Question

Contingency Management To complete this discussion: Describe the major differences in the application of contingency management to moderation-oriented treatment versus abstinence-based treatment. Consider client addiction severity, selection of goals, choice of rewards, and the implications of delay discounting in your response.

Answer 1

Contingency management (CM) is most-widely used in the field of substance abuse.CM mainly includes the application of three term contigency which uses stimulus control and positivve reinforcement.The developers of CM based it on the principles of operant conditioning. In this type of treatment, individuals are rewarded for improved behavior. Some contingency management programs also punish participants for undesirable behaviors. Most individuals need to strengthen their internal motivation in order to change their behavior in the long-term. Nonetheless, contingency management is useful for teaching people they are able to change their behavior when sufficiently motivated.

Abstinence : Abstaining is the most traditional method used for the treatment of drug or alcohol abuse.This method involves completely avoiding the substance use and abuse.Substance abuse treatment, however, is often aversive in nature.Thus, rather than reinforcing substance abusers for their progress and attempts at remaining abstinent, some clinics utilize confrontation techniques when patients are suspected of "using" or discharge patients when they are not adhering to program rules.Importantly, not all aspects of substance abuse treatment are aversive. Many treatment programs routinely use some forms of reinforcement, such as take-home methadone privileges for patients who maintain long periods of abstinence or pins and leadership status in Alcoholics Anonymous meetings.The premise behind CM is to utilize these and other reinforcement procedures systematically to modify behaviors of substance abusers in a positive and supportive manner .Not only can abstinence be reinforced using these CM techniques, but variations of these procedures are effective in modifying other behavior patterns of substance abusers. Reinforcement can be provided for attendance at therapy sessions, for prosocial behaviors within the clinic.

Moderation oriented : Abstinence is not the only path people try to take to soberity.Some believe that addicts can acheive soberity while still drinking on occasion. The theory behind this is that it may work best for those who are not physically dependent on drugs or alcohol and who have suffered from some negative side effects from their substance abuse.MM programs address patterns of problematic and excessive use of alcohol or drugs and works to teach individuals how to direct and manage these episodes. The MM usually asks the client to evaluate their drinking often through a journal.Then MM asks the individual to stop drinking altogether for 30 days where they also explore alternative activities and learn to mange potential triggerers.They also learn how to cope with stressors without substance use, and how to be away from over dribking when drinking is restablished.

The choice of the programs depend upon many factors like if the client has severe and is physically dependent on drugs then the individual might go to the abstinence program otherwise MM is not a bad option.Similarly if the goal of the client is to become sober by complelety eliminating the drug then abstinence is the option for him.If he/she chooses to just learn how to drink but to a certain limit and to be away from excessive use then MM programs is the best option.