Contingency Management (CM) is a highly effective behavioral treatment that allows patients to earn incentives for meeting objective, verifiable treatment goals. In CM, patients earn money, vouchers, or prizes that are contingent on meeting an objective goal. Common goals include negative urine screens, attendance, and medication adherence. CM is believed to work by replacing the positive feelings that patients get from using substances with positive rewards.

In practice, when clinics claim to be delivering CM, they often provide infrequent, low-value incentives. For a treatment to be considered CM, the incentives need to be provided frequently (at least once per week), for a behavior that can be verified, immediately after the goal is met, for a sufficient value (true CM protocols typically cost upwards of several hundred dollars per patient) and over a sufficient amount of time (at least 3 months, ideally longer). Short-term incentives can be helpful in a patient’s early recovery because other benefits of recovery, such as finding a job, feeling healthier, or having better relationships, often take some time to materialize.