Acceptability of contingency management among clinicians and clients within a co-occurring mental health and substance use treatment program

Abstract

Background: Emerging evidence supports the effectiveness of contingency management (CM) for addictions treatment among individuals with co-occurring serious mental illness (SMI). Addiction treatment for people with SMI generally occurs within community mental health centers (CMHCs) and it is not known whether CM is acceptable within this context. Client views regarding CM are also unknown.

Objectives: This study is the first to describe CM acceptability among CMHC clinicians, and the first to explore client views. Clinician-level predictors of CM acceptability are also examined.

Methods: This study examined views about CM among 80 clinicians and 29 clients within a CMHC within the context of a concurrent CM study.

Results: Three-quarters of clinicians reported they would use CM if funding were available. Clinicians and clients affirmed that incentives enhance abstinence motivation. Clinician CM acceptability was related to greater years of experience, and identifying as an addictions or co-occurring disorders counselor, more than a mental health clinician.

Conclusions: The findings provide preliminary evidence that CMHC clinicians, serving clients with addictions and complicating SMI, and client participants in CM, view CM as motivating and a positive tool to facilitate recovery.

Scientific significance: As an evidence-based intervention, CM warrants further efforts toward funding and dissemination in CMHCs.