Patients' beliefs towards contingency management: Target behaviours, incentives and the remote application of these interventions

Abstract

Introduction. Contingency management interventions are among the most efficacious psychosocial interventions in promoting abstinence from smoking, alcohol and substance use. The aim of this study was to assess the beliefs and objections towards contingency management among patients in UK-based drug and alcohol services to help understand barriers to uptake and support the development and implementation of these interventions. Methods. The Service User Survey of Incentives was developed and implemented among patients (N = 181) at three UK-based drug and alcohol treatment services. Descriptive analyses were conducted to ascertain positive and negative beliefs about contingency management, acceptability of different target behaviours, incentives and delivery mechanisms including delivering incentives remotely using technology devices such as mobile telephones. Results. Overall, 81% of participants were in favour of incentive programs, with more than 70% of respondents agreeing with the majority of positive belief statements. With the exception of two survey items, less than a third of participants agreed with negative belief statements. The proportion of participants indicating a neutral response was higher for negative statements (27%) indicating greater levels of ambiguity towards objections and concerns regarding contingency management. Discussion and Conclusions. Positive beliefs towards contingency management interventions were found, including high levels of acceptability towards a range of target behaviours, incentives and the use of technology devices to remotely monitor behaviour and deliver incentives. These findings have implications for the development and implementation of remote contingency management interventions within the UK drug treatment services.

A qualitative exploration of patients' experience of mobile telephone‐delivered contingency management to promote adherence to supervised methadone

“…The results are consistent with prior studies that support the use of technology to monitor behaviour and deliver incentives remotely [18–24]. Mobile telephone‐ownership has been reported to be as high as 96% among UK patients in treatment for substance use disorder, making mCM a feasible approach to address treatment‐related behaviour change [18].…”

“…The use of technology to monitor behaviour and deliver incentives remotely has been deemed appropriate and acceptable by patients surveyed in UK drug clinics, with 81% in favour of CM programs [18]. Engagement and compliance with remote behavioural monitoring procedures have been satisfactory, with many patients in receipt of mCM reporting the technology to be easy and straightforward to use [19][20][21][22][23][24].…”

Client Views of Contingency Management in Gambling Treatment: A Thematic Analysis

“…Investigations of client perspectives have found high acceptability of CM to clients receiving treatment for smoking, cocaine addiction, and alcohol consumption [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. Recently, Getty et al [ 29 ] adapted provider questionnaires to produce the Service User Survey of Incentives (SUSI). London based service users (N = 181), most of whom had no prior experience of CM (92.3%), completed the SUSI.…”

Digital Contingency Management in the Treatment of Substance Use Disorders

“…Two systematic reviews have indicated that digital CM produces effects that are clinically meaningful and consistent with the results from in-person methods (Coughlin et al, in press; Getty et al, 2019). Patients also accept remote methods to monitor and incentivize drug abstinence (Getty et al, 2022). Furthermore, the COVID-19 global pandemic has catalyzed broad efforts to deliver remote therapy via smartphones and other modalities (Regnier & DeFulio, 2022; Sweeney et al, 2022).…”