/j.ypmed.2016.08.008
- Deci, E. L., Koestner, R., and Ryan, R. M. (1999). A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. Psychological Bulletin, 125(6):627–68. DOI: https://doi.org/10.1037/0033-2909.125.6.627
- Gray, K. M., Carpenter, M. J., Baker, N. L., Hartwell, K. J., Lewis, A. L., Hiott, D. W., and Upadhyaya, H. P. (2011). Bupropion SR and contingency management for adolescent smoking cessation. Journal of Substance Abuse Treatment, 40(1):77–86. DOI: https://doi.org/10.1016/j.jsat.2010.08.010
- Hartzler, B., Lash, S. J., and Roll, J. M. (2012). Contingency management in substance abuse treatment: A structured review of the evidence for its transportability. Drug and Alcohol Dependence, 122(1–2):1–10. DOI: https://doi.org/10.1016/j.drugalcdep.2011.11.011
- Higgins, S. T., Alessi, S. M., and Dantona, R. L. (2002). Voucher-based incentives: A substance abuse treatment innovation. DOI: https://doi.org/10.1016/S0306-4603(02)00297-6
- Addictive Behaviors, 27(6):887–910.
- Higgins, S. T., Heil, S. H., and Sigmon, S. C. (2013). Voucher-based contingency management in the treatment of substance use disorders. APA Handbook of Behavior Analysis, 2:481–500. DOI: https://doi.org/10.1037/13938-019
- Higgins, S. T., Wong, C. J., Badger, G. J., Ogden, D. E., and Dantona, R. L. (2000). Contingent reinforcement increases cocaine abstinence during outpatient treatment and 1 year of follow-up. Journal of Consulting and Clinical Psychology, 68(1):64–72. DOI: https://doi.org/10.1037/0022-006X.68.1.64
- Ibrahim, F., Samah, B. A., Talib, M. A., and Sabran, M. S. (2009). Faktor Menyumbang Kepada Penagihan Relaps Dalam Kalangan Penagih Dadah.
- Lipsey, M. W. (1990). Design sensitivity: Statistical power for experimental research. Sage Publications, California.
- Mohamed, M. N., Din, M. S. C., and Ishaq, I. (1998). Treatment of Drug Dependents in the Traditional Setting: The Case of Inabah. Pakistan Journal of Psychological Research, 13(3–4):75–87.
- Mohamed, M. N., Zakaria, M., and Ghani, S. H. (2009). Keberkesanan Modul Model Matrix Untuk Pemulihan Penagih Dadah Dalam Setting Komuniti. Jurnal Antidadah Kebangsaan, 6(2).
- National Anti-Drugs Agency. Dasar Dadah Negara (2015). National Anti-Drugs Agency. Dasar Dadah Negara.
- Petry, N. M. (2000). A comprehensive guide to the application of contingency management procedures in clinical settings. DOI: https://doi.org/10.1016/S0376-8716(99)00071-X
- Drug and Alcohol Dependence, 58:9–25.
- Prendergast, M., Podus, D., Finney, J., Greenwell, L., and Roll, J. (2006). Contingency management for treatment of substance use disorders: a meta-analysis. Addiction, 101(11):1546–1560. DOI: https://doi.org/10.1111/j.1360-0443.2006.01581.x
- Promberger, M. and Marteau, T. M. (2013). When do financial incentives reduce intrinsic motivation? Comparing behaviors studied in psychological and economic literatures. Health Psychology, 32(9):950–957. DOI: https://doi.org/10.1037/a0032727
- Rawson, R. A., McCann, M. J., Flammino, F., Shoptaw, S., Miotto, K., Reiber, C., and Ling, W. (2006). A compar- ison of contingency management and cognitive-behavioral approaches for stimulant-dependent individuals. Addiction, 101(2):267–274. DOI: https://doi.org/10.1111/j.1360-0443.2006.01312.x
- Rohsenow, D. (2008). Contingency Management in Substance Abuse Treatment. Social Service Review, 82. DOI: https://doi.org/10.1086/595875
- Ryan, R. M., Plant, R. W., and O’Malley, S. (1995). Initial motivations for alcohol treatment: relations with patient characteristics, treatment involvment, and dropout. Addictive Behaviors, 20(3):279–297. DOI: https://doi.org/10.1016/0306-4603(94)00072-7
- Sigmon, S. C. and Higgins, S. T. (2006). Voucher-based contingent reinforcement of marijuana abstinence among individ- uals with serious mental illness. Journal of Substance Abuse Treatment, 30(4):291–295. UNODC (2016). World Drug Report 2016. DOI: https://doi.org/10.1016/j.jsat.2006.02.001
- Winstanley, E. L., Bigelow, G. E., Silverman, K., Johnson, R. E., and Strain, E. C. (2011). A randomized controlled trial of fluoxetine in the treatment of cocaine dependence among methadone-maintained patients. Journal of Substance Abuse Treatment, 40(3):255–264. DOI: https://doi.org/10.1016/j.jsat.2010.11.010
- Zeldman, A., Ryan, R. M., and Fiscella, K. (2004). Motivation, autonomy support, and entity beliefs: Their role in methadone maintenance treatment. Journal of Social and Clinical Psychology, 23(5):675–696. DOI: https://doi.org/10.1521/jscp.23.5.675.50744
References
Ali, J., Hassan, S., and Karim, N. A. A. (2009). Kos Ekonomi Penyalahgunaan Dadah. Jurnal Antidadah Malaysia, 6(5):107–121.
Bartholomew, N. G., Rowan-Szal, G. A., and Simpson, D. D. (2005). Contingency Management Strategies and Ideas: A Planning guide for using rewards and start charts to reinforce goal setting, early engagement in treatment settings.
Benishek, L. A., Dugosh, K. L., Kirby, K. C., Matejkowski, J., Clements, N. T., Seymour, B. L., and Festinger, D. S. (2014). Prize-based contingency management for the treatment of substance abusers: A meta-analysis. Addiction, 109(9):1426– 1436. DOI: https://doi.org/10.1111/add.12589
Cahill, M. A., Adinoff, B., Hosig, H., Muller, K., and Pulliam, C. (2003). Motivation for treatment preceding and following a substance abuse program. Addictive Behaviors, 28(1):67–79. DOI: https://doi.org/10.1016/S0306-4603(01)00217-9
Cameron, J., Banko, K. M., and Pierce, W. D. (2001). Pervasive Negative Effects of Rewards on Intrinsic Motivation: The Myth Continues. The Behavior Analyst, 24(1):1–44. DOI: https://doi.org/10.1007/BF03392017
Carroll, K. M. and Onken, L. S. (2005). Behavioral Therapies for Drug Abuse. American Journal of Psychiatry, 162:1452– 1460. DOI: https://doi.org/10.1176/appi.ajp.162.8.1452
Daly, J. C. and Cohen, J. (1977). Statistical Power Analysis for the Behavioral Sciences, Revised Edition. Journal of the American Statistical Association. DOI: https://doi.org/10.2307/2286629
Davis, D. R., Kurti, A. N., Skelly, J. M., Redner, R., White, T. J., and Higgins, S. T. (2016). A review of the literature on contingency management in the treatment of substance use disorders, 2009–2014. Preventive Medicine, 92:36–46. DOI: https://doi.org/10.1016/j.ypmed.2016.08.008
Deci, E. L., Koestner, R., and Ryan, R. M. (1999). A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. Psychological Bulletin, 125(6):627–68. DOI: https://doi.org/10.1037/0033-2909.125.6.627
Gray, K. M., Carpenter, M. J., Baker, N. L., Hartwell, K. J., Lewis, A. L., Hiott, D. W., and Upadhyaya, H. P. (2011). Bupropion SR and contingency management for adolescent smoking cessation. Journal of Substance Abuse Treatment, 40(1):77–86. DOI: https://doi.org/10.1016/j.jsat.2010.08.010
Hartzler, B., Lash, S. J., and Roll, J. M. (2012). Contingency management in substance abuse treatment: A structured review of the evidence for its transportability. Drug and Alcohol Dependence, 122(1–2):1–10. DOI: https://doi.org/10.1016/j.drugalcdep.2011.11.011
Higgins, S. T., Alessi, S. M., and Dantona, R. L. (2002). Voucher-based incentives: A substance abuse treatment innovation. DOI: https://doi.org/10.1016/S0306-4603(02)00297-6
Addictive Behaviors, 27(6):887–910.
Higgins, S. T., Heil, S. H., and Sigmon, S. C. (2013). Voucher-based contingency management in the treatment of substance use disorders. APA Handbook of Behavior Analysis, 2:481–500. DOI: https://doi.org/10.1037/13938-019
Higgins, S. T., Wong, C. J., Badger, G. J., Ogden, D. E., and Dantona, R. L. (2000). Contingent reinforcement increases cocaine abstinence during outpatient treatment and 1 year of follow-up. Journal of Consulting and Clinical Psychology, 68(1):64–72. DOI: https://doi.org/10.1037/0022-006X.68.1.64
Ibrahim, F., Samah, B. A., Talib, M. A., and Sabran, M. S. (2009). Faktor Menyumbang Kepada Penagihan Relaps Dalam Kalangan Penagih Dadah.
Lipsey, M. W. (1990). Design sensitivity: Statistical power for experimental research. Sage Publications, California.
Mohamed, M. N., Din, M. S. C., and Ishaq, I. (1998). Treatment of Drug Dependents in the Traditional Setting: The Case of Inabah. Pakistan Journal of Psychological Research, 13(3–4):75–87.
Mohamed, M. N., Zakaria, M., and Ghani, S. H. (2009). Keberkesanan Modul Model Matrix Untuk Pemulihan Penagih Dadah Dalam Setting Komuniti. Jurnal Antidadah Kebangsaan, 6(2).
National Anti-Drugs Agency. Dasar Dadah Negara (2015). National Anti-Drugs Agency. Dasar Dadah Negara.
Petry, N. M. (2000). A comprehensive guide to the application of contingency management procedures in clinical settings. DOI: https://doi.org/10.1016/S0376-8716(99)00071-X
Drug and Alcohol Dependence, 58:9–25.
Prendergast, M., Podus, D., Finney, J., Greenwell, L., and Roll, J. (2006). Contingency management for treatment of substance use disorders: a meta-analysis. Addiction, 101(11):1546–1560. DOI: https://doi.org/10.1111/j.1360-0443.2006.01581.x
Promberger, M. and Marteau, T. M. (2013). When do financial incentives reduce intrinsic motivation? Comparing behaviors studied in psychological and economic literatures. Health Psychology, 32(9):950–957. DOI: https://doi.org/10.1037/a0032727
Rawson, R. A., McCann, M. J., Flammino, F., Shoptaw, S., Miotto, K., Reiber, C., and Ling, W. (2006). A compar- ison of contingency management and cognitive-behavioral approaches for stimulant-dependent individuals. Addiction, 101(2):267–274. DOI: https://doi.org/10.1111/j.1360-0443.2006.01312.x
Rohsenow, D. (2008). Contingency Management in Substance Abuse Treatment. Social Service Review, 82. DOI: https://doi.org/10.1086/595875
Ryan, R. M., Plant, R. W., and O’Malley, S. (1995). Initial motivations for alcohol treatment: relations with patient characteristics, treatment involvment, and dropout. Addictive Behaviors, 20(3):279–297. DOI: https://doi.org/10.1016/0306-4603(94)00072-7
Sigmon, S. C. and Higgins, S. T. (2006). Voucher-based contingent reinforcement of marijuana abstinence among individ- uals with serious mental illness. Journal of Substance Abuse Treatment, 30(4):291–295. UNODC (2016). World Drug Report 2016. DOI: https://doi.org/10.1016/j.jsat.2006.02.001
Winstanley, E. L., Bigelow, G. E., Silverman, K., Johnson, R. E., and Strain, E. C. (2011). A randomized controlled trial of fluoxetine in the treatment of cocaine dependence among methadone-maintained patients. Journal of Substance Abuse Treatment, 40(3):255–264. DOI: https://doi.org/10.1016/j.jsat.2010.11.010
Zeldman, A., Ryan, R. M., and Fiscella, K. (2004). Motivation, autonomy support, and entity beliefs: Their role in methadone maintenance treatment. Journal of Social and Clinical Psychology, 23(5):675–696. DOI: https://doi.org/10.1521/jscp.23.5.675.50744